[An Epidemiological Survey on Echinococcosis in Yushu Prefecture of Qinghai Province].

Objective: To investigate the prevalence of echinococcosis in Yushu Prefecture of Qinghai Province in 2012. Methods: Two to three towns were selected in each of Chengduo, Nangqian, Qu malai, Yushu, Zaduo and Zhiduo Counties from June to August in 2012. Ultrasound examination was conducted for residents aged over 1 year, and ELISA was performed to detect serum antibody against Echinococcus. Visceral dissection was performed to detect hydatid infection in rodents and livestock. ELISA was used to detect Echinococcus antigen in collected dog feces. Results: A total of 7 025 residents received ultrasound examination, of whom 319 showed hydatid cysts with a morbidity rate of 4.54%. ELISA showed a serum antibody positive rate of 16.38% （457/2 790）. The mobidity of hydatid disease was highest in Chengduo County （7.41%, 181/2 444）, and the rate of serum antibody was highest in Yushu County （23.18%, 127/548）. The morbidity and serum antibody in males were 3.91% （118/3 018） and 13.93% （172/1 235） respectively, and those in females were 5.02% （201/4 007） and 18.33% （285/1 555）. In terms of age distribution, the morbidity was relatively higher in residents of 60- （8.39%, 38/453） and 40- years （6.61%, 67/1 014）; and the rate of serum antibody was highest in residents over 70 years （33.93%, 19/56）. In terms of occupation, the morbidity was relatively higher in herdsmen （5.28%, 252/4 777）, Herdsmen-peasants （6.52%, 24/368）, and religious workers（3.37%, 11/326）, while the rate of serum antibody was relatively higher in children（24%, 6/25）, religious workers （18.79%, 31/165） and herdsmen（18.34%, 328/1 788）. In terms of education level, the morbidity and the rate of serum antibody were both highest in the uneducated（5.04%, 41/4 779; 18.34%, 359/1 958, respectively）. In terms of residential pattern, the morbidity and the rate of serum antibody were both highest in those who were settled in winter and nomadic in summer （8.25%, 227/2 753; 19.48%, 158/811, respectively）. There were significant differences in the morbidity and the rate of serum antibody in aspects of residential region, sex, age, occupation, education level and residential pattern (P<0.05 or P<0.01). In 872 rodents detected, the Echinococcus hydatid rate was 0.46% （4/872）, while in 809 cattle and sheep detected, the Echinococcus hydatid rate was 10.14% （82/809）. The fecal antigen positive rate in 838 samples of dog feces was 10.74%（90/838）. Conclusion: It shows a high morbidity of hydatid diesease and serum antibody positive rate in residents, a high Echinococcus hydatid rate in cattle and sheep, and a high fecal antigen positive rate in dogs in Yushu Prefecture.

Takotsubo Syndrome in Patients With COVID-19: A Systematic Review.

Background: Respiratory conditions are major physical triggers of takotsubo syndrome (TTS) and portend worse outcomes. However, data on TTS in patients with coronavirus disease-2019 infection (COVID-19) are limited. Methods: We searched PubMed, Embase, and Cochrane Library databases for case reports for the period 2019-2022 describing TTS in patients with COVID-19 pneumonia (TTS-COVID). We summarized the clinical data and outcomes and compared them to those in patients with TTS with an acute respiratory disease other than COVID-19 as a trigger (TTS-acute respiratory disease) and those with TTS with no respiratory disease (TTS-no respiratory disease). Results: The mortality rate was higher in those with TTS-COVID (26.0%) than those with TTS-acute respiratory disease (5.7%) or TTS-no respiratory disease (4.2%; P < 0.001 for both). The proportion of men was higher in TTS-COVID (33.3%) than it was in TTS-no respiratory disease (9.1%; P < 0.001). The manifestations of TTS in COVID patients were atypical (dyspnea [70.3%] and cough [40.6%]); few had chest pain (23.4%). Cardiovascular risk factors were common in the TTS-COVID cohort, but fewer patients were on cardioprotective medications in this group than in the other 2 groups. Level of catecholamine use was higher in the TTS-COVID group (37.7%) than it was in the TTS-no respiratory disease (10.9%; P < 0.001) group. Apical ballooning (72.6%) was the most common TTS subtype, and basal segment type was seen in 11.0% of TTS-COVID patients. Conclusions: COVID-19 patients who developed TTS had high mortality rates and unique features, compared with those in the TTS-acute respiratory disease group or the TTS-no respiratory disease group. Understanding the pathophysiology of TTS in COVID-19 may help prevent TTS and direct therapy in this setting.

Contexte: Les troubles respiratoires sont des déclencheurs physiques importants du syndrome de Takotsubo (STT) et présagent une issue funeste. Les données sur le STT chez les personnes ayant contracté la maladie à coronavirus de 2019 (COVID-19) sont néanmoins limitées. Méthodologie: Nous avons fait une recherche dans les bases de données PubMed, Embase et Cochrane Library pour trouver des rapports de cas signalés entre 2019 et 2022 faisant état du STT chez des patients ayant contracté une pneumonie associée à la COVID-19 (STT-COVID). Nous avons synthétisé les données cliniques et les résultats pour les comparer à ceux de patients atteints du STT déclenché par une autre maladie respiratoire aiguë que la COVID-19 (STT-maladie respiratoire aiguë) et de patients atteints du STT sans maladie respiratoire (STT-sans maladie respiratoire). Résultats: Le taux de mortalité a été plus élevé chez les patients atteints du STT-COVID (26,0 %) que chez ceux atteints du STT-maladie respiratoire aiguë (5,7 %) ou du STT-sans maladie respiratoire (4,2 %; p < 0,001 dans les deux cas). La proportion d'hommes était plus élevée dans le groupe STT-COVID (33,3 %) que dans le groupe STT-sans maladie respiratoire (9,1 %; p < 0,001). Les manifestations du STT chez les patients atteints de la COVID étaient atypiques (dyspnée [70,3 %] et toux [40,6 %]); quelques patients présentaient une douleur thoracique (23,4 %). Les facteurs de risque cardiovasculaires étaient courants dans la cohorte STT-COVID, mais les patients qui prenaient des médicaments cardioprotecteurs étaient moins nombreux dans ce groupe que dans les deux autres groupes. Le taux d'utilisation de la catécholamine était plus élevé dans le groupe STT-COVID (37,7 %) que dans le groupe STT-sans maladie respiratoire (10,9 %; p < 0,001). La ballonisation de l'apex (72,6 %) était le sous-type de STT le plus courant, et le type caractérisé par un trouble du segment basal a été observé chez 11,0 % des patients atteints du STT-COVID. Conclusions: Les patients atteints de la COVID-19 ayant développé un STT présentaient des taux de mortalité élevés et des manifestations singulières, comparativement à ceux du groupe STT-maladie respiratoire aiguë ou du groupe STT-sans maladie respiratoire. Comprendre la physiopathologie du STT chez les patients atteints de la COVID-19 pourrait contribuer à prévenir le STT et à orienter le traitement dans ce contexte.

Mpox (monkeypox) information on TikTok: analysis of quality and audience engagement.

BACKGROUND: Online information on mpox (monkeypox) is not well studied. We have analysed the video content, information quality, and audience engagement of mpox-related videos on TikTok. METHODS: Using a hashtag-based searching strategy, we identified 2462 mpox-related videos on TikTok from 1 January to 11 August 2022; 85 were included after exclusion criteria screening. Videos were evaluated for content on features and treatment of mpox. Video and information quality was assessed using the DISCERN instrument and the Journal of the American Medical Association (JAMA) criteria. We recorded video source, evaluation scores, and viewer engagement metrics. The Kruskal-Wallis test was used for statistical analysis and multiple linear regression for factor-association studies. RESULTS: Of the 85 videos, two assessed all content topics and highlighted 33% of all content items in clinical guidelines. The overall average score for the videos was 39.56 of 80 on the DISCERN instrument and 1.93 of 4 on the JAMA criteria. No video met all JAMA criteria. Subgroup analysis based on author identity suggested the variance in video scores by source (p<0.05 for all). Overall scores were higher for videos produced by doctors and science communicators than for those made by institutional users, nurses, and the general public. Multiple linear regression analysis showed that having people in the video (69.20, p=0.0001) and including information on treatment choices (1.15, p=0.045) were significant, independent determinants of audience engagement. CONCLUSION: Public-directed TikTok videos on mpox frequently provide incomplete, inaccurate information, highlighting the potential risks of using TikTok as a health information source.