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Louis Tanquerel des Planches (1810-1862) only left us with one significant medical work, his Traité des maladies de plomb ou saturnines (treatise on lead or saturnine diseases), published in 1839. The work served as a reference for diagnosing and treating lead poisoning throughout the second half of the nineteenth century. The word "encephalopathy" that he coined at that time referred to toxic damage to the central nervous system. Whereas for two millennia and for most physicians, lead poisoning was considered lead colic, i.e. paroxysms of abdominal pain, Tanquerel collected seventy-two observations of damage to the central nervous system in workers exposed to lead in Parisian workshops (which no longer exist). He then inventoried and described forms of paralysis, delirium, coma, and convulsions related to lead poisoning. Having no qualms about stepping away from La Charité Hospital where he had treated patients with lead poisoning, he inspected their workplaces and unambiguously presented the deplorable conditions that caused so many patients to die. His "preservative" advice was an initial attempt at medical-social prophylaxis with the goal of helping the working class exposed in workshops without any respect for human life. With support from chemists and pharmacists, Tanquerel showed the presence of lead in brain tissue and thus demonstrated its neurological toxicity as early as 1839. This article is also an opportunity to note the contributions on this topic of some other physicians François-de-Paule Combalusier (1713-1762), François Victor Mérat de Vaumartoise (1780-1851), Jean-Louis Brachet (1789-1858), Auguste Mirande (1802-1865), Vincent Nivet (1809-1893), Augustin Grisolle (1811-1869), and Ferdinand de Bernard de Montessus (1817-1899).

Neuromyelitis optica spectrum disorder (NMOSD) is a disabling autoimmune disease of the central nervous system that can start at ages of 50 or more, when it is called late-onset NMOSD (LO-NMOSD). Data on this disorder are sparse. In this cross-sectional study, patient characteristics of the disease were studied. LO-NMOSD patients of a tertiary center in Tehran were studied from 2016 to 2020.

Eight patients were identified, half of whom were men. The diagnostic delay was from no time-lapse to three years (mean 0.62, SD 1.06), which was significantly shorter than in early-onset patients. Seven patients (87.5%) tested positive for AQP4-IgG which was significantly higher compared to early-onset patients (p-value=0.01). Four patients (50%) had both transverse myelitis and optic neuritis as presenting symptoms, while three (38%) had just myelitis and only one (12%) had optic neuritis.

There is discrepancy regarding different aspects of LO-NMOSD. Further studies are needed to clarify the subject in order to enhance diagnosis and treatment.

There is discrepancy regarding different aspects of LO-NMOSD. Further studies are needed to clarify the subject in order to enhance diagnosis and treatment.Geobatteries are redox-active substances that can take up, store, and release electrons reversibly. Provided that their redox activity can be maintained by fluctuations of oxidizing and reducing redox conditions, geobatteries could also improve the performance of engineered systems, such as in biological nitrogen removal from wastewater or constructed wetlands.

Laparoscopic cholecystectomy operative difficulty is highly variable and influences outcomes. This systematic review analyzes the performance and clinical value of statistical models to preoperatively predict laparoscopic cholecystectomy operative difficulty.

PRISMA guidelines were followed. PubMed, Embase, and the Cochrane Library were searched until June 2020. Primary studies developing or validating preoperative models predicting laparoscopic cholecystectomy operative difficulty in cohorts of >100 patients were included. Studies not reporting performance metrics or enough information for clinical implementation were excluded. Data were extracted according to CHARMS, and study quality was assessed using the PROBAST tool.

In total, 2,654 articles were identified, and 22 met eligibility criteria. Eighteen were model development, whereas 4 were validation studies. Eighteen studies were at high risk of bias. However, 11 studies showed low concern for applicability. Identified models predict 9 definitioatively predict laparoscopic cholecystectomy operative difficulty have generally good performance and seem applicable. However, an unambiguous definition of operative difficulty, validations, and clinical studies are needed to implement patients' stratification in laparoscopic cholecystectomy.Thyroidectomy remains the gold standard treatment for benign, symptomatic, or enlarging thyroid nodules, malignant nodules, and metastatic lymph node disease. However, in the past 2 decades, image-guided interventional techniques have emerged as promising alternative treatments for these conditions. Percutaneous ethanol ablation is now an accepted first-line treatment for recurring cystic thyroid nodules. Thermal ablation techniques such as high-intensity focused ultrasound, laser ablation, radiofrequency ablation, and microwave ablation have shown efficacy in producing a nodular volume reduction of greater than 50% that is maintained for several years with resolution of local compressive symptoms. There is also increasing evidence that these techniques can effectively treat papillary thyroid microcarcinomas and recurrent metastatic lymph node disease. Because these interventional ablation techniques are performed safely in an outpatient setting, are well tolerated, and the risk for needing thyroid hormone supplementation is negligible, they are becoming a popular alternative treatment to surgical resection. In this comprehensive review, we discuss each of these percutaneous interventions the devices and techniques, the advantages and disadvantages of each energy, and summarize the outcomes published in the literature.This study aims to examine the changes in efficiency and efficiency levels of the maternal and child health hospitals in Turkey from 2014 to 2017, by applying two-stage data envelopment analysis (DEA). At the first stage of the study, the efficiency of the hospitals was evaluated with input-oriented CCR (Charnes, Cooper, Rhodes) and Malmquist Productivity Index (MPI). Ivacaftor purchase At the second stage, panel Tobit regression analysis was utilized to find out the factors that affect the efficiency scores specified at the first stage. According to the results of the first stage, the mean efficiency values calculated for 2014, 2015, 2016, and 2017 were 0.83, 0.90, 0.86, and 0.80, respectively. At the second stage, it was revealed that the variables of not being in a metropolis and having 200 beds at least had statistically a significant effect on the efficiency score (p 0.05). The number of the studies which assess the efficiency of maternal and child health hospitals in Turkey was quite limited. Moreover, such studies do not contain second-stage analyses. Lastly, it is thought that those results will provide health policy-makers substantial and evidence-based information in the allocation of the resources for the related services.

In 2014 a National Nursing Ethics Summit was undertaken to chart a future for nursing ethics in the United States.

The purpose of this study was to understand changes in the field over a 5-year period as a measure of longitudinal impact and identify recommendations for education, practice, research and scholarship, and policy.

This cross-sectional study used a mixed method design.

Nineteen participants from 15 institutions participated in the survey. The majority of respondents agreed or strongly agreed on their effort in promoting education (84%), contributing to scholarship (74%), creating a sustained environment for ethical practice (63%) and developing new initiatives (58%) in nursing ethics.

Further investment is needed to establish a more broadly funded research agenda for ethical issues in nursing, improvement in evidence-based practice, and development of policy initiatives to promote ethical practice and infrastructure for sustainability and responsiveness to contemporary challenges.

Further investment is needed to establish a more broadly funded research agenda for ethical issues in nursing, improvement in evidence-based practice, and development of policy initiatives to promote ethical practice and infrastructure for sustainability and responsiveness to contemporary challenges.

Self-medication of antibiotics among children is a very common problem in Tunisia. Its prevalence isn't well established. The aims of this study are to evaluate parents' knowledge concerning antibiotic use, and identify the factors associated with this problem.

We conducted a cross-sectional study over a one year period (between August 2019 and July 2020). Data collection was performed using a questionnaire guided interview. We included parents of children consulting or hospitalized in the pediatric department of the university hospital Taher Sfar in Mahdia.

A total of 354 parents were included with an average age of 36.4±9.2 years. The average knowledge score was 2±1.3 points. In fact, 61.6% of the parents had poor knowledge about antibiotics. The frequency of non-prescription antibiotics use among children was 20.6%. Amoxicillin was the most used antibiotic (72.6%). Sore throat, important fever and flu-like symptoms were the main symptoms justifying non-prescription antibiotic use among our pediatric and in the other hand promote the education of the public through different procedures to stop this major health problem.

A notable proportion of COVID-19 patients need statins for their co-existing conditions. Statins possess several anti-inflammatory properties. We have attempted to describe potential association of exposure to statins and severity of COVID symtpoms in a historical study in hospitalized COVID-19 patients.

This single-center, historical cohort study was performed in Baharloo hospital as a referral hospital for COVID-19 patients in Tehran. Patients were divided into two groups; 163 statins users and 547 non-users. Mortality rate, intensive care unit (ICU) admission and length of hospitalization were compared between studied groups. In addition, during the investigation, pre-existing conditions were evaluated for groups. If a significant difference was observed between groups, the feature was considered in the adjustment of the odds ratio.

At the beginning, statistical analysis study showed that statins users had significantly (p<0.0001) higher mortality rate, ICU admission and length of hospitalization. But after implementation of variables such as age, sex, diabetes, hypertension status, stroke, dyslipidemia, cardiovascular diseases, chronic kidney disease (CKD), corticosteroids, renin-angiotensin-aldosterone axis inhibitors and proton pump inhibitors (PPIs) for adjustment of the odds ratio, a considerable alteration appeared in the studied values. Following adjustment of odds ratio it was shown that statins did not change mortality (95% CI, OR 0.71 (0.41-1.22), p=0.22), ICU admission (95% CI, OR 1.05 (0.66-1.66), p=0.835) and length of hospitalization (95% CI, OR 1.30 (0.78-2.17), p=0.311). In addition, we found that statins could not decrease inflammatory markers in COVID-19 infected patients.

The use of statins did not seem to change outcomes in COVID19.

The use of statins did not seem to change outcomes in COVID19.