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[Professional military training of women a social-hygienic study].

The author discusses the process of training of women at a military higher institution. The main group consisted of 110 women, future military doctors. The control group were 87 men studying at a parallel course. In general women study better, the motivation of study and the time course of formation of sociopsychological relations are different in men and women, the two groups differ by the level and time course of the physiological potential of the organism, disease incidence is higher in women and the morbidity structure among them is peculiar, and shifts in the immune status are more expressed in women; moreover, the "price" of adaptation of women to novel conditions of professional training is higher. Improvement of military professional training of women is based on the primary prediction of its expected efficacy, using a specially developed method.

Adaptation, Physiological↗

No effect of seasonal variation in training load on immuno-endocrine responses to acute exhaustive exercise.

This study was designed to examine the relationship between seasonal changes in training and competition load, and changes in leukocyte subsets, stress hormones, and interleukin-6 (IL-6) in response to a standardised bout of endurance exercise. In addition, changes in mood states were monitored. Ten male, international Nordic skiers, age 20-29, maximal oxygen uptake 70-82 ml x kg(-1) x min(-1) performed the same incremental treadmill tests to exhaustion at the same time of day (+/-1 h), during the competitive season (in-season HI test) and the recovery season (off-season LO test). The subject filled out a training and competition log (TC score) for three weeks prior to each test and a 65-item Profile of Mood State (POMS) test on arrival at the laboratory. Venous blood for haematological, hormonal, and IL-6 analysis was drawn before and at 0, 15, 30, 60, 120 and 240 min after the test. TC score was more than twice as high during the competitive season (16.0 +/- 3.9) compared to the off-season period (7.0 +/- 4.4). An ANOVA procedure for repeated measures showed no difference in exercise induced changes in concentrations of neutrocytes, lymphocytes, epinephrine, ACTH or cortisol between the in-season HI and off-season LO tests; however, norepinephrine and the IL-6 concentrations were elevated at the in-season HI test compared to the off-season LO test. There were no significant differences in POMS global mood score or sub-scores between the in-season HI and the off-season LO tests. Thus, in a group of elite Nordic skiers, we conclude that a doubling of the training and competition load during the winter season does not alter the leukocyte and stress hormone responses to an incremental exercise test to exhaustion.

Adaptation, Physiological↗

Infection control practices and compliance to national recommendations among dentists in Romania.

The aim of this study was to measure dental office compliance with current Romanian infection control regulations. A questionnaire was completed and returned from 61 randomly selected offices (32 private and 29 public with 94 dentists), where the sterilizers were also biologically monitored. Results indicated that with few exceptions, infection control practices in public and private offices were the same, with compliance on sterilising reusable instruments. Private offices monitored their sterilizers more frequently and had much newer equipment. Gowns were universally worn, but use of gloves, masks and protective eye-wear showed non-compliance with less than 10 per cent of the offices using personal protective equipment for all patients. Cost was the deciding factor. Predominant environmental disinfectants were alcohol and bleach. Offices were in compliance as to the use of disposable anaesthetic needles and carpules. Dentists reported reluctance to be vaccinated against hepatitis B even when offered free immunizations (6.4 per cent) and only 18.1 per cent of dentists had received any infection control training in the last three years. Results indicate that offices were in compliance for most national regulations. However, there are no recently published standards for dentistry in Romania concerning disinfectants or continuing education. Comparison with the literature indicates comparable compliance with recommended national infection control procedures for Romanian dentists as for dentists in other countries.

Attitude of Health Personnel↗

Long-duration freewheel running and submandibular lymphocyte response to forced exercise in older mice.

Submandibular lymph nodes (SLN) are crucial for immune surveillance of the anterior ocular chamber and upper respiratory tract; little is known about how training and exercise affect SLN lymphocytes. The intent of this study was to describe the impact of long term freewheel running followed by acute strenuous exercise on SLN lymphocytes in mice. Female C57BL/6 mice were assigned to running wheels or remained sedentary for 8 months, and further randomized to treadmill exercise and sacrifice immediately, treadmill exercise and sacrifice 24 h after exercise cessation, or no treadmill exposure. SLN lymphocytes were isolated and analyzed for CD3, CD4, CD8, and CD19 cell surface markers, phosphatidylserine externalization as a marker of apoptosis, and intracellular glutathione as a marker of oxidative stress. Compared with running wheel mice, older sedentary mice had a lower percent of T cells and higher percent of B cells (p < 0.05). Although intracellular glutathione did not differ between groups, running mice had a lower percent of Annexin V(+) SLN lymphocytes 24 h after treadmill exercise. Further research will be needed to determine if voluntary exercise translates into improved anterior ocular and upper respiratory tract health.

Animals↗

Report of a medical mission to Somaliland, 2001.

Somaliland is a self-declared state, not recognized by the nations of the world. Sixty percent of the population are herders or small scale farmers. Gross national product and other data are not available, but it is evident, according to surveys conducted by the United Nations, that most of the population has a low income. The health-care system consists of a public sector, which covers primary care, hospital care, immunizations, and tuberculosis care. The major clinical problems are tuberculosis, malaria and childhood diarrhea. Lack of trained personnel is a major difficulty in the health care system. This paper describes visits to health care facilities in Somaliland, and suggests some improvements for the system.

Journal Article↗

Developing a machine learning-based prognosis and immunotherapeutic response signature in colorectal cancer: insights from ferroptosis, fatty acid dynamics, and the tumor microenvironment.

INSTRUCTION: Colorectal cancer (CRC) poses a challenge to public health and is characterized by a high incidence rate. This study explored the relationship between ferroptosis and fatty acid metabolism in the tumor microenvironment (TME) of patients with CRC to identify how these interactions impact the prognosis and effectiveness of immunotherapy, focusing on patient outcomes and the potential for predicting treatment response. METHODS: Using datasets from multiple cohorts, including The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), we conducted an in-depth multi-omics study to uncover the relationship between ferroptosis regulators and fatty acid metabolism in CRC. Through unsupervised clustering, we discovered unique patterns that link ferroptosis and fatty acid metabolism, and further investigated them in the context of immune cell infiltration and pathway analysis. We developed the FeFAMscore, a prognostic model created using a combination of machine learning algorithms, and assessed its predictive power for patient outcomes and responsiveness to treatment. The FeFAMscore signature expression level was confirmed using RT-PCR, and ACAA2 progression in cancer was further verified. RESULTS: This study revealed significant correlations between ferroptosis regulators and fatty acid metabolism-related genes with respect to tumor progression. Three distinct patient clusters with varied prognoses and immune cell infiltration were identified. The FeFAMscore demonstrated superior prognostic accuracy over existing models, with a C-index of 0.689 in the training cohort and values ranging from 0.648 to 0.720 in four independent validation cohorts. It also responses to immunotherapy and chemotherapy, indicating a sensitive response of special therapies (e.g., anti-PD-1, anti-CTLA4, osimertinib) in high FeFAMscore patients. CONCLUSION: Ferroptosis regulators and fatty acid metabolism-related genes not only enhance immune activation, but also contribute to immune escape. Thus, the FeFAMscore, a novel prognostic tool, is promising for predicting both the prognosis and efficacy of immunotherapeutic strategies in patients with CRC.

Ferroptosis↗

Measles in rural Bangladesh: issues of validation and age distribution.

In the Third World, scientists have described thoroughly the pattern of measles in Africa. In Asia, however, the epidemiology of measles has been poorly described. In 1989, a measles surveillance system was initiated in Matlab, rural Bangladesh in order to monitor measles incidence in the area. The population (100,000), which has relatively low immunization coverage, has an excellent demographic surveillance system which allows accurate follow-up. The system works through trained community health workers who visit all households every fortnight and report possible cases of measles. Medical doctors review a proportion of index cases and cases in infants soon after the appearance of the rash. Of the 4673 cases reported in all age groups, 18% were visited by medics. Confirmation of diagnosis was related to the age at onset and overreporting by community health workers is documented. The incidence of measles was estimated at 43% of children < 5 years old. Of cases < 5 years of age, 14% occurred below the age at vaccination (incidence rate = 5.5%). A strong seasonal pattern is reported. Case-fatality rates are low. This is the first report which shows the effect of age on reliability of reported measles. It shows the misclassification likely to occur when reporting measles in large-scale surveys, particularly in infants. It also shows that the pattern of measles in this community resembles the pattern reported for African communities and calls for a review of immunization strategies with vaccination below 9 months of age.

Age Factors↗

Selective primary health care: strategies for control of disease in the developing world. IX. Poliomyelitis.

Poliomyelitis is an acute viral disease primarily afflicting children. It can be very mild, permanently crippling, or fatal. In the developed nations, poliomyelitis is controlled by the use of trivalent vaccines: killed virus administered by injection and/or attenuated virus administered orally. The latter is cheaper. A combination of the two may be required in some tropical countries. In many developing nations poliomyelitis remains endemic and prevalent, especially in children; 37,747 cases were reported to the World Health Organization in 1979, but greater than 200,000 cases probably occurred. Socioeconomic improvement and public health measures (i.e., immunizations) remain the major strategies for control. While global eradication may be a more distant goal, poliomyelitis could be controlled better. Effective programs for control include safe, efficacious, and inexpensive vaccines; methods for successful management of vaccine delivery systems; commitment and training of health personnel; public education; commitment of funds; and research to improve vaccines and their delivery. The major obstacle to control of poliomyelitis is failure to immunize an adequate number of susceptible children. Development of strategies for immunization is crucial to elimination of poliomyelitis as a major world health problem.

Adolescent↗

The use of pharmacy immunization services in rural communities.

Pharmacies have been recommended as alternative sites for the delivery of immunization services, especially to medically underserved adults and children in inner cities and rural areas. Currently, 35 of 50 states in the USA have legalized the administration of vaccines by pharmacists on the basis of certain training requirements and specific protocols. Since the role of pharmacists is expected to expand, it is important to assess the factors that would enable them to improve the delivery of immunization services and the acceptance of these services by communities. It is particularly important for pharmacists to have knowledge of community circumstances and be able to respond to community needs. This case study of a pharmacy immunization programme (PIP) in rural West Virginia assessed how well pharmacists were aware of community circumstances and which community factors affected the utilization of pharmacy-delivered immunizations. Our findings suggest that although pharmacists played important roles as facilitators, hosts and motivators in PIP, they overestimated the trust placed in them by community members. The convenient locations of pharmacies and the convenient times when they offered immunization services were found to be the determining factors of mothers' decisions to take their children to these places for their vaccinations. The study concludes that as the use of pharmacies as sources of immunization is expected to continue to expand, pharmacists should take these factors into consideration when they decide to offer immunizations.

Chi-Square Distribution↗

Protective effect of immune serum globulin (ISG) against hepatitis A infection in a natural epidemic.

Serologic evidence now confirms epidemiologic evidence that human immune serum globulin (ISG) protects susceptible patients from hepatitis A provided it is administered prior to exposure to the virus. In two wards of young patients housed at the Lynchburg (Virginia) Training School and Hospital for the mentally retarded, 44 out of 60 patients had no detectable antibody to hepatitis A prior to an epidemic which took place there in 1970; 12 of 19 non-immunized susceptible patients contracted the disease, while only four of 25 patients receiving ISG developed hepatitis. These four were probably infected with the virus prior to ISG administration. Of the 16 patients with pre-existing antibody, none showed any signs of symptoms of hepatitis.

Antibodies, Viral↗

The effects of oral glutamine supplementation on athletes after prolonged, exhaustive exercise.

Athletes undergoing intense, prolonged training or participating in endurance races suffer an increased risk of infection due to apparent immunosuppression. Glutamine is an important fuel for some cells of the immune system and may have specific immunostimulatory effects. The plasma glutamine concentration is lower after prolonged, exhaustive exercise: this may contribute to impairment of the immune system at a time when the athlete may be exposed to opportunistic infections. The effects of feeding glutamine was investigated both at rest in sedentary controls and after exhaustive exercise in middle-distance, marathon and ultra-marathon runners, and elite rowers, in training and competition. Questionnaires established the incidence of infection for 7 d after exercise: infection levels were highest in marathon and ultra-marathon runners, and in elite male rowers after intensive training. Plasma glutamine levels were decreased by approximately 20% 1 h after marathon running. A marked increase in numbers of white blood cells occurred immediately after exhaustive exercise, followed by a decrease in the numbers of lymphocytes. The provision of oral glutamine after exercise appeared to have a beneficial effect on the level of subsequent infections. In addition, the ratio of T-helper/T-suppressor cells appeared to be increased in samples from those who received glutamine, compared with placebo.

Administration, Oral↗

Child survival and safe motherhood program in Rajasthan.

OBJECTIVE: This study was planned to evaluate the MCH services, particularly immunization in rural areas of the poor-performing state of Rajasthan. METHODS: A community-based, cross-sectional survey using the WHO 30 cluster technique was carried out as a field exercise by participants of 9th Field Epidemiology Training Programme (FETP) course by National Institute of Communicable Diseases (NICD) in rural areas of Alwar district of Rajasthan. RESULTS: Less than one third (28.9%) of children, aged 12-23 months, were fully immunized with BCG, 3 DPT, 3 OPV and Measles vaccines; around a quarter (26.5%) had not received even a single vaccine (non immunized), and little less than half (44.5%) were found partially immunized. Around half of the eligible children were vaccinated for BCG (55.9%) and Measles (43.6%). Though nearly two-third (66.8%) were covered with first dose of DPT and OPV, but about one third of these children dropped out of third dose of DPT and OPV for various reasons. National Family Health Survey (NFHS) data also had revealed that BCG coverage was 64.3%; measles was 36.2%; and coverage by DPT 1, 2, 3 and Polio 1,2 and 3 were 64.4%, 57.0%, 46.6% and 77.5%, 71.1% and 54.4% respectively in rural areas. The main reasons for drop-out or non-immunization was "lack of information about the immunization programme" (41.3%). Though nearly all (more than 96%) of the children were immunized through Government established centers, but immunization cards/documents were made available only to 27.6% of children. CONCLUSION: The problem of low coverage and high drop-out rate of immunization could be overcome by creating awareness of the program and relevance of 2nd and 3rd doses of DPT and polio vaccines. Increasing community participation through intensive and extensive health education campaign should also be undertaken. Since most of the deliveries were done at home under the supervision of untrained midwives, training programme as well as involving them in IEC activities should be contemplated.

Communicable Disease Control↗

INSECT STING ANAPHYLAXIS.

Anaphylaxis from insect stings, which is considerably commoner than has been recognized, is a distinct emergency, requiring prompt and energetic treatment. Such reactions require the immediate intramuscular or deep hypodermic injection of 0.5 cc of 1:1000 epinephrine, which may have to be repeated shortly. After the initial critical phase is passed, there may be indication for intramuscular antihistamines and corticosteroids.Persons who have survived insect sting anaphylaxis should be immunized with insect antigens for a minimum period of three years and perhaps indefinitely. The choice between pure venom and extracts of whole insect bodies rests with the physician, although the latter are far more often used.Until immunization has become effective susceptible persons must carry with them at all times a kit containing epinephrine for both injection and aerosol use, and they must be trained by physicians in the proper use of these preparations.

Adrenal Cortex Hormones↗

Construction and validation of a &#x3b2;-hydroxybutyrylation-related molecular model for predicting prognosis of papillary thyroid carcinoma.

BACKGROUND: Papillary thyroid carcinoma (PTC) usually has a favorable prognosis, yet a subset of patients develops persistent, recurrent, or biologically aggressive disease. The clinical relevance of lysine &#x3b2;-hydroxybutyrylation (Kbhb)-related transcriptional programs in PTC remains unclear. Accordingly, this study aimed to characterize Kbhb-related molecular heterogeneity in PTC, construct a prognostic signature, and explore its association with the tumor microenvironment (TME). METHODS: Transcriptomic and clinical data from PTC samples within The Cancer Genome Atlas Thyroid Carcinoma (TCGA-THCA) cohort were analyzed to identify Kbhb-related differentially expressed genes (DEGs), define molecular subtypes, construct a prognostic signature, and characterize tumor microenvironmental features. Single-cell RNA-sequencing data from PTC were further used to explore the cellular distribution of representative genes. RESULTS: We identified 51 Kbhb-related DEGs in PTC and defined two Kbhb molecular subtypes. The Kbhb_C2 subtype showed shorter progression-free interval (PFI) and a more immune- and stroma-enriched microenvironment. A six-gene prognostic signature comprising TARID, CDSN, PIMREG, KLRC1, SYT13, and NPR3 was then established. High-risk patients had significantly worse PFI in the full, training, and testing cohorts, with 1-, 3-, and 5-year areas under the curve (AUCs) of 0.715, 0.793, and 0.771, respectively, in the full cohort. High-risk tumors also exhibited higher stromal, immune, and ESTIMATE scores, altered immune infiltration, and increased expression of multiple immune checkpoint molecules. Single-cell analysis confirmed distinct cell-type-specific expression patterns of representative genes. CONCLUSIONS: Kbhb-related transcriptional programs define clinically relevant molecular heterogeneity in PTC and are closely associated with prognosis and TME remodeling. The identified six-gene signature provides a biologically interpretable framework for risk stratification in PTC.

Papillary thyroid carcinoma (PTC)↗

Shingles Immunity and Health Functioning in the Elderly: Tai Chi Chih as a Behavioral Treatment.

Both the incidence and severity of herpes zoster (HZ) or shingles increase markedly with increasing age in association with a decline in varicella zoster virus (VZV)-specific immunity. Considerable evidence shows that behavioral stressors, prevalent in older adults, correlate with impairments of cellular immunity. Moreover, the presence of depressive symptoms in older adults is associated with declines in VZV-responder cell frequency (VZV-RCF), an immunological marker of shingles risk. In this review, we discuss recent findings that administration of a relaxation response-based intervention, tai chi chih (TCC), results in improvements in health functioning and immunity to VZV in older adults as compared with a control group. TCC is a slow moving meditation consisting of 20 separate standardized movements which can be readily used in elderly and medically compromised individuals. TCC offers standardized training and practice schedules, lending an important advantage over prior relaxation response-based therapies. Focus on older adults at increased risk for HZ and assay of VZV-specific immunity have implications for understanding the impact of behavioral factors and a behavioral intervention on a clinically relevant end-point and on the response of the immune system to infectious pathogens.

Journal Article↗

[Structural indices of blood cells in young athletes after one month of training taking into account different types of sport].

Blood cells of young sportsmen have been studied taking into account different types of sport (classical wrestling, judo, free-style wrestling). Our observations have shown that the most important shifts in blood cells take place during classical wrestling and judo. The most intensive changes were noted in erythrocytes and thrombocytes. The immune response shows different patterns in classical wrestling and judo. Data obtained using light microscope method are further supported by morphometric study of our clinical material. Thus, physical training plays an important role in the activation of functions of the organism, particularly in the activation of blood cells. Increase of euchromatin indicates to the activation of the nucleus, while the decrease, particularly in the cases of classical wrestling and judo, to the activation of perinuclear space and increase of interaction between the nucleus and cytoplasm.

Adolescent↗

Attitudes of medical students toward the acquired immune deficiency syndrome (AIDS).

Several studies have reported negative attitudes toward AIDS patients, homosexuals and drug abusers among physicians, nurses, and health workers in training. To examine attitudes towards AIDS of a group who in the near future would be practising physicians in the Caribbean, medical students at the Cave Hill Campus of the University of the West Indies were surveyed regarding their attitudes toward AIDS. This paper analyses responses to 21 Attitude Items with reference to five primary areas related to AIDS: Testing for HIV, Homosexuality, Fear of Contagion, Comfort in Interacting with AIDS Patients, and Intention to care for Persons with AIDS. The analysis indicates that these students were all not comfortable with issues related to homosexuality, and there was wide variation and some inconsistency in opinions regarding controversial and contentious issues. Most of these students, regardless of their choice of specialty after graduating, will eventually come into contact with an HIV-positive individual or an AIDS patient. There is a distinct possibility that biases and misperceptions held during the period of training are at risk of being carried over into clinical practice, resulting in unwillingness, or even refusal, to treat certain types of patients. What has also become evident is that emphasis should be placed on ethical and attitudinal training within the Faculty of Medical Sciences. Our future doctors have to be trained to effectively manage the many psycho-social, ethical, and legal problems that will be generated by the AIDS epidemic. What is urgently needed, therefore, is relevant curriculum design and development in the area of AIDS Education directed at the region's future physicians.

Acquired Immunodeficiency Syndrome↗

Prospects for universal immunization: strategies for achievement.

The technology, experience, management abilities, and international organization now exist for universal immunization coverage in most areas of the world. Unprecedented improvements in immunization coverage have been achieved in recent years because of the collaborative efforts of the international agencies and individual countries. The major barriers still existing can potentially be solved by providing for long-term external support for some countries, by improving the training available to health workers, by enlisting the involvement of political leaders, and by mobilizing all segments of society to improve the health of their children so that immunization does not become the responsibility of the health departments alone.

Communicable Disease Control↗