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Background: The impact of COVID-19 sanitary measures on the time trends in infectious and chronic disease consultations in Sub-Saharan Africa remains unknown., Methods: We conducted a cohort study on all emergency medical consultations from January 2016 to July 2020, from SOS Medecins in Dakar, Senegal. The consultation records provided basic demographic information such as age, ethnicity (Senegalese or Caucasian), and sex as well as the principal diagnosis using an ICD-10 classification ("infectious", "chronic", and "other"). We first investigated how the pattern in emergency consultation differed from March to July 2020 compared to previous years. Then, we examined any potential racial/ethnic disparities in COVID-19 consultation., Results: We obtained data on emergency medical consultations from 53 583 patients of all ethnic origins. The mean age of patients was 37.0 (standard deviation (SD) = 25.2) and 30.3 (SD = 21.7) in 2016-2019 and 45.5 (SD = 24.7) and 39.5 (SD = 23.3) in 2020 for Senegalese and Caucasian patients, respectively. The type of consultations between January and July were similar from 2016 to 2019; however, in 2020, there was a drop in the number of infectious disease consultations, particularly from April to May 2020, when sanitary measures for COVID-19 were applied (average of 366.5 and 358.2 in 2016-1019 and 133.0 and 125.0 in 2020). The prevalence of chronic conditions remained steady during the same period (average of 381.0 and 394.7 in 2016-2019 and 373.0 and 367.0 in 2020). In a multivariate analysis adjusted for age and sex, infectious disease consultations were significantly more likely to occur in 2016-2019 compared to 2020 (2016 odds ratio (OR) = 2.39, 2017 OR = 2.74, 2018 OR = 2.39, 2019 OR = 2.01). Furthermore, the trend in the number of infectious and chronic consultations was similar among Senegalese and Caucasian groups, indicating no disparities among those seeking treatment., Conclusions: During the implementation of COVID-19 sanitary measures, infectious disease rates dropped as chronic disease rates remained stagnant in Dakar. We observed no racial/ethnic disparities among the infectious and chronic consultations., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

Little is known about pathways underlying inpatient hospital (re)admissions in older adults unable to meet basic needs. This study examined the factors associated with (re)admissions in a sample of low-income older Medicare beneficiaries in need of food assistance in Georgia in 2008 (N = 892, mean age 75.4 ± 8.8 years, 30.3% Black, 68.5% female). About 35.3% of the sample experienced 1 + hospital (re)admissions. (Re)admissions were significantly more likely in individuals who requested Older Americans Act Nutrition Program Home Delivered Meals services (OR 2.3; 95% CI 1.4, 3.8), had more outpatient emergency room visits (1 visit: OR 2.1; 95% CI 1.4, 3.1; 2+ visits: OR 3.6; 95% CI 2.4, 5.4), and experienced greater multimorbidity (OR 1.6; 95% CI 1.4, 3.1). Support for home and community-based services may be critical in reducing potentially avoidable inpatient hospital (re)admissions.

Little is known about diabetes management among low-income older Americans. This study used statewide self-administered survey and Medicare claims data to examine the relationships of food insecurity and medication (re)fill adherence in a sample of Medicare Part D beneficiaries with type 2 diabetes in need of food assistance in Georgia in 2008 (n = 243, mean age 74.2 ± 7.8 years, 27.2% African American, 77.4% female). (Re)fill adherence to oral hypoglycemics was measured as Proportion of Days Covered. Food insecurity was assessed using a six-item validated standard measure. About 54% of the sample were food insecure. About 28% of the diabetic sample did not (re)fill any diabetes medication and over 80% had at least one diabetes complication. Food insecure participants showed comparable (re)fill adherence to food secure participants. However, 57% of food insecure participants were nonadherent to oral hypoglycemics. Underlying basic needs must be addressed to improve diabetes management in this population.

Medication nonadherence is a significant public health problem that affects the health and well-being of older Americans while burdening the US healthcare system. Pharmacy claims data have gained importance in deriving objective medication (re)fill adherence measures; however, little is known about application of such measures in older Americans. The objective of this study was to assess the types and characteristics of pharmacy claims-derived medication (re)fill adherence measures used in older Americans. A comprehensive literature search strategy was employed to identify all articles using pharmacy claims data to measure (re)fill adherence to prescription medications in older Americans aged 65+ years. Included were articles reporting original research studies conducted and published in the USA in English between 1 January 2000 and 1 November 2012. The basic search used multiple key terms indicating adherence, combined with the term "medication" and the term "pharmacy claims or administrative claims." Due to the variety of measure names used in the literature, a more specific search was added to repeat the basic search for 29 previously used medication (re)fill adherence measure names. Articles identified through the database search were manually reviewed to select only articles meeting the inclusion criteria. The search resulted in a total of 36 articles. Information on medication (re)fill measurements were extracted and summarized. The 36 articles used 20 differently named measures under the three main concepts: medication adherence, persistence, and discontinuation. Measures of medication adherence cumulatively assessed the proportion of time at which medications were (not) filled over a predefined observation period (e.g., medication possession ratio). Measures of medication persistence assessed the continuity of medication filling over a specified time period, while medication discontinuation measures focused on termination of medication (re)fills. Overall, almost two thirds of all identified articles used a single medication (re)fill adherence measure. Among them, 77 % used a medication possession measure. The term "medication possession ratio" (MPR) was used most frequently (65 %), followed by the "proportion of days covered" (PDC; 30 %). No single measure can be generally recommended for the use in older Americans. The challenges in using pharmacy claims-based medication (re)fill adherence measures in older Americans include a lack of consensus terminology and algorithms among measures of the same concepts, insufficient transparency of individual measure operationalization, and inadequate consideration of unique characteristics of the older population, such as temporary nursing home care. Although medication (re)fill adherence measures may be well suited for measuring medication adherence in older Americans, little guidance is available on how to use them in this population. Further efforts need to be given to the development and standardization of pharmacy claims-based medication (re)fill measures that are specifically tailored toward use in older Americans.

The purpose of this study was to examine relationships between changes in food insecurity (FI) and cost-related medication nonadherence (CRN) among Older Americans Act Nutrition Program participants and wait-listed individuals in Georgia. This study used data collected from 3 waves of self-administered mail surveys conducted 4 months apart in 2008 and 2009 (n = 664, mean age 74.6 ± 8.9 years, 71.5% female, 31.0% African American). FI was assessed by using a validated 6-item U.S. Household Food Security Survey Module. Practice of 5 CRN behaviors was evaluated. Changes in FI and CRN were determined based on ≥ 2 repeated measures. Participants with persistent FI and CRN were more likely to be younger, low-income, and in poorer health. After controlling for potential confounders, persistently food insecure individuals and those who became food insecure showed 8.2 (95% CI: 5.4-12.5) times and 5.3 (95% CI: 3.2-8.8) times increased odds of reporting higher levels of CRN than persistently food secure individuals.

Aim: It is possible to detect disturbances of bile acid absorption using a whole body counter after administration of Se-75 labelled bile acid analogues. We scrutinized the benefit of a modification of the test method., Methods: We investigated 77 patients with different forms of a gastrointestinal disease. After application of Se 75 homotaurocholic acid we measured patient-activity up to 7 days later including whole-body profile scans in the first 6 h., Results: The fractional retention after 7 days was between 20 and 67%. In cases of impaired absorption it was below 12%. Patients with liver diseases and after cholecystectomy (without bile acid resorption disturbance) showed normal values. Patients with Crohn's disease of the ileum or with intestinal ileac by-pass or with colestyramine treatment or with disturbance of vitamin B12-absorption or with cystic fibrosis showed a disturbance of bile acid absorption. The normal whole-body half-life was more than 2.8 days. The 24 and 72 h values were 62 and 31% in cases with normal absorption. Smaller values are signs of bile acid malabsorption. Impulse rates measured with the whole body counter are of an order of magnitude that allows to reduce the usually administered dose of 37 kBq to 9.25 kBq., Conclusion: This is an efficient method to detect disturbances of bile acid absorption. The usually administered activity of 37 kBq can be reduced to 9.25 kBq.

The amount of caesium 134 and 137 in Hessian game hunted for food (556 animals) after the reactor accident at Chernobyl was investigated. Comparisons have been made before and after the accident. Although there was only a very low level of contamination, the contamination rate of different species varied; on average, the Red Deer showed the highest activity (130 Bq/kg). The level of caesium contamination was mostly influenced by the permanent habitat of the animals. The main influence was due to regional, geographical and meteorological conditions. The influence of age or sex could not be determined. The contamination rate was shown to decrease with time.

The recovery of Syrian hamsters after split dose application (interval 11 days) was studied on the basis of the weight response and of food uptake. Two periods of weight loss and anorexia can be distinguished, an early one immediately after irradiation and a secondary one 6-10 days later. The secondary response is a function of the radiation dose and allows to distinguish survivors from non-survivors, since it is much more pronounced and longer lasting in the latter than in the former. The first response appears not to be influenced by a previous conditioning irradiation.

A method of lymphoscintigraphy is described which provides additional diagnostic information, of particular value prior to surgery for the removal of cutaneous tumours. The technique demonstrates the individual physiology of the lymphatic drainage system from a particular region of the skin. However, it is not the aim of the method to diagnose possible lymph node metastases.

In our experiments, carried out hitherto, concerning the effect of incorporated and radioactive substances, weight behaviour and food uptake have proved to be a sensitive test. With regard to these experiments and the half-life of the radionuclides used, it is reported about trial series in Wistar rats. These rats were applied, with Co-60 gamma irradiation, different whole-body doses protracted over 48 hours. A total of 32 groups of experimental animals (20 animals each) was exposed to irradiation doses of lethal, medium lethal, and sublethal ranges, control and pseudo-irradiation series included. The experiments were carried out under observance of constant irradiation and attitude conditions, night and day changes, as conditioned by the season, included. Even in the inferior sublethal range (12 to 24 R), a significant trend of decreased food uptake is registered. This trend remains for a short period after the end of irradiation, but then it returns to normal conditions. Furthermore, a new decrease with subsequent increase seems to become evident-about ten days after termination of the radiotherapy (especially after several hundred R); report about these items will be made later on.

Calcium absorption in man was studied by means of labelling an ampoule of Frubiase Calcium forte with calcium-47. For comparative purpose a solution containing the same amount of calcium salts as the ampoule was labelled as well. Already 10 minutes after oral administration of Ca-47 in 10 ml of Frubiase Calcium forte radioactivity was statistically significant measurable in blood. At the same time there was no significant radioactivity demonstrable out of the calcium salt solution. Between 45 and 120 minutes following oral application of the isotope both groups showed a statistically significant difference concerning the measurable blood activity. The Frubiase Calcium forte values were always higher, especially one and two hours after administration of the radiocalcium (up to 40%). The levels at these times correlate well with the total calcium absorption. Measurements over the compact bone region of the ankle demonstrated significantly higher values of calcium-47 in case of Frubiase Calcium forte compared with the calcium salt solution. These findings indicate in the case of Frubiase Calcium forte a higher bone mineral accretion. There is a good direct proportionality between the amount of these values and the total calcium absorption.

Guniea pigs showed an increased uptake of 99m-Tc-04 in the inflamed joints during the first days of experimental arthritis. Tc-04 was found in the joint fluid and inflamed synovia. The uptake of Tc-04 and Tc-MDP was reduced by therapy in 13 patients with RA. Classical RA showed an increased uptake of Tc-MDP compared with probable RA. Scintigraphy offers the possibility of early diagnosis and study of progression.

Radiation inactivation of alpha 1-adrenoceptors in rat cerebral cortex membranes has been performed with 10 MeV electrons from a linear accelerator at temperatures less than or equal to -100 degrees C. Alpha 1-adrenoceptor inactivation was monitored with [ 3H ]-prazosin and [( 125I ]-2-(beta-4-hydroxylphenyl)ethylaminomethyl)tetralone [( 125I ]-HEAT). Saturation analysis of irradiated membranes with both ligands indicated that a decrease in alpha-adrenoceptor density occurred with increasing radiation dose. The dissociation constants of [ 3H ]-prazosin and [ 125I ]-HEAT were not markedly changed by the irradiation. Application of the target volume theory gave molecular weights of 91,500 +/- 1,700 (S.D.) (D37: 19,6 +/- 0.36 Mrad) with [ 125I ]-HEAT as ligand, and 77,000 +/- 18,000 (S.D.) (D37: 23.3 +/- 4.6 Mrad) with [ 3H ]-prazosin, respectively, when an empirical temperature correction factor of 2.8 was used. [ 3H ]-flunitrazepam-labelled benzodiazepine receptor target size was used as an internal control. The molecular weight of the alpha 1-adrenoceptors, corrected for this internal control, was 85,000 +/- 1.600 [( 125I ]-HEAT) and 71,500 +/- 17,000 [( 3H ]-prazosin).

Extracorporeal measurement of incorporated radioactive organic compounds needs labelling with gamma emitters. The elements of organic compounds have only very short-lived gamma-emitting isotopes. (Organic compounds, therefore, up to now were labelled by more or less stable chemical coupling with gamma-emitting isotopes of the halogens or of certain metals as, for instance, chromium-51). The use of the C-11 isotope with a half-life period of about 20 min, emitting gamma radiation due to the annihilation radiation of its positrons, is very problematical, because these very short-lived nuclides can be used only at the place of their production by nuclear engineering. But especially these nuclides are very interesting just because of their short half-life period, the radiation load being lessened thereby and, in addition, the organic compound remaining chemically unchanged. Utilizing the (gamma, n) reaction, we have succeeded in labelling organic molecules in solid state directly within the electron beam due to the retarding of particles from a linear electron accelerator, and the absolute as well as the specific yield was satisfying. Till now, we have tested almost exceptionally amino-acids; during experimentation with rats, an example of the practicable utilization in nuclear medicine was set by means of the amino-acid methionine. This was confirmed by results of comparative studies using C-14 and Se-75 labelled methionine (Se-methionine respectively).

The turnover of 125I-labelled fibrinogen and 131I-labelled albumin was studied in the course of galactosamine-induced hepatitis in rabbits. In addition to galactosamine, some animals were treated with epsilon-aminocaproic acid (EACA) to inhibit the activation of the fibrinolytic system. The infusion of galactosamine and EACA caused generation of fibrin-rich microclots in the renal glomerular capillaries in seven out of 12 rabbits. Correspondingly, the incorporation of 125I-radioactivity into liver, spleen, and kidneys was pronounced in galactosamine- and EACA-treated rabbits compared with control animals treated with EACA. An acceleration of the 125I-fibrinogen elimination from the plasma was observed between eight and 12 hours after the start of the galactosamine infusion. The administration of heparin in addition to galactosamine and EACA prevented the occurrence of intravascular coagulation, but shortened the survival times of the animals because of bleeding into visceral organs. The elimination of 131I-albumin in plasma as well as the distribution of 131I-radioactivity in organs were similar in all the rabbits independent of the treatment with galactosamine, EACA, or heparin. The experiments indicate that, in addition to diminished synthesis of coagulation factors, disseminated intravascular coagulation is involved in galactosamine-induced hepatitis and contributes to the haemostatic disorder.

The influence of the metabolic status of mitochondria upon their radiation response was studied. It turned out that the reduction of pyridine nucleotides by addition of beta-hydroxybutyrate (BOH) and the decrease through respiration were distinctly impaired in mitochondria with a substrate deficit by an irradiation with 2.7 krd already. The evolution of the lesion depends on the incubation conditions following irradiation, a presence of BOH having protective effects. The general redox level seems to be essential for radiation response of mitochondria. An exit of NAD from mitochondria has proved to be the main cause for inhibition of the respiratory BOH-consumption.

Via recoil activation, carrier-free 18F-labeled acetic acid can be produced by the irradiation of a mixture of glacial acetic acid and potassium fluoride. The labeling yield seems to be high enouth to produce this compound with activity amounts suitable for nuclear medical investigation. Using a mixture of glacial acetic acid and freon-11, 18F-labeled acetic acid could be found. This system is assumed to be more applicable for the production of other 18F-labeled carboxylic acids. Under optimized irradiation conditions we expect to produce some mCi of labeled monofluoroacetic acid.

Effects of cations and nucleotides on the in vivo binding properties of alpha-adrenoceptors in rat cerebral cortex membranes are described. Na+ ion converts a large fraction alpha-adrenoceptors in the absence or presence of Mg2+ into a low affinity state. The effects of 10 mM Na+ can be observed in 250 mM Tris-HCL buffer. It is suggested that alpha 2-adrenoceptor agonists alter the affinity of Na+ for a receptor-associated membrane component. alpha 2-Adrenoceptors are linked to guanylnucleotide binding proteins, which may be involved in signal transfer. These sites are altered in their nucleotide binding properties by pretreatment of the membranes with a medium that allows for ADP ribosylation or/and phosphorylation. alpha 1-Adrenoceptors were probed with a new, high affinity ligand, 125J-HEAT. 125J-HEAT binds (30 degrees C) with Kd values between 6 and 8 pM to alpha 1-adrenoceptors if Na+ slows down the dissociation of 125J-HEAT in comparison with MG2+. Na+ as well as Mg2+ reverse the inhibitory action of phosphatidic acid on the alpha 1-adrenoceptors labeled by 125J-HEAT. Data on the target size, obtained by radiation inactivation, of the alpha 1-adrenoceptors are presented.