Medicine

Over one million annual deaths have been attributed to bacterial antimicrobial resistance. Although antibiotics have saved countless other lives, overuse and misuse of antibiotics increases this global threat. Developing new antibiotics and retraining clinicians can be undermined by patients who pressure clinicians to prescribe unnecessary antibiotics. So we validated two low-cost, scalable interventions for improving antibiotic decisions in an online randomized control trial and a pre-registered replication (N = 985). Both first-person vignette experiments found that an infographic and text message (...) caused intermediate to large improvements in antibiotic decisions compared to active controls — even when controlling for a dozen confounds. Notably, these educational interventions also reduced trust in a clinician who offered antibiotics for an upper respiratory infection. These data show how low-cost adjustments to existing communication systems can teach people to reduce the existential risks of antibiotic resistance and how inappropriate antibiotic prescribing can erode trust in health systems. (shrink)

This is an article about death from a medical point of view.

... having succeeded in protecting and prolonging the life of many around the world for reasons which seem natural and intrinsically good to all, we are once again faced with the dilemma of confronting our patent inability to cure it all. -/- Faced with this recurring predicament, we somehow backtrack in our steps and decide the next best thing to assuage suffering is assisted dying and euthanasia. -/- No matter how many reasons we conjure up in their favour, both assisted (...) dying and euthanasia remain a stab into the unknown, into the supernatural, by patients, by its proponents, and by its practitioners both lay and medical. (shrink)

Although global awareness of environmental challenges is increasing, modern healthcare systems marginalize nature-based healing practices. This paper advocates for a renewed integration of healthcare and the natural world by highlighting the cultural, historical, and scientific foundations of natural healing. Through a multidisciplinary synthesis spanning ethnobotany, public health, and ecological psychology, we examine how home gardens serve as practical embodiments of an eco-surplus culture—a worldview that positions nature as foundational to human well-being and planetary sustainability. Home gardens offer measurable health benefits, (...) such as stress reduction, immune enhancement, biodiversity conservation, and climate resilience. Drawing on diverse case studies—from Indigenous land-based healing to immigrant communities preserving ethnomedicine—we show how gardening fosters physical, psychological, and cultural health. The paper concludes by proposing integrative care models that align biomedical treatments with nature-based interventions and calls for policy innovations that recognize gardens as essential health infrastructure. Reimagining home gardens in this way opens new pathways toward more holistic, equitable, and sustainable approaches to wellness. (shrink)

We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)

Gallbladder disease commonly affects the general population of Western developed nations and the standard surgical treatment of laparoscopic cholecystectomy normally follows severe cases of this condition. However, the negative health and life quality consequences of this standard line of treatment are lesser known and stand the chance of being taken lightly by healthcare professionals. Complications include bile duct injury, dropped gallstones and a second open invasive surgery, of which could be life threatening for some rare cases. It is, therefore, necessary (...) to highlight the limitations of such a procedure and the need for improvement and widening of the range of treatment options for vulnerable members of the patient population. Additionally, here is a brief overview introduction of a new procedure called endoscopic ultrasound guided gallbladder drainage with promising success rates that can be a potentially feasible alternative to traditional surgical procedures to offer gallbladder disease patients. (shrink)

Insofar as value theory is relevant to the philosophy of medicine, two goods have dominated reflection: well-being and morality. This essay casts doubt on whether those values are sufficient to resolve an array of important debates about medical practice, maintaining that the value of what makes a life meaningful should play a much larger role. After first indicating how meaningfulness differs from happiness and rightness, the essay argues that meaningfulness cannot reasonably be ignored when thinking comprehensively about the proper aims (...) of medicine, the appropriate constraints on their pursuit, and the effective means by which to realize them. The essay’s goal is not to draw any firm conclusions about the suitable ends, constraints, and means of medical practice, but rather to show that, in order to arrive at any, one has to consider the category of life’s meaning, which should be much more prominent in the philosophy of medicine than it has been. (shrink)

MALARIA, SCIENCE AND SOCIETY IN FERRARA FROM THE MIDDLE AGES TO THE NINETEENTH CENTURY -/- In this paper it is outlined the history of malaria in Ferrara and its suburbs, from ancient times up to the nineteenth century. It is considered the issue of malaria in Roman times, during the Middle Ages and the Renaissance, the discovery of quinine, the first scientific studies made at the University of Ferrara, the first analysis about the causes and the spread of the disease. (...) The conditions of backwardness of Ferrara society are considered, especially of the people living in the countryside, and the most common medical knowledge. Statistics about the spread of malaria after the unification of Italy are resumed. Problems of environmental recovery are taken into account. Scientific progresses due to positivism and to the doctors who faced the first anti-malarial campaigns, bringing their testimonies. The essay ends up with the reorganization of public health and places of health care in modern hospitals all over the province of Ferrara. (shrink)

MALARIA, SCIENCE AND SOCIETY IN FERRARA FROM THE MIDDLE AGES TO THE NINETEENTH CENTURY -/- In this paper it is outlined the history of malaria in Ferrara and its suburbs, from ancient times up to the nineteenth century. It is considered the issue of malaria in Roman times, during the Middle Ages and the Renaissance, the discovery of quinine, the first scientific studies made at the University of Ferrara, the first analysis about the causes and the spread of the disease. (...) The conditions of backwardness of Ferrara society are considered, especially of the people living in the countryside, and the most common medical knowledge. Statistics about the spread of malaria after the unification of Italy are resumed. Problems of environmental recovery are taken into account. Scientific progresses due to positivism and to the doctors who faced the first anti-malarial campaigns, bringing their testimonies. The essay ends up with the reorganization of public health and places of health care in modern hospitals all over the province of Ferrara. (shrink)

Mainstream views of medical research tell us it should be a fact-based, value-free endeavor: what a scientist (or her funding source) wants or cares about should not influence her findings. At the same time, we also sometimes criticize medical research for failing to embody certain values, e.g. when we criticize pharmaceutical companies for largely ignoring the diseases that affect the global poor. This chapter seeks to reconcile these perspectives by distinguishing appropriate from inappropriate influences of values on medical research. It (...) divides this broad question into two narrower ones, the Role Question (at what points in the research process is value influence potentially acceptable?) and the Content Question (when value influence is potentially acceptable, what specific values should researchers use?), and then draws on the philosophical literature on values in science to explore answers to each of them. (shrink)

Health Technology Assessment (HTA) has traditionally focused on efficacy, safety, and cost-effectiveness. There has long been concern, however, that this is determined by the goals of healthcare providers/payers, not patients. As a result, HTA arguably fails to reflect the overall value of health technologies—including their “non-clinical” or “personal” utility to patients and their families. The use of genomic testing in clinical care is one domain where this problem is evident, as the personal utility of results is often especially significant. As (...) such, there are growing calls for HTA frameworks to adopt personal utility as a distinct element of value when assessing clinical genomic tests. We agree that personal utility is important to HTA in clinical genomics. However, against a trend toward comprehensive conceptions of personal utility within HTA, we advocate for a restrictive approach to assessing the value of personal utility in the case of clinical genomic testing. (shrink)

Pain is a refractory problem in healthcare. One proposed solution is to promulgate best practices derived from the highest quality evidence stipulating how to assess pain and which treatment interventions are the most efficacious. Such a solution seamlessly integrates into evidence-based medicine, the dominant ‘revolutionary paradigm’ in healthcare. This paper argues that such a ‘revolutionary’ approach is theoretically untenable and ethically abhorrent. Section 1 adumbrates the evidence-based medicine framework, how best practices are often formulated under its auspices, and which methods (...) it might use to address pain. Section 2 points out that this approach faces profound theoretical issues when applied to pain, even by its own lights. Section 3 argues that attempts to use such best practices in the clinic generate grave ethical problems. Finally, Sect. 4 briefly sketches a different form of medicine, one that casts evidence as a helpful handmaiden of medicine, instead of a domineering mistress. (shrink)

Trong nhiều thập kỷ, ethylene oxide (EtO) đã đóng một vai trò quan trọng trong nhiều ngành công nghiệp, phục vụ như một chất khử trùng cho thiết bị y tế, một thành phần chính trong sản xuất nhựa và chất khử trùng để chế biến thực phẩm. Tuy nhiên, mặc dù có tầm quan trọng đối với sức khỏe cộng đồng và sản xuất, EtO cũng được phân loại là một chất gây ung thư ở người. Một nghiên cứu (...) mới toàn diện đã cung cấp bằng chứng chắc chắn về liên kết giữa sự phơi nhiễm nghề nghiệp lâu dài với EtO và nguy cơ tử vong do ung thư vú ở phụ nữ. (shrink)

Khi khí hậu toàn cầu ấm lên, một mối lo ngại cấp bách đang nổi lên: nhiệt độ tăng và thời tiết biến đổi sẽ ảnh hưởng thế nào đến sự lây lan của các bệnh truyền nhiễm?

The use of omega fatty acids during pregnancy and lactation could be a beneficial strategy to improve health and production in ruminants. In this study, the effect of the dietary addition of c9, t11 and t10, c12 isomers of conjugated linoleic acid (CLA) in pure soybean oil (T1) was compared with pure soybean oil (T2) and soybean oil discarded after frying fish (Centropomus undecimalis, Pagrus pagrus, and Caranx crysos; T3) on the fatty acid profile in ewe milk and the tissues (...) of their lambs. Forty-five multiparous ewes (East Friesian × Katahdin), 32 to 35 months old, 70 days pregnant, were randomly assigned to one of the three experimental diets. The fatty acid profile, total solids, fat, protein, and lactose in milk were determined 14 days postpartum. Fifteen lambs from each treatment were sacrificed at 70 days of age, and the fatty acid profiles in perirenal fat, muscle, and brain were determined. In milk, fat and total solids content were lower with T1. On the other hand, linoleic acid content, the sum of omega-6 and DHA were higher in T1 compared to other groups (p < 0.05). In the brain, stearic acid and linoleic acid concentration increased with T1; eicosapentaenoic acid decreased and omega-3s increased with T3, while DHA was lower in T2 (p < 0.05). The addition of CLA isomers or discarded soybean oil in ewe diet from pregnancy to lactation is advantageous for the ewe since less energy in the form of milk fat is lost. In addition, increasing the concentration of omega fatty acids in ewe diet to improve omega fatty acids in lamb’s brain could be a feed strategy to increase their productivity and health. (shrink)

El síndrome de apnea obstructiva del sueño y el trastorno depresivo mayor comparten una cantidad significativa de síntomas, de tal forma que es posible plantear la posibilidad que haya personas con diagnóstico de depresión que padecen de un síndrome de apnea obstructiva del sueño no diagnosticado como causa de sus síntomas psiquiátricos. En este manuscrito se presentan argumentos sobre cómo una persona con apneas del sueño satisface criterios diagnósticos de depresión, y que un médico que no las considera como hipótesis (...) puede realizar un diagnóstico erróneo. Dado que el tratamiento para ambas patologías es distinto, se concluye que es importante incorporar en los algoritmos diagnósticos de depresión la búsqueda de apneas del sueño y de estudiar su incidencia en la población con síntomas depresivos. (shrink)

The medical and public health communities are divided around the use of benzodiazepine (“benzo”) pharmacotherapy for anxiety disorders. Recent years have seen increased attention to benzo overprescription and its risks, leading to a pervasive emphasis on deprescribing. Some have resisted this trend, arguing that the balance of evidence supports the safety and efficacy of benzo pharmacotherapy for both short-term and long-term treatment of anxiety disorders. Given that rising rates of anxiety disorders and benzo misuse are both serious public health concerns, (...) there is an urgent need for comprehensive evidence-based best practices for the prescription of benzos for anxiety. At present, however, major scientific gaps make it impossible to formulate such guidance. Most concerning is the lack of research into as-needed and intermittent prescription and use, which are both what benzos are best suited for, and likely, how they are most commonly administered. Further research into the safety and efficacy of both long-term daily and intermittent, as-needed benzo prescription and use are badly needed. But a roundly “anti-benzo” sentiment may be causing problematic underprescription of benzos, particularly when superior alternatives like cognitive-behavioral therapy are not widely available. (shrink)

Ô nhiễm không khí từ lâu đã được biết đến với những tác động nghiêm trọng đến hệ hô hấp.

Di truyền biểu sinh môi trường (environmental epigenetics) nghiên cứu cách các yếu tố bên ngoài như chất độc, nhiệt độ và các tác nhân gây bệnh có thể ảnh hưởng đến sự biểu hiện gen mà không làm thay đổi trình tự DNA cơ bản. Trong khi các nghiên cứu ở người và các loài động vật có vú khác đã tiết lộ mối liên hệ giữa việc tiếp xúc với môi trường và những thay đổi biểu sinh, việc (...) xác định các cơ chế phân tử cụ thể vẫn là một thách thức lớn. Loài giun tròn Caenorhabditis elegans (C. elegans), với cấu tạo cơ thể đơn giản và sự tương đồng di truyền đáng kể với con người, cung cấp một mô hình giá trị và dễ nghiên cứu để thu hẹp khoảng cách kiến thức này. (shrink)

Các chất per- và poly-fluoroalkyl (PFAS) – được gọi là "hóa chất vĩnh cửu" vì chúng tồn tại rất lâu trong môi trường – là các hợp chất nhân tạo được tìm thấy trong nhiều sản phẩm và ngành công nghiệp khác nhau, bao gồm bao bì thực phẩm, vải chống nước và chống bám bẩn, bọt chữa cháy và sản xuất chất bán dẫn. Mặc dù nhiều sự chú ý đã tập trung vào mối liên hệ của chúng với (...) ung thư, vô sinh, các bệnh về gan, thận và rối loạn hệ miễn dịch ở người lớn, nhưng mối lo ngại ngày càng tăng tập trung vào việc phơi nhiễm PFAS trong thời kỳ mang thai và những năm đầu đời có thể làm suy giảm sự phát triển não bộ ở trẻ em như thế nào. (shrink)

The ever-growing volume of scientific research challenges for traditional publishing models. This necessitates innovative approaches to journal editing and adopting by Artificial Intelligence (AI) in publication. This scoping review aims to explore the emerging trends shaping the field of journal editing by AI. Literature employed to search relevant databases published between 2008 and 2024. A total of 25 studies met the inclusion criteria. The review synthesizes key trends of inclusion of the technological tools integration for manuscript processing, the rise of (...) open-access publishing models, and evolving considerations around research ethics. The study underscores the pivotal role of emerging trends in shaping the future of scientific publishing. It offers valuable perspectives for editors to adeptly maneuver through the evolving terrain of scholarly communication. By suggesting possible best practices, it serves as a beacon for maintaining editorial excellence. Furthermore, it identifies critical domains warranting deeper exploration, thereby setting the stage for continuous advancement in the field. This forward-looking approach not only facilitates informed decision-making but also fosters a proactive stance towards embracing change in scientific discourse. (shrink)

Medicine has always existed in a marketplace, and there have been extensive discussions about the ethical implications of commerce in health care. For the most part, this discussion has focused on health professionals’ interactions with pharmaceutical and other health technology industries, with less attention given to other types of commercial influences, such as corporatized health services and fee-for-service practice. This is a significant lacuna because in many jurisdictions, some or all of healthcare is delivered in the private sector. Using the (...) exemplar of Assisted Reproductive Technologies (ART), this paper asks: what, if any, responsibilities do doctors have to challenge the distorting influence of commerce in healthcare, other than those arising from their own interactions with health technology companies? ART provides a good focus for this question because it is an area of practice that has historically been provided in the private sector. First, we describe a range of concepts that offer helpful heuristics for capturing how and when doctors can reasonably be said to have responsibilities to resist commercial distortion, including: complicity, acquiescence, wilful ignorance, non-wilful ignorance, and duplicity. Second, we present ways that individual doctors can act to stop questionable behaviour on the part of their colleagues, clinics/corporations, and their profession. Third, we note that there are many situations where change cannot be achieved by individuals acting alone, and so we consider the responsibilities of health professionals as collectives as well as the role that professional bodies and regulators should play. (shrink)

Supplemental zinc in fattening lambs improves their health, performance, and meat quality. However, the Zn effect on grazing animals combined with different levels of concentrate should be known unknown. The objective was to evaluate the Zn-organic effect in the diet of grazing lambs supplemented with two levels of concentrate on growth, dry matter (DM) intake, carcass traits, body composition, meat quality, and fatty acid profile in Longissimus dorsi muscle. Twenty-eight lambs were used in a factorial arrangement of two levels of (...) concentrate (C) feed intake (C-0.75 and C-1.5% of live weight) and two Zn-Met levels (0 and 80 ppm Zn kg−1 DM) on the grazing of Lolium perenne L. Digestibility and dry matter intake, weight gain, and productive performance were measured. At the end of the fattening period (90 d), the lambs were slaughtered and the carcass traits, body composition, instrumental quality, and lipid profile of meat were evaluated. The effect of treatment (T), measurement period (P), and T × P interaction was observed (p < 0.05) for dry matter intake (DMI). For the final live weight (FLW) and daily weight gain (DWG), there was an effect (p < 0.05) of T and P, with Zn-80 ppm + C-1.5% treatment being greater. The live weight at slaughter (LWS) and leg length (LL) showed an effect (p < 0.05) of C × Zn. Zn-80 ppm + C-1.5% treatment was higher in the kidney fat, empty body weight, carcass fat, fat and retained energy but lower in protein content (p < 0.05). The physicochemical characteristics and fatty acid content of meat were not affected (p > 0.05). It can be concluded that the concentrated-organic zinc synergy in grazing lambs improved the performance, weight gain, and body composition, which resulted in heavier carcasses with greater amounts of fat, protein, and energy deposited. Furthermore, the physical and chemical meat traits were not affected, but the n-3 fatty acid content and n-3/n-6 ratio in Longissimus dorsi was affected by the Zn level supplemented. (shrink)

This compilation focuses on success stories—cases of courage, innovation, and the application of knowledge and power in overcoming illness and suffering. It features twelve ethnographic case studies that describe how people were able to alleviate or overcome serious issues including alcoholism, severe anxiety and depression, suicidal behavior, and psychotic disorders caused by ignorance, neglect, violence, war, and sexual abuse. It is a tribute to the possibility of healing. -/- See also the companion volume 'Ayahuasca revisited: Case studies & observations'.

This study comprehensively analyses traditional Slovak ewe lump cheese, focusing on determining protein, NPN, casein, fat, DM, and ash content. The results revealed significant variations among cheese samples collected from different producers across Slovakia, with casein content ranging from 15.33% to 23.07% and true protein content ranging from 16.0% to 23.93% and a strong correlation between these parameters. Additionally, NPN accounted for 0.51% to 0.79% of the total nitrogen in the samples. Fat content ranged from 18.31% to 31.08%, DM from (...) 35.52% to 55.15% and ash content from 1.76% to 3.80%. Significant changes in individual fatty acid concentrations were also observed, which may indicate varying feeding practices and production methods among producers. These findings enhance understanding of the protein and fatty acid composition of traditional ewe lump cheese, offering insights critical for quality control, production standardization, and developing more detailed national specifications of this traditional specialty-guaranteed cheese. (shrink)

Resumo: Diante da preocupação e diminuição do uso de antimicrobianos como promotores de crescimento, aumentaram-se as buscas por aditivos que os substituam. Portanto, objetivou-se avaliar o uso de tanino condensado de Acácia-negra (Acacia mearnsii) na dieta de galinhas poedeiras na fase de cria (1 a 5 semanas) sob a biometria dos órgãos. Foram utilizadas 432 pintainhas de postura da linhagem Hy-line W80, distribuídas em delineamento inteiramente casualizado em 3 tratamentos com 8 repetições de 18 aves cada, sendo os tratamentos: dieta (...) sem aditivos; dieta com inclusão de bacitracina metileno disalicilato e dieta com inclusão de 1,00 kg/t de tanino condensado de Acácia-negra. Ao final, duas aves por unidade experimental foram selecionadas dentro do peso médio e eutanasiadas por deslocamento cervical para coleta e pesagem dos seguintes órgãos: baço, bursa, cecos, coração, fígado, timo, intestino, pâncreas e moela cheia e vazia, bem como realizada a mensuração do comprimento do intestino, bem como os cecos com fita métrica. Os dados obtidos foram analisados pelo procedimento GLM do programa SAS versão 9.4, e as médias comparadas pelo método de contrastes ortogonais (p≤0,05). Não foram encontrados efeito entre os tratamentos experimentais para o peso do baço, timo, bursa, pâncreas, coração, moela cheia e vazia, bem como para o comprimento do intestino. Houve efeito de tratamento para peso de fígado (p<0,0144) e intestino (p<0,0397); em relação ao comprimento houve efeito de tratamento para o ceco direito (p<0,0149) e ceco esquerdo (p<0,0159), onde as médias mostraram que os órgãos foram mais pesados e maiores no tratamento com adição de tanino condensado de Acácia-negra em comparação com os demais tratamentos. Diante disso, o tanino condensado de Acácia-negra se destaca como um bom substituto da bacitracina metileno disalicilato, pois proporcionou maior peso de fígado e maior comprimento intestinal. -/- . (shrink)

RESUMO Os cuidados para atender às necessidades específicas da fêmea gestante são indispensáveis para o sucesso no manejo reprodutivo de qualquer espécie. Entretanto, é necessário entender que podem acontecer problemas em qualquer uma das fases reprodutivas, inclusive na gestação. Antes de tudo, na clínica e na produção, a sobrevivência dos fetos significa êxito no manejo reprodutivo. Durante o período gestacional podem se desenvolver diversas afecções no útero da fêmea, dentre elas podem ser citadas: mumificação fetal, gravidez ectópica, maceração fetal, prenhez (...) múltipla patológica e diversas anomalias que podem acometer os envoltórios e líquidos fetais. Essas doenças representam prognóstico ruim para a fêmea e para o feto, podendo resultar em perdas fetais. O conhecimento acerca das características dessas afecções, bem como a fisiopatologia e diagnóstico são indispensáveis para o sucesso da reprodução animal. Palavras-chave: Ginecologia, reprodução, gestação. ABSTRACT Care to meet the specific needs of pregnant females is essential for the successful reproductive management of any species. However, it is necessary to understand that problems may occur in any of the reproductive stages, including pregnancy. First of all, in the clinic and production, the survival of fetuses means success in reproductive management. During the gestational period, several pathological conditions can develop in the female uterus, among them fetal mummification, ectopic pregnancy, fetal maceration, pathological multiple pregnancy, and the various anomalies that can affect fetal envelopes and fluids. These illnesses represent a poor prognosis for the female and the fetus and may result in fetal loss. Knowledge about the characteristics of these conditions, as well as the pathophysiology and diagnosis are essential for the success of animal reproduction. Keywords: Gynecology, reproduction, gestation. -/- INTRODUÇÃO Na fisiologia da reprodução nos mamíferos, a implantação e a placentação são processos essenciais na nutrição do embrião e do feto e do seu desenvolvimento. Nos bovinos leiteiros, estima-se uma taxa de fertilização de 95%, com apenas 55% desses zigotos se desenvolvendo a termo e com perda de gestações de 35% (SILVA, 2021). Em equinos varia entre 5 e 15% (BRINSKO et al., 2011) e em suínos chega a 40% (VAN DER LENDE et al., 1994). A reprodução permite a manutenção do equilíbrio biótico, entretanto, falhas podem ocorrer, desde a concepção até o parto, incapacitando o pleno desenvolvimento gestacional e acarretando danos à cadeia produtiva (BRAGA e BARROSO, 2014). A taxa de perda gestacional atinge o pico durante o desenvolvimento embrionário e diminui após 45 dias, à medida que a gestação progride e a placentação ativa está completa (REESE et al., 2020). A placenta permite contato vascular eficaz entre as membranas fetais e o endométrio materno, através do qual ocorre a troca de oxigênio e de nutrientes vindos pelo sangue materno, além dos produtos de excreção do sangue fetal. Ela apresenta quatro membranas: a) âmnio, que contém o fluido amniótico que banha o embrião; b) saco vitelínico, que armazena os nutrientes; c) saco alantoide, onde os restos do metabolismo embrionário são estocados e d) córion, que delimita os limites do embrião e interage seletivamente com o ambiente externo, permitindo nutrientes e/ou oxigênio cheguem ao embrião (SILVA, 2020). No aparelho reprodutivo feminino as estruturas internas são presas pelo ligamento mesovário, que sustenta o ovário; o mesossalpinge, que ancora o oviduto e o mesométrio, que mantém o útero no seu lugar. Ele compreende os ovários, tubas, útero, cérvix, vagina, vestíbulo e vulva (KÖNIG e LIEBICH, 2021). O útero é formado por dois cornos, na região mesogástrica, que formam o corpo uterino, dorsal a vesícula urinária e ventral ao cólon descendente (PINTO e LORIGADOS, 2015). A cérvix fica na região caudal do útero (DYCE, 2019) e é composta pelo óstio uterino interno e o externo (KÖNIG e LIEBICH, 2021). O líquido amniótico é um complexo biológico que proporciona proteção mecânica, nutrientes e substâncias para o crescimento fetal e possui efeito antimicrobiano (UNDERWOOD et al., 2005). Ele desempenha várias funções: protege o feto contra traumas, desidratação e mudanças de temperatura; permite o desenvolvimento fetal e sua mobilidade; amplia a lubrificação da vagina após a ruptura da bolsa, inibe o crescimento bacteriano por ação mecânica de limpeza e previne aderências (GRUNERT e BIRGEL, 1984). As enfermidades do trato reprodutivo têm causado problemas reprodutivos, acarretando perdas econômicas (JÚNIOR et al., 2009). Os problemas na esfera da fisiopatologia da reprodução em animais, está associada ao período do periparto (SCOTT, 2005). Entretanto, existem relatos de sua ocorrência em fêmeas não gestantes e também fora do período puerperal (PRESTES et al., 2008; SALES et al., 2011). Devido à importância das diversas patologias que atingem o útero gravídico, esse trabalho tem como objetivo buscar identificar na literatura científica existente as características, diagnóstico e tratamento de cada alteração uterina, pautando discussão crítica sobre os processos de formação de cada uma. (shrink)

This article examines the late-medieval plague tractate by Augustine of Trento, an Augustinian friar who addressed the matter of plague before the Black Death of 1347/1348. I will investigate Augustine’s astrological approach to the prognostication, prevention, and cure of the plague epidemic. Further, I will compare his work to the Compendium medicinalis astrologiae, composed by the Dominican Niccolò de Paganica in 1330, and to the consilia produced by the master of medicine Gentile da Foligno in 1348. This double comparison will (...) help to better understand the shared intellectual milieu and the different approaches of these three authors. (shrink)

This essay explores the theoretical treatment of leprosy in 13th-century theological discussions on the transmission of the original sin. According to scholastic theologians, both the existence of the original sin and its transmission from parents to progeny were factual truths, whose dynamics could be explained by analogy with inherited diseases, such as leprosy. Different uses of natural philosophy and medicine in discussing the transmission of leprosy will be shown in theological and biblical-exegetical works of William of Auvergne, Roland of Cremona, (...) Bonaventure, Thomas Aquinas, and Henry of Ghent. -/- . (shrink)

Sheep production is the most representative livestock activities in Brazil and in the world. However, the reproductive performance of these animals is determined by factors genetic, physical environment, management and, especially, nutritional. Thirty half-breed lambs from Dorper × Santa Inês were used, with initial weight and age of 31.87 ± 0.5 kg and 157 days, respectively. These animals were prepared on a diet with three food levels (ad libitum, 30% and 70%). Morphometric measurements were measured at intervals of 16 to (...) 20 days in 56 experimental days. The measurements performed were scrotal circumference (CE), chest circumference (CT), body condition score (ECC), withers height (AC) and scrotal bag thickness (EBE), body weight (CP) and semen collection. Interaction occurrence for biometric measurements between food levels and age (p <0.05). The TC and ECC values were higher in animals fed ad libitum (p <0.001). EBE had higher values in animals ad libitum and at 211 days of age (p <0.001). The CP was increasing for the animals ad libitum and (p <0.05) throughout the experiment, while the T30 was only in the initial period. T70 animals did not grow during the whole experiment. CE was influenced by diet (p <0.001) and age (p <0.001) independently. So that animals under food restriction had less development and was higher in older animals. The AC values were influenced only by age (p <0.001), demonstrating the effect of age growth. We conclude that it is not advantageous to submit lambs, it corrects food reproduction. Although it was not possible to assess whether initial malnutrition would bring future problems for the animal's seminal quality, it proved to be immensely negative for the onset of puberty and the development of reproductive structures. -/- REFERÊNCIAS BIBLIOGRÁFICAS AKUMBUGU, F. E., et al. Correlation between Body and Testicular Biometric Characteristics of West African Dwarf Rams. Multidisciplinary Advances in Veterinary Science. 2.4, 2018 ALLAOUI, A. et al. Factors affecting scrotal measurements and weight of Ouled Djellal rams in Eastern and South-eastern Algeria. APCBEE procedia, v. 8, p. 260-265, 2014. ALVES, J. M. et al. Estação de nascimento e puberdade em cordeiros Santa Inês. Revista Brasileira de Zootecnia, v. 35, n. 3, p. 958-966, 2006. ALVES, K. S. et al. Níveis de energia em dietas para ovinos Santa Inês: características de carcaça e constituintes corporais. Revista Brasileira de Zootecnia, v. 32, n. 6, p. 1927-1936, 2003. BIELLI, A. et al. Low maternal nutrition during pregnancy reduces the number of Sertoli cells in the newborn lamb. Reproduction, Fertility and Development, v. 14, n. 6, p. 333-337, 2002. BROWN, D. C.; STIRLING, H. F.; KELNAR, C. J. H. Precocious puberty. Paediatrics and Child Health, v. 4, n. 3, p. 184-188, 1994. BUDAI, C. Performance and adaptability of the Dorper sheep breed under Hungarian and Romanian rearing conditions. Scientific Papers Animal Science and Biotechnologies, v. 46, n. 1, p. 344-349, 2013. CARNEIRO, P. L. S. et al. Desenvolvimento ponderal e diversidade fenotípica entre cruzamentos de ovinos Dorper com raças locais. Pesquisa Agropecuária Brasileira, v. 42, n. 7, p. 991-998, 2007. CARRIJO JUNIOR, O. A. et al. Morphological evaluation of the testicles of young santa Inês rams submitted to different regimes of protein supplementation and drenching. Ciência animal brasileira, Goiânia, v. 9, n. 2, p. 433-441, abr./jun. 2008. CASTRO, F.A.B. de et al. Desempenho de cordeiros Santa Inês do nascimento ao desmame filhos de ovelhas alimentadas com diferentes níveis de energia. Semina: Ciências Agrárias, v. 33, n. 6 supl 2, p. 3379-3388, 2012 CEZAR, M. F. et al. Avaliação de parâmetros fisiológicos de ovinos Dorper, Santa Inês e seus mestiços perante condições climáticas do trópico semi-árido nordestino. Ciência e Agrotecnologia, v. 28, n. 3, p. 614-620, 2004. CHACÓN, L. et al. Características de la pubertad en corderos de pelo y sus cruces en Colombia en condiciones de baja altitud. Revista MVZ Cordoba, v. 24, n. 1, p. 7099-7103, 2019. CHEMINEAU, P. et al. Training manual on artificial insemination in sheep and goats. Rome: FAO; 1991. DA SILVA, Emanuel Isaque Cordeiro. Comportamento Sexual dos Animais Domésticos. 2020. DA SILVA, Emanuel Isaque Cordeiro. Fisiologia do ciclo estral dos animais domésticos. Emanuel Isaque Cordeiro da Silva, 2021. Da Silva EIC. Formulação de ração para ovinos. 1ª ed. Belo Jardim, PE: IPA, 2021. DA SILVA, Emanuel Isaque Cordeiro. Puberdade e Estacionalidade Reprodutiva dos Animais. 2020. FAO. Animal Production and Health Paper, v. 83. ELMAZ, Ö. et al. Prediction of postpubertal reproductive potential according to prepubertal body weight, testicular size, and testosterone concentration using multiple regression analysis in Kıvırcık ram lambs. Turkish journal of veterinary and animal sciences, v. 32, n. 5, p. 335-343, 2008. JUCÁ, A. F. et al. Performance of the Santa Ines breed raised on pasture in semiarid tropical regions and factors that explain trait variation. Tropical animal health and production, v. 46, n. 7, p. 1249-1256, 2014. FOURIE, P. J. et al. Scrotal, testicular and semen characteristics of young Dorper rams managed under intensive and extensive conditions. Small Ruminant Research, v. 54, n. 1-2, p. 53-59, 2004. GUNN, R. G.; SIM, D. A.; HUNTER, E. A. Effects of nutrition in utero and in early life on the subsequent lifetime reproductive performance of Scottish Blackface ewes in two management systems. Animal Science, v. 60, n. 2, p. 223-230, 1995. HÖTZEL, M. J. et al. Morphometric and endocrine analyses of the effects of nutrition on the testis of mature Merino rams. Reproduction, v. 113, n. 2, p. 217-230, 1998. Instituto Brasileiro de Geografia e Estatística (IBGE). Produção Pecuária municipal. Rio de Janeiro, v. 46, p.1-8, 2018. KENYON, P. R.; MALONEY, S. K.; BLACHE, D. Review of sheep body condition score in relation to production characteristics. New Zealand Journal of Agricultural Research, v. 57, n. 1, p. 38-64, 2014. KHERADMAND, A.; BABAEI, H.; ALI BATAVANI, R. Effect of improved diet on semen quality and scrotal circumference in the ram. Veterinarski arhiv, v. 76, n. 4, p. 333-341, 2006. KORKMAZ, M. K.; EMSEN, E. Growth and reproductive traits of purebred and crossbred Romanov lambs in Eastern Anatolia. Anim. Reprod., v. 13, n. 1, p. 3-6, 2016. KRIDLI, R. T. et al. Age at puberty and some biological parameters of Awassi and its first crosses with Charollais and Romanov rams. Italian journal of animal science, v. 5, n. 2, p. 193-202, 2006. LOUW, D. F. J.; JOUBERT, D. M. Puberty in the male Dorper sheep and Boer goat. S. Afr. J. Agric. Sci, v. 7, p. 509-520, 1964. MAIA, A. S. C.; SILVA, R. G.; ANDRADE, P. C. Efeitos da temperatura e da movimentação do ar sobre o isolamento térmico do velo de ovinos em câmara climática. Revista Brasileira de Zootecnia, v. 38, n. 1, p. 104-108, 2009. MARTINS, R. D. et al. Avaliação da sazonalidade reprodutiva de carneiros Santa Inês criados no Distrito Federal. R. Bras. Zootec., Viçosa, v. 32, n. 6, supl. 1, p. 1594-1603, Dec. 2003. MENDES, A. M. P. et al. Zoneamento bioclimático para a raça ovina Dorper no Estado de Pernambuco. Pesquisa Agropecuária Brasileira, v. 49, n. 12, p. 986-993, 2014. MOULLA, F. et al. Characterization of the onset of puberty in Tazegzawt lambs, an endangered Algerian sheep: Body weight, thoracic perimeter, testicular growth, and seminal parameters. Veterinary world, v. 11, n. 7, p. 889, 2018. NATIONAL RESEARCH COUNCIL (NRC). Nutrient Requirements of Small Ruminants: Sheep, Goats, Cervids, and New World Camelids. Washington, D.C.: National Academy Press, 2007. NOTTER, D. R.; LUCAS, J. R.; MCCLAUGHERTY, F. S. Accuracy of estimation of testis weight from in situ testis measures in ram lambs. Theriogenology, v. 15, n. 2, p. 227-234, 1981. SEJIAN, V. et al. Effect of body condition score on the allometric measurements and reproductive performance of Garole X Malpura ewes under hot semi-arid environment. Journal of Dairy, Veterinary & Animal Research, v. 2, n. 6, p. 1-4, 2015. PACHECO, A.; MADELLA-OLIVEIRA, A. F.; QUIRINO, C. R. Biometria e formas dos testículos em cordeiros da raça Santa Inês explorados em regime de manejo intensivo. Revista Brasileira de Ciências Agrárias, v. 5, n. 1, p. 123-128, 2010. REGO NETO, A. A. et al. Population genetic structure of Santa Inês sheep in Brazil. Tropical animal health and production, v. 50, n. 3, p. 503-508, 2018. RHIND, S. M. Effects of maternal nutrition on fetal and neonatal reproductive development and function. Animal Reproduction Science, v. 82, p. 169-181, 2004. RIBEIRO, E. L. A.; GONZÁLEZ-GARCÍA, E. Indigenous sheep breeds in Brazil: potential role for contributing to the sustainability of production systems. Tropical animal health and production, v. 48, n. 7, p. 1305-1313, 2016. RIBEIRO, M. S. et al. Repeatability and effect of age on reproductive characteristics in Santa Ines rams. Archivos de zootecnia, v. 67, n. 257, p. 143-147, 2018. RUSSEL, A. J. F.; DONEY, J. M.; GUNN, R. G. Subjective assessment of body fat in live sheep. The Journal of Agricultural Science, v. 72, n. 3, p. 451-454, 1969. SILVA, N. V. et al. Medidas in vivo e da carcaça e constituintes não carcaça de ovinos alimentados com diferentes níveis do subproduto agroindustrial da goiaba. Revista Brasileira de Saúde e Produção Animal, v. 17, n. 1, p. 101-115, 2016. SILVA, P. et al. Influence of placentally mediated fetal growth restriction on the onset of puberty in male and female lambs. Reproduction, v. 122, n. 3, p. 375-383, 2001. SIQUEIRA FILHO, E. R. Influência dos níveis protéicos fornecidos na dieta sobre o sistema reprodutivo de carneiros. 2007. 75 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina Veterinária e Zootecnia de Botucatu, 2007. SOUZA, J. S da et al. Biometric measurements of Santa Inês meat sheep reared on Brachiaria brizantha pastures in Northeast Brazil. Plos one, v. 14, n. 7, p. e0219343, 2019. (shrink)

Spermatogenesis is the process of producing sperm in the testicles. It occurs in several stages, starting with the primordial germ cells, which differentiate into spermatogonia. Spermatogonia undergo successive mitoses to form primary spermatocytes, which, in turn, undergo meiosis, resulting in secondary spermatocytes. Secondary spermatocytes later transform into spermatids, which are immature sperm. Spermatids undergo maturation and differentiation to become mature sperm, ready for fertilization. This process is highly regulated by hormones and is essential for male fertility and reproduction. Spermatogenesis is (...) a complex process divided into three phases: spermatogonial or proliferative phase, meiotic phase, and spermiogenic phase, which are strictly related to animal physiology. These phases are influenced by several factors, including temperature, nutrition, diseases, and stress. Understanding these factors that influence spermatogenesis determines the animals’ productivity, in cases of changes, it can be suspected whether they are of genetic origin or environmental causes. (shrink)

This Viewpoint analyzes policies for covering GLP-1 receptor agonist drugs for obesity treatment across 13 high-income countries. It identifies four key lessons for developing coverage policies: 1) using up-to-date cost-effectiveness analyses that incorporate new evidence of benefits, 2) negotiating lower prices while preserving innovation incentives, 3) prioritizing coverage for specific populations rather than issuing blanket denials, and 4) treating obesity medications similarly to high-cost drugs for other conditions. It argues that blanket coverage denials are unethical and that countries should implement (...) targeted coverage policies that maximize benefits while managing costs. (shrink)

Due to his first-hand experience with the Black Death, the Italian physician Gentile da Foligno (d. 1348) became a famous authority in this field. He devoted various writings to the pestilence; one of them was a Consilium addressed to the city of Pisa. This same Advice on the Plague was then rendered into Hebrew by an anonymous translator. The practical character of the Consilium, which contains numerous instructions and recipes to prevent contagion and treat the disease, might have aroused the (...) interest of Jewish physicians who, excluded from academic education, were looking for useful treatments. In this paper, the Latin text and its Hebrew translation are analyzed, and in the appendix the edition of both versions is provided. (shrink)

This paper combines considerations from ethics, medicine and public health policy to articulate and defend a systematic case for mask wearing mandates (MWM). The paper argues for two main claims of general interest in favour of MWM. First, MWM provide a more effective, just and fair way to tackle the ongoing COVID-19 pandemic than policy alternatives such as laissez-faire approaches, mask wearing recommendations and physical distancing measures. And second, the proffered objections against MWM may justify some exemptions for specific categories (...) of individuals, but do not cast doubt on the justifiability of these mandates. Hence, unless some novel decisive objections are put forward against MWM, governments should adopt MWM. (shrink)

El derecho a una muerte digna es ampliamente ignorado por el ordenamiento jurídico brasileño. Esta invisibilidad del proceso de finitud y sus consecuencias son el objeto de este estudio, que tiene como objetivo realizar una encuesta exploratoria para identificar los puntos relevantes que deben desarrollarse para garantizar un proceso de finitud digno. Se analizaron 50 publicaciones a través de una encuesta online y física de obras publicadas hasta marzo de 2023. Los estudios analizados expresan preocupación por los dilemas éticos de (...) la atención a seres humanos en finitud, pero no analizan las formas de pro-tección a la finitud existentes ni cuáles son las áreas que aún necesitan regulación para hacer efectiva esta atención. Se espera que esta investigación contribuya a fortalecer la visión crítica de la finitud, considerando la protección actual de la finitud, los límites jurídicos del Estado y los posibles pasos futuros para avanzar en los estudios aplicados a la actualización práctica del sistema jurídico brasileño. (shrink)

The placebo effect has puzzled scientists for centuries. Philosopher Dien Ho argues that we now know how it works, and that this should transform our understanding of the relationship between mind and body. We must stop thinking of improvements in health due to placebo as somehow less real than those due to other medicines: there can no longer be a clean distinction between ill-health that’s “all in the head” and ill-health that involves a malfunctioning body. Ho argues that our improved (...) understanding of placebos means that doctors should now harness their power in treatment, especially since research shows that they can be effective even when patients are told that they’re taking a placebo. (shrink)

Two arguments in Eudemian Ethics 2 that are crucial to Aristotle’s definition of moral virtue as a mean state contain claims that Aristotle says are clear by induction. In these contexts, he explicitly appeals to examples coming from arts and sciences like gymnastic training and medicine for evidence. But Aristotle does not here, or elsewhere (at least in any extant work), including the parallel arguments in the Nicomachean Ethics, actually supply or discuss the evidence that makes these inductive arguments clear. (...) Fortunately, strong support for them can be found in the Hippocratic Corpus, especially in On Ancient Medicine and On Regimen. (shrink)

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences during the first (...) semester of an undergraduate problem-based learning medical program at an African medical school. Method: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Results: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Conclusions: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem based learning process. (shrink)

Disintegration is the most important step for drug bioavailability because after, the disintegration process, the ingredients of solid dosage forms dissolve and become bioavailable. Generally, the tablets and capsules should be taken with a glass of water otherwise the manufacturer gives instructions to use the proper beverage. Several drugs are taken with different forms of beverages to ensure easy swallowing of the tablet, masking the bad taste of the drug and overcoming the drug aftertaste, these beverages can influence the disintegration (...) of the solid dosage form. The most common cold beverages consumed by the Libyan population are juice, milk, and Coca-Cola. These beverages are consumed without awareness of the possible effect of these beverages on drugs, especially over-the-counter drugs such as analgesic, antipyretic, and anti-inflammatory drugs that are taken without a prescription. This study aimed to evaluate the influence of three beverages, namely: orange juice, milk, and Coca-Cola on the disintegration time of four over-the-counter-drugs: Panadol, Congestal, Brufen, and Reality Extra using disintegration test of drugs in 0.1 N HCL and in hybrid medium prepared by combination of 150 ml 0.1 N HCL and 550 ml of beverage to simulate in vivo condition. The findings show that the orange juice significantly increases the disintegration time of all the investigated drugs. Coca-Cola significantly increases the disintegration time of Reality Extra, and slightly increases the disintegration time of Brufen, Congestal, and Panadol and the full-fat milk significantly increases the disintegration time of Reality Extra and Panadol while slightly increasing the disintegration time for Brufen and Congestal. It is concluded that commonly used beverages affect the disintegration time of the examined over-the-counter drugs. Patients should be advised to take these medications without beverages which may delay the disintegration and the onset of action of the drug. (shrink)

ALTERNATIVE FOODS IN THE FORMULATION OF DIETS FOR GOATS AND SHEEP ABSTRACT Alternative nutrition refers to the use of unconventional ingredients or agro-industrial byproducts in formulating diets that would otherwise be discarded (Moraes, et al., 2011). Providing nutritional support to animals is essential in optimizing digestibility, associated with good management and water availability, which increases the producer's profitability. The search for alternative foods to meet market demand can arise for several reasons, whether to obtain a greater supply of feed during (...) the seasons, always maintaining a favorable trade balance with regard to the cost of the diet, bringing this These foods that are used to feed sheep and goats have been carried out more effectively, however, these foods must provide the supply of all nutrients. Furthermore, these foods have economic viability and nutritional values capable of supplementing the nutritional needs of small ruminants, such as: Whey, mandacaru, beans and castor seeds. Keyword: small ruminants, food, nutritional management. (shrink)

In this editorial, we argue that midwives should focus on climate change, a link which has been underexplored.

Henry of Herford frequently addresses medical topics throughout his encyclopedia, the Catena aurea entium. The paper offers an overview of the sections that deal with health, sickness, and diseases. While including key texts of medieval medical literature, Henry’s ‘medical library’ has a specific focus on practical medicine, pharmacology, and the regimen. The paper also includes editions of some questions dedicated to specific diseases.

During the Middle Ages, physicians, philosophers, and theologians developed a complex and rich discourse on the concept of sickness. Illness (infirmitas) was perceived as the natural state of existential imperfection for homo viator, fallen due to sin and impaired in his bodily integrity. Leprosy, smallpox, plague and the other collective diseases that constantly plagued medieval societies prompted reflections on etiology and modes of transmission of epidemics. Building on Galenic teachings, medieval medicine – both Arabic and Latin – delved into the (...) study of fevers. Key concepts in medical pathology, such as the humors, humidum radicale, and spiritus, were assimilated and reinterpreted within philosophical and theological frameworks. The ten contribution collected in this volume explore this rich array of concepts and themes by closely examining the theories and works of prominent and lesser-known figures in medicine, theology, and philosophy active across Latin Christendom, the Islamic context, and the Jewish world: from Augustine to ʿAlī ibn al-ʿAbbas al-Maǧūsī, from Avicenna to Constantine the African, from Maimonides to Albert the Great, from Arnau de Vilanova to Gentile da Foligno, from Henry of Herford to Michele Savonarola. (shrink)

Individual attributes, such as educational background, may influence the degree of health consideration in food consumption. The local social norms may affect the same consideration in the collective level. Represented by education level and the custom rules adherence in food choosing behavior, this study aimed to examine how knowledge influences health consideration in food consumption and how the local social norms moderate this association in a multicultural enriched society. By utilizing the Bayesian Mindsponge Framework (BMF) as a conceptual framework, this (...) study analyzed a dataset of 710 urban residents in Indonesia. There was a negative association between education level and health consideration in food consumption in which the custom rules adherence in food choosing behavior moderated against this negative association. For those with a low level of custom-based food consumption, their health consideration is lower as they have higher education level. However, the opposite trend which is a more intuitive positive association was found in those who consume more custom-based food. Socio-cultural factors have a complex impact on food choosing behavior among Indonesian urban residents. Therefore, governmental policies in the health promotion campaign of healthy-nutritious food should incorporate socio-cultural aspects with a deeper understanding of the human mind’s information processing. (shrink)

Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the WJ (...) criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)