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BACKGROUND: Primary biliary cholangitis (PBC) is a chronic, cholestatic liver disease that can lead to end-stage liver disease and impairs the quality of life. At current, most data come from few large cohorts. AIM: This cross-sectional study evaluated treatment response and symptom burden in patients with PBC in Germany to expand the available data. METHODS: A total of 140 PBC patients were prospectively enrolled at the outpatient liver clinic of the University Medical Center in Mainz starting in June 2016. Historic and current response rates of UDCA treatment were determined using published binary models. Symptom burden was assessed using the PBC-40 questionnaire. RESULTS: The primary treatment response ranged between 73 and 86% depending on the definition used. Importantly, this response rate was maintained over a median time of 5 years in follow-up. The highest symptom burden was observed for fatigue and emotional (2.4 ± 1; 2.3 ± 1.1 of 5), while pruritus (1.1 ± 1.1 of 5) had the lowest scores. IgG correlated with the PBC-40 domain social (r = 0.211, p = 0.032), while HDL inversely correlated with the symptom burden of pruritus (r = - 0.236; p = 0.018). CONCLUSION: In this tertiary care cohort, 75% of the patients showed biochemical response after 1 year according to the acknowledged Paris II criteria. Patients reported a significant symptom burden, and the domain fatigue of the PBC-40 was most prominently impaired.
Assuntos
Colagogos e Coleréticos/uso terapêutico , Cirrose Hepática Biliar/diagnóstico , Cirrose Hepática Biliar/tratamento farmacológico , Avaliação de Sintomas , Ácido Ursodesoxicólico/uso terapêutico , Idoso , Estudos Transversais , Feminino , Alemanha , Nível de Saúde , Humanos , Cirrose Hepática Biliar/complicações , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Qualidade de Vida , Fatores de Tempo , Resultado do TratamentoRESUMO
Introduction: Healthcare-associated infections, primarily caused by microorganisms, are widespread in healthcare facilities. These infections pose a significant challenge, especially in low and middle-income countries, and have a detrimental impact on patient outcomes. It is crucial to assess the level of microbial load and associated factors to prevent the spread of these infections. The objective of this study was to assess the microbial load and identify the factors associated with it in various wards at Jimma Medical Center. Method: A cross-sectional study conducted at Jimma Medical Center. Indoor air samples were collected using the settle plate method with a 1/1/1 scheme. Inanimate surfaces and medical equipment were sampled using Swabs from a 10 × 10 cm area. A total of 268 samples were collected from 10 rooms. Pertinent information regarding the associated factors was gathered using an observational checklist. A multiple linear regression model was used to identify any associations with the microbial load. Result: Out of the total samples, 181 (67.5%) tested positive for culture, and 270 microbes were isolated. The average load of bacteria and fungi in the indoor air ranged from 124.4 to 1607 and 96 to 814.6 Colony-forming unit (CFU)/m3, respectively. The mean total aerobic colony counts of bacteria and fungi from all surfaces in the wards ranged from 5.25 to 43.3 CFU/cm2. Crowdedness [ß = 2.748 (95% Confidence Interval (CI): 1.057-4.44)], the presence of waste material [ß = 1.747 (95% CI: 0.213-3.282)], and an unclean room [ß = 2.505 (95% CI: 0.990-4.019)] were significantly associated with the microbial load. Conclusion: The microbial load detected in indoor air, inanimate surfaces and medical equipment was posing potential health risks. Consequently, it is recommended to implement regular microbial surveillance of the hospital environment and enhance the infection prevention program to mitigate these concerns.
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Background: According to available studies, 12%-20% of reported foodborne outbreaks start in the household. It is projected that 1 out of every 10 persons will become ill as a result of consuming tainted food. Poor food handling practices cause 600 million foodborne illnesses each year. In a given year, this leads to 420 000 deaths. In Ethiopia, there is a scarcity of studies on home-food-safety practices and the factors that affect them. This has resulted in a shortage of relevant information on the status of home-food-related illnesses in the country. Methods: A community-based cross-sectional study was carried out from May to June 23, 2021. A standardized and pre-tested questionnaire was used to collect data from 622 households. The total plate count method was used to analyze bacteria on cleaned plates. Epi data version 3.1 was used to enter data, while SPSS version 25 was used to analyze the data. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with food safety practices. Result: 51.1% of the study participants had a safe food handling practice. The mean total plate count was 2.34 CFU/cm2. In the multivariable regression, Household wealth (AOR = 2.05, 95% CI [1.01-3.16]), Education (AOR = 3.33, 95% CI [1.41-6.31]), Training (AOR = 2.85, 95% CI: [1.31-3.19]), Knowledge of safe practices (AOR = 1.95, 95% CI [1.23-3.08], and Attitude (AOR = 2.04, 95% CI [1.09, 3.82]) were associated with safe food handling practices. Conclusion: Although data gathering systems for food-borne diseases typically overlook a large number of home-based outbreaks of sporadic infection, it is now widely understood that many episodes of food-borne sicknesses are caused by individuals' inappropriate food handling and preparation in their kitchens. In the current study, educational status, household wealth, food safety training, attitude, and knowledge about FBDs were found to be strongly associated with safe practices. This implies that public education is a key factor in improving food safety practices at home.
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Background: Tattoos and piercings, which were once considered taboo, are now widespread like an epidemic, among people of all ages and gender. The rising demand for such body alterations has given rise to a large number of infective complications. This study was, therefore, designed to assess the infection control knowledge, attitudes, and practices of body modification artists in Ethiopia, 2021. Methods: An anonymous observational cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 25 to June 22, 2021. The data collection instrument was a structured questionnaire that covered the participants' socio-demographic characteristics, knowledge, attitudes, and practices related to infection control. On the whole, 172 tattoo and body piercing artists participated in the study. SPSS v.20 software was used for data entry and analysis. Pearson's correlation test, t-test, Tukey's test, and multiple linear regression analysis were conducted during the data analysis. Results: Male participants constituted well over three-fourths (96.5%, n = 166) of the sample considered in the study. According to the result, the participants' knowledge of infection control received the lowest score (7.1 ± 1.22). Participants' scores of knowledge of infection control increased with an increase in their experience in the multiple linear regression. Experience and training time were also associated with knowledge. Infection control practice was positively associated with the respondents' attitudes. After controlling other variables, it was found that a one-unit increase in respondents' attitude scores increased their practice level by 86%. Conclusion: This is the first study in Ethiopia to examine tattooists' and body piercers' infection control knowledge, attitude, and practice. Minimum standards for infection control in inking and piercing establishments are necessary. It is therefore important that local authorities and public health professionals work towards laying down the minimum code of practice for infection control in inking and piercing establishments.