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1.
Artículo en Inglés | MEDLINE | ID: mdl-34062783

RESUMEN

The COVID-19 pandemic is a public health emergency of international concern, and the main measures to contain the spread of the coronavirus causing COVID-19 were social distancing, quarantine, and self-isolation. Although these policies are effective in containing the spread of the virus, they might represent a challenge to psychological well-being, increasing levels of depressive and anxiety-related symptoms. AIMS: We explored the frequency of anxiety and depression symptoms during COVID-19 restrictions and associations with sociodemographic factors in a Brazilian sample. METHOD: Data of a total of 936 Brazilian adults (68.2% women) aged 18 to 77 years old (M = 38.95, SD = 13.91) were collected through an online survey. RESULTS: In general, we observed a frequency of 17.36% for severe anxiety and 66.13% for severe depression symptoms, in which younger participants (18-39 years old) and women showed higher scores in anxiety and depression scales compared to older age groups. Logistic regressions showed that women were more likely to present severe symptoms of anxiety (20.4%) compared to men (10.9%), as well as respondents in the educational sector (24.3%) compared to those in the health sector (10%). CONCLUSIONS: We highlight the importance of mental health professionals in developing strategies to help younger adults to mitigate the effects of social restriction.


Asunto(s)
Pandemias , Adolescente , Adulto , Anciano , Ansiedad/epidemiología , Brasil/epidemiología , Estudios Transversales , Depresión/epidemiología , Brotes de Enfermedades , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
2.
Sensors (Basel) ; 21(9)2021 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-34063144

RESUMEN

Postural control decreases with aging. Thus, an efficient and accurate method of detecting postural control is needed. We enrolled 35 elderly adults (aged 82.06 ± 8.74 years) and 20 healthy young adults (aged 21.60 ± 0.60 years) who performed standing tasks for 40 s, performed six times. The coordinates of 15 joint nodes were captured using a Kinect device (30 Hz). We plotted joint positions into a single 2D figure (named a joint-node plot, JNP) once per second for up to 40 s. A total of 15 methods combining deep and machine learning for postural control classification were investigated. The accuracy, sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), and kappa values of the selected methods were assessed. The highest PPV, NPV, accuracy, sensitivity, specificity, and kappa values were higher than 0.9 in validation testing. The presented method using JNPs demonstrated strong performance in detecting the postural control ability of young and elderly adults.


Asunto(s)
Aprendizaje Automático , Equilibrio Postural , Anciano , Envejecimiento , Humanos , Adulto Joven
3.
Artículo en Inglés | MEDLINE | ID: mdl-34064950

RESUMEN

The use of traditional medicinal plants in Saudi Arabia stems mainly from consumers' belief in prophetic medicine. This study was conducted to explore changes in patients' use of dietary or herbal supplements among individuals infected with COVID-19 before and during infection and the association between herbal or dietary supplements and hospitalization. A cross-sectional, questionnaire-based study was conducted enrolling symptomatic patients who had recently recovered from COVID-19. Data were collected through phone interviews, and McNemar's test was used to investigate changes to consumption of dietary or herbal supplements before and during infection. Multivariable logistic regression was used to investigate the association between supplements use during patients' infection and hospitalization. A total of 738 patients were included in this study, of whom 32.1% required hospitalization. About 57% of participants were male with a mean age of 36.5 (±11.9) years. The use of lemon/orange, honey, ginger, vitamin C, and black seed among participants significantly increased during their infection. In contrast, patients using anise, peppermint, and coffee peel before their infection were more likely to stop using them during their infection. In addition, using lemon/orange (p < 0.0001), honey (p = 0.0002), ginger (p = 0.0053), vitamin C (p = 0.0006), black seed (p < 0.0001), peppermint (p = 0.0027), costus (p = 0.0095), and turmeric (p = 0.0012) was significantly higher among nonhospitalized patients than hospitalized ones. However, in the multivariable logistic regression, only use of vitamin C (OR = 0.51; 95% CI 0.33-0.79), peppermint (OR = 0.53; 95% CI 0.31-0.90), and lemon/orange (OR = 0.54; 95% CI 0.33-0.88) was associated with significantly lower odds of hospitalization. The study reveals that patients' consumption of dietary or herbal supplements changed in response to their COVID-19 infection, with hospitalized patients having a lower likelihood of using these supplements. Because some supplements were associated with lower odds of hospitalization, these supplements or their bioactive components should be further investigated as feasible options for COVID-19 treatment.


Asunto(s)
Adulto , Estudios Transversales , Suplementos Dietéticos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arabia Saudita/epidemiología , Adulto Joven
4.
Artículo en Inglés | MEDLINE | ID: mdl-34065093

RESUMEN

After a decrease in detected cases in the summer, Europe faced the emergence of a second wave of coronavirus disease 19 (COVID-19). Few studies have investigated adolescents, who may constitute a target group with possible lower compliance to public health measures, particularly the social distancing measures. A total sample of 492 participants was included in the study, and the ages of the participants ranged from 18-24 years. According to the hypothesis of our study, the sample was divided into two groups: those who experienced COVID-19 symptoms and those who did not experience COVID-19 symptoms. Demographic characteristics, knowledge, perceptions, and behaviors related to COVID-19 were investigated with ad hoc items; in addition, mood disorders, self-efficacy, and social connectedness were explored. Our results showed significant differences in the variables of risk perception, self-efficacy, and measures of belongingness among older adolescents who did or did not experience COVID-19 symptoms. In this period, adolescents experienced unprecedented disruptions in their daily lives, leading them to isolation and loneliness. Compliance with restrictive measures is considered both a proactive behavior and a social responsibility, especially if supported by prosocial reasons to prevent others from getting sick; therefore, this must be the focus of raising awareness of anti-COVID-19 compliance among adolescents.


Asunto(s)
Salud Mental , Adolescente , Adulto , Europa (Continente) , Humanos , Percepción , Aislamiento Social , Adulto Joven
5.
BMC Health Serv Res ; 21(1): 568, 2021 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-34107950

RESUMEN

BACKGROUND: The epidemiology and cost of surgical care delivery in low-and middle-income countries (LMICs) is poorly understood. This study characterizes the cost of surgical care, rate of catastrophic medical expenditure and medical impoverishment, and impact of surgical hospitalization on patients' households at Soroti Regional Referral Hospital (SRRH), Uganda. METHODS: We prospectively collected demographic, clinical, and cost data from all surgical inpatients and caregivers at SRRH between February 2018 and January 2019. We conducted and thematically analyzed qualitative interviews to discern the impact of hospitalization on patients' households. We employed the chi-square, t-test, ANOVA, and Bonferroni tests and built regression models to identify predictors of societal cost of surgical care. Out of pocket spending (OOPS) and catastrophic expenses were determined. RESULTS: We encountered 546 patients, mostly male (62%) peasant farmers (42%), at a median age of 22 years; and 615 caregivers, typically married (87%), female (69%), at a median age of 35 years. Femur fractures (20.4%), soft tissue infections (12.3%), and non-femur fractures (11.9%) were commonest. The total societal cost of surgical care was USD 147,378 with femur fractures (USD 47,879), intestinal obstruction (USD 18,737) and non-femur fractures (USD 10,212) as the leading contributors. Procedures (40%) and supplies (12%) were the largest components of societal cost. About 29% of patients suffered catastrophic expenses and 31% were medically impoverished. CONCLUSION: Despite free care, surgical conditions cause catastrophic expenses and impoverishment in Uganda. Femur fracture is the most expensive surgical condition due to prolonged hospitalization associated with traction immobilization and lack of treatment modalities with shorter hospitalization.


Asunto(s)
Composición Familiar , Gastos en Salud , Adulto , Femenino , Servicios de Salud , Humanos , Masculino , Pobreza , Uganda/epidemiología , Adulto Joven
6.
Artículo en Inglés | MEDLINE | ID: mdl-34081044

RESUMEN

INTRODUCTION: In response to the SARS-CoV-2 pandemic, physician attire has evolved to incorporate personal protective equipment (PPE). Although PPE is mandated for all healthcare workers, variability exists in choice and availability. The purpose of this study was to determine patient perception of physician attire during the COVID-19 pandemic in an outpatient setting. METHODS: Three hundred sixty-eight patients who presented to our outpatient orthopaedic clinics completed an anonymous survey. In addition to demographic characteristics, patient preferences for attire, PPE, and social distancing were obtained. RESULTS: Scrubs (81%, 298/368) were found to be the most acceptable physician attire. Eye protection (34.2%, 126/368) and gloves (32.6%, 120/368), however, were deemed much less acceptable; 93.5% (344/368) of patients reported that no mask was unacceptable, with 41.0% (151/368) preferring a surgical mask. Predilection for a surgical mask and N95 rose with increasing patient education level. Interestingly, 55.2% (203/368) responded that physicians should stop wearing PPE only when the Center for Disease Control recommends. CONCLUSION: During the COVID-19 pandemic, most of the patients found scrubs to be the most acceptable attire in an office-based outpatient setting. Patients also found physician mask-wearing to be important but are less accepting of providers wearing eye and hand protection.


Asunto(s)
Atención Ambulatoria , Actitud Frente a la Salud , COVID-19/prevención & control , Vestuario , Dispositivos de Protección de los Ojos , Guantes Quirúrgicos , Respiradores N95 , Satisfacción del Paciente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Escolaridad , Femenino , Humanos , Masculino , Máscaras , Persona de Mediana Edad , Equipo de Protección Personal , Ropa de Protección , SARS-CoV-2 , Encuestas y Cuestionarios , Adulto Joven
7.
MMWR Morb Mortal Wkly Rep ; 70(22): 807-810, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34081684

RESUMEN

The effect of HIV infection on COVID-19 outcomes is unclear. Studies in South Africa (1) and the United Kingdom (2) found an independent association between HIV infection and COVID-19 mortality; however, other studies have not found an association between poor COVID-19 outcomes and either HIV status among hospitalized patients (3-5) or HIV-associated factors such as CD4 count, viral load, or type of antiretroviral therapy (ART) (6). The effect of HIV infection on COVID-19 outcomes remains an urgent question in sub-Saharan Africa, where many countries are experiencing dual HIV and COVID-19 epidemics, and capacity to treat severe COVID-19 is limited. Using data from patients with probable or confirmed COVID-19 admitted to specialized treatment centers during March-December 2020 in Zambia, the Zambian Ministry of Health and CDC assessed the relationship between HIV infection and severe COVID-19 and COVID-19-associated death. Among 443 patients included in the study, 122 (28%) were HIV-positive, and of these, 91 (89%) were receiving ART at the time of hospitalization. HIV status alone was not significantly associated with severe COVID-19 at admission or during hospitalization or with COVID-19-associated death. However, among HIV-positive persons, those with severe HIV disease were more likely to develop severe COVID-19 and were at increased risk for COVID-19-associated death. Ensuring that persons maintain HIV disease control, including maintaining ART continuity and adherence, achieving viral suppression, and addressing and managing underlying medical conditions, could help reduce COVID-19-associated morbidity and mortality in sub-Saharan Africa.


Asunto(s)
COVID-19/mortalidad , COVID-19/terapia , Infecciones por VIH/epidemiología , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven , Zambia/epidemiología
8.
J Aging Stud ; 57: 100929, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34082999

RESUMEN

Early reports of COVID-19 often inaccurately presented the virus as a serious concern only among older adults. On the social media platform of Twitter, #BoomerRemover originated as a hashtag intended to express the age-related disparities of COVID-19. This study used a content analysis to examine tweets over a two-week period in March 2020 that used #BoomerRemover to discuss COVID-19 among older adults. A total of 1875 tweets were analyzed. Salient themes include: (1) There's a Real Intergenerational Divide, (2) Young People are Affected Too, (3) It's Being Used for Political Gain, and (4) #BoomerRemover is Simply Disrespectful. Findings suggest that many of the tweets employing #BoomerRemover were grounded in either personal or political ageism. In addition, a significant portion of tweeters used #BoomerRemover to defend older adults and speak out against ageism. This study highlights the importance of recognizing and addressing the growing intergenerational divide on social media, particularly during the COVID-19 pandemic.


Asunto(s)
Ageísmo/psicología , Ageísmo/estadística & datos numéricos , COVID-19/psicología , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Humanos , Persona de Mediana Edad , SARS-CoV-2 , Adulto Joven
9.
Mayo Clin Proc ; 96(6): 1418-1425, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34088413

RESUMEN

OBJECTIVE: To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. METHODS: A retrospective study of patients with rCDI who underwent FMT from May 26, 2020, to September 30, 2020, with stool from well-screened donors with health and infectious screening and a newly implemented strategy for COVID-19 screening with every 2-week bookend testing with stool quarantine. Patients were followed up for development of rCDI and COVID-19. RESULTS: Of the 57 patients who underwent FMT for rCDI, 29 were tested for COVID-19 via nasopharyngeal polymerase chain reaction (PCR) and 22 via serology. All results were negative, except for 1 positive serology. Donor testing every 2 weeks for COVID-19 via serology and nasopharyngeal swab PCR was negative, except for 2 donors at 1 center who were excluded. Three patients had rCDI after FMT, and 1 underwent repeat FMT. One patient developed respiratory symptoms suggestive of COVID-19 and tested negative via nasopharyngeal PCR. Eleven patients who underwent COVID-19 testing for elective procedures or hospitalizations tested negative. No SARS-CoV-2 transmission was noted. CONCLUSIONS: With appropriate donor screening, FMT can be performed safely for rCDI during the COVID-19 pandemic. Development of a validated stool assay for SARS-CoV-2 will simplify this process further.


Asunto(s)
COVID-19/epidemiología , Clostridioides difficile , Infecciones por Clostridium/terapia , Trasplante de Microbiota Fecal , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/diagnóstico , COVID-19/prevención & control , Trasplante de Microbiota Fecal/efectos adversos , Trasplante de Microbiota Fecal/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , SARS-CoV-2 , Adulto Joven
10.
Am J Case Rep ; 22: e931665, 2021 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-34120138

RESUMEN

BACKGROUND Since the outbreak of the SARS-CoV-2 infection, extensive research has been conducted on the pulmonary implications of this novel disease. However, there has been limited data on the extrapulmonary manifestations. There have been few documented causes of optic involvement and little is understood about the pathophysiology around its presentation and the possible treatments to prevent long-term complications. Here, we describe a case of optic neuritis in a female patient concurrently infected with SARS-CoV-2. Given the plethora of evidence supporting neurological manifestations of the virus, we hypothesize that there is an association between our patient's optic neuritis and her infection with SARS-CoV-2. CASE REPORT A 21-year-old woman with no past medical history who presented with blurry vision in her left eye. Optic neuritis was suspected with physical examination and confirmed with imaging of the optic nerve. Further diagnostic evaluation was nonsuggestive of multiple sclerosis and other demyelinating diseases; however, the patient was found to be positive for SARS-CoV-2. Steroids and remdesivir treatment were started, but without the presence of any respiratory symptoms. The patient's symptoms completely resolved by day 5 of hospitalization and she was discharged home without any complications. CONCLUSIONS Optic neuritis has remained an uncommon complication of SARS-CoV-2. This rather rare complication of SARS-CoV-2 is one that clinicians should be cognizant of due to the long-term implications of optic neuritis. Furthermore, it is pertinent to consider ophthalmic involvement in SARS-CoV-2 infection to appropriately guide patient care during the pandemic, as prompt treatment can lead to improved outcomes.


Asunto(s)
COVID-19 , Esclerosis Múltiple , Neuritis Óptica , Adulto , Femenino , Humanos , Neuritis Óptica/diagnóstico , Neuritis Óptica/etiología , Pandemias , SARS-CoV-2 , Adulto Joven
11.
Endocr Pract ; 27(6): 607-613, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34120701

RESUMEN

OBJECTIVE: The American Joint Committee on Cancer tumor node metastasis (TNM) staging system eighth edition (TNM-8) for differentiated thyroid cancer (DTC) has been introduced as a replacement for tumor node metastasis staging system seventh edition (TNM-7). We present the first study from a Middle Eastern population comparing these 2 versions of the TNM staging system. METHODS: We compared TNM-8 with TNM-7 in 701 patients with DTC seen during a 3-year period with a median age of 37 years (6-83) and a female-to-male ratio of 558 (79.6%) to 143 (20.4%). RESULTS: The number (%) of patients within each stage in TNM-7 and TNM-8, respectively, are as follows: stage I = 503 (71.6%) and 583 (83.2%), stage II = 52 (7.4%) and 81 (11.4%), stage III = 53 (7.6%) and 6 (0.9%), and stage IV = 93 (13.2%) and 31 (4.6%). Overall, 172 patients (24.5%) were downstaged in TNM-8 compared to that in TNM-7, as follows: 26, 30, and 24 patients from stages II, III, and IV in TNM-7 to stage I in TNM-8; 23 and 32 patients from TNM-7 stages III and IV to TNM-8 stage II; 6 patients from stage IVa in TNM-7 to stage III in TNM-8; and 31 patients from stage IVc in TNM-7 to stage IVb in TNM-8. TNM-7 and TNM-8 predicted the long-term outcome well (median follow-up, 7.9 years), but Kaplan-Meier analysis showed better separation of cancer-specific survival in TNM-8 compared to TNM-7. CONCLUSIONS: Compared with TNM-7, TNM-8 approximately downstaged a quarter of DTC patients and was more robust in separating the outcome of different stages over time.


Asunto(s)
Neoplasias de la Tiroides , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Hospitales , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Neoplasias de la Tiroides/patología , Adulto Joven
12.
Niger J Clin Pract ; 24(6): 833-840, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34121730

RESUMEN

Aims: To investigate the distribution, characteristics, and association with subarachnoid hemorrhage (SAH) of aneurysms identified in Turkish adult patients with computed tomography angiography (CTA) performed with suspicion of intracranial aneurysms and/or SAH. Subjects and Methods: A total of 356 patients (164 male, and 192 female) with a mean age of 55.6 ± 4.0 (range, 18-90) years were analyzed retrospectively. The dimension in millimeters, localization, type, and multiplicity of aneurysms were noted. The differences in these parameters between females and males were investigated. The correlations of sex, aneurysm size, multiplicity, and size with SAH were researched. Results: On 356 CTA, 140 cases were identified to have aneurysm (39.3%) (56 males [40.0%], 84 females [60.0%]). The incidence of aneurysms and SAH in females was high relative to males. In 140 patients, a total of 187 aneurysms were present (mean size, 7.25 ± 2.56 mm). The highest number of aneurysms was found in the middle cerebral artery 64 (34.2%) while the least was in posterior circulation 20 (10.7%). There was no significant difference between genders in terms of aneurysm size, type, and multiplicity. Individuals with aneurysm site on the internal carotid artery had lower SAH incidence. Receiver Operating Characteristic curve analysis results determined that individuals with aneurysm size >13.5 mm had increased incidence of SAH. Conclusions: The general properties of intracranial aneurysms investigated with CTA in Turkish adults had similarities to information defined in the literature. These results will likely be beneficial to direct approaches to aneurysm diagnosis and treatment in routine practice.


Asunto(s)
Aneurisma Intracraneal , Hemorragia Subaracnoidea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Angiografía Cerebral , Angiografía por Tomografía Computarizada , Femenino , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Hemorragia Subaracnoidea/diagnóstico por imagen , Hemorragia Subaracnoidea/epidemiología , Adulto Joven
13.
Niger J Clin Pract ; 24(6): 883-891, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34121737

RESUMEN

Background: Endotracheal suctioning is a vital procedure performed by intensive care nurses to maintain airway patency and optimal gas exchange in critically ill patients under mechanical ventilation. As the procedure can cause several complications, intensive care nurses should have adequate evidence-based knowledge on how to perform the procedure. Aims: This study aimed at examining intensive care nurses' knowledge and experience of the closed suctioning system. This study was a prospective, cross-sectional, descriptive, and multi-centered study conducted with 195 nurses working in the tertiary intensive care units in five Turkish hospitals. Subjects and Methods: The data were collected with a questionnaire developed by the researchers in light of the literature. The data were evaluated with Kruskal-Wallis and Mann-Whitney U tests. Results: The mean age of the nurses was 30.58 ± 6.28 years. The mean knowledge score of the nurses for the closed system was 27.35 ± 12.05 (range = 0-80) and 80.5% of them obtained scores ranging between 0 and 40. Also, 71.8% stated that they did not have any difficulty performing suctioning with the closed system catheter, and 85% said that they saved time with the closed system. However, 50.8% of the nurses said they were not able to suction viscous and sticky secretions efficiently, 44.6% stated they did not need to irrigate the inside of the catheter, and 45.1% of them were undecided whether the coude tip catheter led to hemorrhagic secretion more than straight tip catheter. Conclusions: Almost one-fifth of the nurses had good scores on evidence-based knowledge of suctioning. Most of the nurses' experiences regarding the use and manipulation of the closed system were positive. However, almost half of the nurses pointed out that the closed system was not effective enough to suction viscous and sticky secretions. Regular in-service training sessions may help to improve nurses' current knowledge and experiences.


Asunto(s)
Competencia Clínica , Enfermeras y Enfermeros , Adulto , Cuidados Críticos , Estudios Transversales , Humanos , Intubación Intratraqueal , Estudios Prospectivos , Adulto Joven
14.
Niger J Clin Pract ; 24(6): 925-936, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34121743

RESUMEN

Background: The high maternal death burden in developing countries when compared to the developed could be attributed to differences in use of antenatal and skilled delivery care. Aim: To assess the differences in utilization of antenatal and delivery services in urban and rural communities of Ebonyi state, Nigeria. Methods: A cross-sectional comparative study design was used. Two stage (cluster) sampling technique was used to select 660 women in 4 of 13 local government areas in the state. The respondents were women who were permanent residents of communities and have delivered in last one year. Outcome measure was good utilization of antenatal and delivery services and was assessed by proportion of respondents who obtained antenatal and delivery from a skilled provider and also made at least four antenatal visits. Results: The mean age of respondents was urban, 29.6 ± 6.2 and rural, 28.6 ± 5.1 years. Majority in urban, 51.8% utilized tertiary health facility for antenatal care while in rural, 77.9% used primary health centers (P < 0.001). Comparable proportions in urban, (77.3%) and rural, (79.1%) had good use of antenatal and delivery services (P = 0.572). Predictors of good use of antenatal and delivery services in urban included having one child (AOR = 4.8; 95%C1: 1.4--17.0), having attained tertiary education, (AOR = 2.6; 95%C1: 1.2--5.5), being in low socioeconomic class, (AOR = 0.4; 95%C1: 0.2--0.7), and having good knowledge of danger signs, (AOR = 2.6; 95%C1: 1.3--5.4). In rural, predictors included having one child, (AOR = 2.8; 95%C1:1.1--7.1), being unmarried, (AOR = 0.3; 95%C1: 0.1--0.9), and having good knowledge of danger signs (AOR = 3.7; 95%C1: 1.8--7.5). Conclusion: Utilization of antenatal and delivery services in health facilities in study area was high but there is room for improvement. There is need to plan specific interventions aimed at improving utilization of maternal health services by some groups like urban poor and unmarried mothers, especially teenagers. Emphasis should also be placed on improving community understanding of danger signs of pregnancy.


Asunto(s)
Servicios de Salud Materna , Población Rural , Adolescente , Adulto , Niño , Estudios Transversales , Parto Obstétrico , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Nigeria , Embarazo , Atención Prenatal , Adulto Joven
15.
Biomed Environ Sci ; 34(5): 348-355, 2021 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-34059171

RESUMEN

Objective: To examine increases in average height among Chinese children and adolescents. Methods: The data were obtained from the China Health and Nutrition Survey conducted during the period 1989-2015. A stratified multistage cluster sampling method was utilized to select participants aged 2-22 years in each province. Linear regression was used to examine the effects of age, birth cohort, and survey period on height. Results: A total of 15,227 males and 13,737 females were included in the final analysis. Age (A) showed a continuous effect on height. The average heights of the investigated groups increased continuously during the investigation period. By 2015, the average height of the overall group increased by 7.87 cm compared to the average height during the 1989 survey. Moreover, birth year (cohort, C) also had a stable effect on height. Using the height of individuals born in or before 1975 as a reference, the average height of each birth cohort increased in comparison to the previous birth cohort. Conclusions: The height of Chinese children and adolescents was affected by age, period, and cohort effects, and this effect is governed by certain rules. The age-period-cohort model can be used to analyze the trends of children's and adolescent's heights. The findings provide a scientific basis for the formulation of children's and adolescents' growth and development policies in China.


Asunto(s)
Desarrollo del Adolescente , Estatura , Desarrollo Infantil , Indicadores de Salud , Adolescente , Salud del Adolescente , Factores de Edad , Niño , Salud del Niño , Preescolar , China , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Lineales , Masculino , Factores Sexuales , Adulto Joven
16.
Biomed Environ Sci ; 34(5): 372-378, 2021 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-34059174

RESUMEN

Objective: To develop a preliminary subjective evaluation scale for assessing the built environments of China's Hygienic City Initiative and to evaluate its reliability and validity. Methods: The initial items of the scale were determined based on a review of policy documents and consultations with experts. The final items of the scale were confirmed through individual interviews with residents combined with the discretetrend method, critical ratio method, correlation coefficient method, and factor analysis method. Then, the dimensions of the scale were determined using exploratory factor analysis (EFA). The Cronbach's α coefficient, split-half reliability coefficient, and confirmatory factor analysis (CFA) were used to assess the reliability and validity of the scale. Results: A scale containing five dimensions with 22 items was established, including urban lifestyle, governance, basic functions, environmental sanitation, and amenities. The Cronbach's α coefficient of the scale was 0.876, and the split-half reliability coefficient was 0.796. The CFA results indicate that each inspection level was within the standard limit. Conclusion: The preliminarily subjective evaluation scale for assessing the built environments of China's Hygienic City Initiative demonstrates a high level of reliability and validity. Additional empirical studies should be carried out to further verify the value of the scale in terms of practical application.


Asunto(s)
Entorno Construido/psicología , Política de Salud , Higiene , Satisfacción Personal , Salud Urbana , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Percepción , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto Joven
17.
Biomed Environ Sci ; 34(5): 395-399, 2021 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-34059177

RESUMEN

Climate change has been referred to as one of the greatest threats to human health, with reports citing likely increases in extreme meteorological events. In this study, we estimated the relationships between temperature and outpatients at a major hospital in Qingdao, China, during 2015-2017, and assessed the morbidity burden. The results showed that both low and high temperatures were associated with an increased risk of outpatient visits. High temperatures were responsible for more morbidity than low temperatures, with an attributed fraction (AF) of 16.86%. Most temperature-related burdens were attributed to moderate cold and hot temperatures, with AFs of 5.99% and 14.44%, respectively, with the young (0-17) and male showing greater susceptibility. The results suggest that governments should implement intervention measures to reduce the adverse effects of non-optimal temperatures on public health-especially in vulnerable groups.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Enfermedades Cardiovasculares/etiología , Frío/efectos adversos , Enfermedades del Sistema Digestivo/etiología , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Calor/efectos adversos , Enfermedades Respiratorias/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/terapia , Niño , Preescolar , China/epidemiología , Costo de Enfermedad , Enfermedades del Sistema Digestivo/epidemiología , Enfermedades del Sistema Digestivo/terapia , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Distribución de Poisson , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/terapia , Factores de Riesgo , Adulto Joven
18.
Int J Mol Sci ; 22(9)2021 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-34068701

RESUMEN

In addition to its canonical functions, vitamin D has been proposed to be an important mediator of the immune system. Despite ample sunshine, vitamin D deficiency is prevalent (>80%) in the Middle East, resulting in a high rate of supplementation. However, the underlying molecular mechanisms of the specific regimen prescribed and the potential factors affecting an individual's response to vitamin D supplementation are not well characterized. Our objective is to describe the changes in the blood transcriptome and explore the potential mechanisms associated with vitamin D3 supplementation in one hundred vitamin D-deficient women who were given a weekly oral dose (50,000 IU) of vitamin D3 for three months. A high-throughput targeted PCR, composed of 264 genes representing the important blood transcriptomic fingerprints of health and disease states, was performed on pre and post-supplementation blood samples to profile the molecular response to vitamin D3. We identified 54 differentially expressed genes that were strongly modulated by vitamin D3 supplementation. Network analyses showed significant changes in the immune-related pathways such as TLR4/CD14 and IFN receptors, and catabolic processes related to NF-kB, which were subsequently confirmed by gene ontology enrichment analyses. We proposed a model for vitamin D3 response based on the expression changes of molecules involved in the receptor-mediated intra-cellular signaling pathways and the ensuing predicted effects on cytokine production. Overall, vitamin D3 has a strong effect on the immune system, G-coupled protein receptor signaling, and the ubiquitin system. We highlighted the major molecular changes and biological processes induced by vitamin D3, which will help to further investigate the effectiveness of vitamin D3 supplementation among individuals in the Middle East as well as other regions.


Asunto(s)
Colecalciferol/genética , Inmunomodulación/inmunología , Receptores de Lipopolisacáridos/genética , Receptor Toll-Like 4/genética , Vitamina D/genética , Adolescente , Adulto , Colecalciferol/administración & dosificación , Colecalciferol/inmunología , Suplementos Dietéticos , Femenino , Expresión Génica/efectos de los fármacos , Humanos , Inmunomodulación/efectos de los fármacos , Terapia Nutricional , Vitamina D/inmunología , Deficiencia de Vitamina D/dietoterapia , Deficiencia de Vitamina D/genética , Deficiencia de Vitamina D/inmunología , Deficiencia de Vitamina D/patología , Adulto Joven
19.
BMC Infect Dis ; 21(1): 520, 2021 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-34078300

RESUMEN

BACKGROUND: Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea. METHODS: N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009-2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified ß-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher's exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance. RESULTS: In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced ß-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018-2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment. CONCLUSIONS: The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.


Asunto(s)
Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana , Gonorrea/tratamiento farmacológico , Neisseria gonorrhoeae/efectos de los fármacos , Adolescente , Adulto , Anciano , Antibacterianos/farmacología , Farmacorresistencia Bacteriana/efectos de los fármacos , Femenino , Gonorrea/epidemiología , Gonorrea/microbiología , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Neisseria gonorrhoeae/aislamiento & purificación , República de Belarús/epidemiología , Adulto Joven
20.
NPJ Prim Care Respir Med ; 31(1): 33, 2021 06 03.
Artículo en Inglés | MEDLINE | ID: mdl-34083541

RESUMEN

Accurate prediction of the risk of progression of coronavirus disease (COVID-19) is needed at the time of hospitalization. Logistic regression analyses are used to interrogate clinical and laboratory co-variates from every hospital admission from an area of 2 million people with sporadic cases. From a total of 98 subjects, 3 were severe COVID-19 on admission. From the remaining subjects, 24 developed severe/critical symptoms. The predictive model includes four co-variates: age (>60 years; odds ratio [OR] = 12 [2.3, 62]); blood oxygen saturation (<97%; OR = 10.4 [2.04, 53]); C-reactive protein (>5.75 mg/L; OR = 9.3 [1.5, 58]); and prothrombin time (>12.3 s; OR = 6.7 [1.1, 41]). Cutoff value is two factors, and the sensitivity and specificity are 96% and 78% respectively. The area under the receiver-operator characteristic curve is 0.937. This model is suitable in predicting which unselected newly hospitalized persons are at-risk to develop severe/critical COVID-19.


Asunto(s)
COVID-19/diagnóstico , Hospitalización/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/análisis , COVID-19/patología , Niño , Preescolar , Progresión de la Enfermedad , Femenino , Humanos , Lactante , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Pronóstico , Tiempo de Protrombina , Curva ROC , Medición de Riesgo , Sensibilidad y Especificidad , Adulto Joven
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