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1.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artículo en Español | LILACS, CUMED | ID: biblio-1252327

RESUMEN

La gastroenteritis causada por rotavirus constituye un importante problema de salud mundial, por lo que se recomienda incluir la vacunación contra el rotavirus en los programas de inmunización. Para evaluar el impacto de una futura introducción en Cuba de una vacuna contra este patógeno, resulta necesario crear una línea de base pre-vacunación de la carga de la gastroenteritis causada por este virus. Entre noviembre 2017 a abril 2018 se implementó en el Hospital Pediátrico de Centro Habana un sistema de vigilancia para la gastroenteritis causada por rotavirus. Se establecieron las definiciones para las categorías de caso sospechoso, probable y confirmado. Por cada niño captado se recogió una muestra de heces que se analizó con tiras rápidas y se confirmó la presencia de rotavirus por ELISA. Para determinar la severidad de la enfermedad se utilizó la escala de Vesikari. Los resultados fueron expresados en cifras absolutas y relativas, el análisis se realizó a través de la prueba de chi-cuadrado. Del total de ingresos por enfermedad diarreica aguda, el 26 por ciento cumplió los criterios de inclusión y el 46 por ciento resultó confirmado como rotavirus. El hacinamiento en el hogar y asistir al círculo infantil se comportaron como factores de riesgo. El servicio de gastroenterología absorbió la mayor carga de ingresos hospitalarios por esta causa. Los resultados mostrados validan la funcionalidad del sistema de vigilancia implementado y brindan nuevas evidencias sobre la carga de la enfermedad y la utilización de los servicios de un hospital pediátrico cubano, debido a la gastroenteritis provocada por rotavirus, lo que justifica la introducción de la vacuna(AU)


Gastroenteritis caused by rotavirus is a major global health problem, therefore it is recommended that vaccination against rotavirus be included in immunization programs. To evaluate the impact of a future introduction in Cuba of a vaccine against this pathogen, it is necessary to have a pre-vaccination baseline of the burden of gastroenteritis caused by rotavirus. Between November 2017 and April 2018, a surveillance system for gastroenteritis caused by rotavirus was implemented in the Paediatric Hospital of Centro Habana. Definitions were established for the categories of suspected, probable and confirmed cases. For each captured child, stool samples were collected, analyzed with rapid strips and confirmated by ELISA. To determine the severity of the disease, the Vesikari score was used. The results were expressed in absolute and relative figures; the analysis was performed through chi-square. Of the total admissions for acute diarrheal disease, 26 percent met the inclusion criteria and 46 percent were confirmed for rotavirus. Overcrowding at home and attending a day care center were risk factors. The gastroenterology service absorbed the greatest burden of hospital admissions for this cause. The results shown validate the role of the implemented surveillance system and provide new evidence on the burden of disease and use of services for rotavirus gastroenteritis in a cuban pediatric hospital(AU)


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Infecciones por Rotavirus/prevención & control , Factores de Riesgo , Vacunas contra Rotavirus , Diarrea/etiología , Gastroenteritis/epidemiología , Epidemiología Descriptiva , Estudios Prospectivos , Cuba , Estudios Observacionales como Asunto
2.
Biomolecules ; 11(6)2021 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-34073591

RESUMEN

Angiotensin-converting enzyme 2 (ACE-2) is the main cell entry receptor for severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2), thus playing a critical role in causing Coronavirus disease 2019 (COVID-19). The role of smoking habit in the susceptibility to infection is still controversial. In this study we correlated lung ACE-2 gene expression with several clinical/pathological data to explore susceptibility to infection. This is a retrospective observational study on 29 consecutive COVID-19 autopsies. SARS-CoV-2 genome and ACE-2 mRNA expression were evaluated by real-time polymerase chain reaction in lung tissue samples and correlated with several data with focus on smoking habit. Smoking was less frequent in high than low ACE-2 expressors (p = 0.014). A Bayesian regression also including age, gender, hypertension, and virus quantity confirmed that smoking was the most probable risk factor associated with low ACE-2 expression in the model. A direct relation was found between viral quantity and ACE-2 expression (p = 0.028). Finally, high ACE-2 expressors more frequently showed a prevalent pattern of vascular injury than low expressors (p = 0.049). In conclusion, ACE-2 levels were decreased in the lung tissue of smokers with severe COVID-19 pneumonia. These results point out complex biological interactions between SARS-CoV-2 and ACE-2 particularly concerning the aspect of smoking habit and need larger prospective case series and translational studies.


Asunto(s)
Enzima Convertidora de Angiotensina 2/metabolismo , COVID-19/patología , Pulmón/metabolismo , Anciano , Anciano de 80 o más Años , Enzima Convertidora de Angiotensina 2/genética , Teorema de Bayes , COVID-19/virología , Femenino , Humanos , Pulmón/patología , Masculino , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2/aislamiento & purificación , Fumadores
3.
Artículo en Inglés | MEDLINE | ID: mdl-34074233

RESUMEN

Abstract: With COVID-19 affecting millions of people around the globe, quarantine of international arrivals is a critical public health measure to prevent further disease transmission in local populations. This measure has also been applied in the repatriation of citizens, undertaken by several countries as an ethical obligation and legal responsibility. This article describes the process of planning and preparing for the repatriation operation in South Australia during the COVID-19 pandemic. Interagency collaboration, development of a COVID-19 testing and quarantining protocol, implementing infection prevention and control, and building a specialised health care delivery model were essential aspects of the repatriation operational planning, with a focus on maintaining dignity and wellbeing of the passengers as well as on effective prevention of COVID-19 transmission. From April 2020 to mid-February 2021, more than 14,000 international arrivals travellers have been repatriated under the South Australian repatriation operations. This paper has implications to inform ongoing repatriation efforts in Australia and overseas in a pandemic situation.


Asunto(s)
COVID-19/epidemiología , Control de Infecciones/legislación & jurisprudencia , Salud Pública/legislación & jurisprudencia , Cuarentena/legislación & jurisprudencia , COVID-19/diagnóstico , COVID-19/transmisión , Prueba de COVID-19/métodos , Prueba de COVID-19/normas , Atención a la Salud , Humanos , Control de Infecciones/métodos , Reglamento Sanitario Internacional , Pandemias , Salud Pública/métodos , Cuarentena/métodos , Medición de Riesgo , Factores de Riesgo , SARS-CoV-2/aislamiento & purificación , Australia del Sur/epidemiología , Viaje
4.
BMC Infect Dis ; 21(1): 512, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-34074249

RESUMEN

BACKGROUND: Migrants are a high priority group for TB control measures due to their high exposure to risk factors such as poverty and social vulnerability. The study aimed to identify factors associated with latent TB among international migrants living in four Brazilian state capitals. This was a cross-sectional study conducted in September and October 2020 in a sample of 903 international migrants living in four Brazilian state capitals: Boa Vista/RR (458), Manaus/AM (136), São Paulo/SP (257), and Curitiba/PR (52). Data were collected with a questionnaire consisting of open and closed questions on personal characteristics, information on TB, and use of preventive measures. Tuberculin skin test (TST) was performed, with reading after 72 h by trained nurses and using 5 mm induration as the positive cutoff. Chi-square test (X2) and Fisher's exact test, both two-tailed, were used to compare statistically significant levels of association between the migrants´ sociodemographic characteristics, vulnerability, and latent TB infection (LTBI). Binary logistic regression was applied to calculate odds ratios and respective 95% confidence intervals. For all the tests, type I error of 5% was defined as statistically significant (p < 0.05). RESULTS: Prevalence of LTBI among migrants was 46.1% in Manaus/AM, 33.3% in São Paulo/SP, 28.1% in Curitiba/PR, and 23.5% in Boa Vista/RR. Factors associated with latent infection were age, male gender, and brown or indigenous race. CONCLUSIONS: The study showed high prevalence of latent TB among international migrants.


Asunto(s)
Tuberculosis Latente/epidemiología , Migrantes/estadística & datos numéricos , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Prueba de Tuberculina/efectos adversos
5.
BMC Infect Dis ; 21(1): 514, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-34074256

RESUMEN

BACKGROUND: Talaromyces marneffei (TM) bloodstream infection is common in Acquired Immunodeficiency Syndrome (AIDS) patients with extreme immunodeficiency in Southeast Asia and South China, however, clinical case study on TM bloodstream infection is scarce. We retrospectively analyzed the clinical characteristics of TM bloodstream infection in hospitalized AIDS patients and determined the outcomes of hospitalization after diagnosis in our hospital over the past 5 years. METHODS: From January 2015 to July 2020, 87 cases of TM detected by blood culture in patients admitted to our center were collected. The admission complaints, blood cells, biochemistry, CD4 and CD8 cell counts and 1,3-ß-D-glucan (BDG), procalcitonin (PCT), CRP level on the day of blood culture test, and outcomes during hospitalization were analyzed. Logistic regression analysis was performed for the risk factors for poor prognosis (60 cases). Spearman correlation analysis was used to analyze the correlation between peripheral blood cells, albumin and the time required for TM turnaround in blood culture. The difference was statistically significant when the P value was < 0.05. RESULTS: A total of 87 patients were collected, with a median age of 34 years, a median hemoglobin of 94 g/L and CD4 count of 7/µl. The rate of TM bloodstream infection among all in-hospital patients increased from 0.99% in 2015 to 2.09% in 2020(half year). Patients with TM bloodstream infection with CD8 count < 200/µl had a 12.6-fold higher risk of poor prognosis than those with CD8 count > 200/µl (p = 0.04), and those with BDG < 100 pg/mL had a 34.9-fold higher risk of poor prognosis than those with BDG > 100 pg/mL (p = 0.01). CONCLUSIONS: TM bloodstream infection is becoming more common in advanced AIDS patients in endemic areas. For those patients with extremely low CD4 and CD8 cell counts below 200/µl is with an increased risk of poor prognosis.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Fungemia/epidemiología , Micosis/epidemiología , Talaromyces/aislamiento & purificación , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Adulto , China/epidemiología , Femenino , Fungemia/diagnóstico , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Micosis/diagnóstico , Pronóstico , Estudios Retrospectivos , Factores de Riesgo
6.
BMC Emerg Med ; 21(1): 67, 2021 06 02.
Artículo en Inglés | MEDLINE | ID: mdl-34078273

RESUMEN

BACKGROUND: Coronavirus disease highly contagious, is prevalent in all age and sex groups infecting the respiratory system. The present study seeks to investigate the epidemiology and effective factors in mortality of patients with COVID-19 in Ardabil province, northwestern Iran. METHODS: In a retrospective study, the hospitalized patients with laboratory-diagnosed COVID-19 between February to August 2020 were enrolled. The data registration portal was designated according to Iranian Ministry of Health and Medical Education guidelines. In this portal, demographic information, clinical presentation, laboratory and imaging data were registered for patients in all hospitals in the same format. The Hosmer-Lemeshow strategy was used for variable selection in a multiple model. RESULTS: Of the patients involved 2812(50.3%) were male and 150 (2.7%) had contact with a confirmed case of COVID-19 in the last 14 days. Pre-existing comorbidity was reported in 1310 (23.4%) patients. Of all patients, 477(8.5%) died due to COVID-19. the result of the multiple logistic regression model indicated that after adjusting for other factors, higher age (OR = 3.11), fever or chills (OR = 1.61), shortness of breath (OR = 1.82), fatigue (OR = 0.71), headache (OR = 0.64), runny nose (OR = 1.54), Skeletal muscle pain (OR = 1.53), hospitalization (OR = 5.66), and hospitalization in ICU (OR = 5.12) were associated with death. CONCLUSIONS: Hospitalization had the strongest effect on mortality followed by hospitalization in ICU, and higher age. This study showed that having some extra-pulmonary symptoms in contrast with pulmonary symptoms can predict as good prognostic factors.


Asunto(s)
COVID-19/mortalidad , Hospitalización/estadística & datos numéricos , Neumonía Viral/mortalidad , Adulto , Distribución por Edad , Factores de Edad , Anciano , COVID-19/terapia , Comorbilidad , Femenino , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Neumonía Viral/terapia , Estudios Retrospectivos , Factores de Riesgo
7.
Arch Esp Urol ; 74(5): 503-510, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34080570

RESUMEN

OBJECTIVES: The goal of current study was to evaluate prevalence of postoperative urinary tract infections (UTI) following flexible ureteroscopy (f-URS) and to determine predictive factors for those UTIs. METHODS: A total of 420 patients with urolithiasis that underwent f-URS between August 2018 and August 2019 were enrolled in the study. Peri-operative characteristics of patients with and without postoperative UTIs were compared using univariate analyses. Predictive factors for UTIs following f-URS were determined using multivariate logistic regression analysis. RESULTS: Forty-one (9.8%) out of 420 patients had postoperative urinary infection after f-URS and those patients were classified as group 1. Group 2 consisted of 379 patients that did not develop postoperative UTIs. The percentage of female gender was 58.5% vs 42% in groups 1 and 2, respectively (p=0.042). The preoperative UTI history rate was 51.2% vs 20.8% (p<0.001) and preoperative double J stent (DJS) insertion rate 39% vs 17.7% in groups 1 and 2, respectively (p=0.001). Univariate regression analyses showed that the female gender (OR=1.98), history of UTI (OR=3.99), and preoperative DJS insertion (OR=2.98) significantly increased the possibility of postoperative UTI (p<0.05). Multivariate regression analyses revealed that history of UTI (OR=3.41, 95%CI:1.73-6.72, p<0.001) and preoperative DJS insertion (OR=2.30, 95%CI:1.13-4.68, p=0.021) were independent risk factors for infectious complications following f-URS. If both factors are present, the probability of infection is 55.2%. CONCLUSIONS: Even if f-URS is considered a safe procedure, the risk of postoperative infectious complications is far from negligible. We found that the presence of UTI history and preoperative DJS were independent risk factors for UTI after f-URS.


Asunto(s)
Litotricia , Infecciones Urinarias , Femenino , Humanos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Ureteroscopios , Ureteroscopía/efectos adversos , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiología
8.
Sci Total Environ ; 784: 147106, 2021 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-34088062

RESUMEN

Fine particle matter (PM2.5) is recognized as atrial fibrillation (AF) risk factor, especially for older adults. However, studies on the relationship between PM2.5 and AF were inconsistent. Herein, we present a systematic review to further assess the correlation between PM2.5 and AF in older adults (average age > 50 years old). A comprehensive search was conducted with the keywords in PubMed (675 records), Web of Science (1130 records), Embase (82 records), and the Cochrane Library (42 records). Using Stata12.0 software to test the heterogeneity between studies, and select the corresponding model to calculate the comprehensive effect value, odds ratio (OR, odds ratio), the pooled %-change (percentage change) and its 95% confidence interval (CL, confidence interval). A total of 16 observational studies were included, involving 10,580,394 participants, the results showed that PM2.5 had an adverse effects on AF in older adults. An association was found between exposure to PM2.5 (per 10 µg/m3 increase) and AF in older adults, with the corresponding pooled OR (1.11, 95% CI: 1.03-1.19) and pooled %-change (1.01%, 95% CI: 0.14%-1.88%). Our study indicated that PM2.5 exposure was significantly related to increased incidence of AF in older adults. Both the pooled OR and %-change value were higher in areas with higher levels of PM2.5(≥25 µg/m3).


Asunto(s)
Contaminantes Atmosféricos , Fibrilación Atrial , Anciano , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Fibrilación Atrial/inducido químicamente , Fibrilación Atrial/epidemiología , Humanos , Incidencia , Persona de Mediana Edad , Material Particulado/efectos adversos , Material Particulado/análisis , Factores de Riesgo
9.
BMC Public Health ; 21(1): 1063, 2021 06 04.
Artículo en Inglés | MEDLINE | ID: mdl-34088290

RESUMEN

BACKGROUND: Coronavirus Disease 2019 (COVID-19) is a global pandemic and an anxiety-provoking event. There are few studies to identify potential risk and protective factors related to anxiety during COVID-19 pandemic. METHODS: We collected information on demographic data and lifestyles by a web-based survey of 19,802 participants from 34 provinces in China during COVID-19 pandemic. Level of anxiety was evaluated using the Self-Rating Anxiety Scale. We used ordinal multivariable logistic regression to estimate the associations of anxiety level with potential risk and protective factors. We further developed a new score to simplify the assessment of anxiety during COVID-19 crisis. RESULTS: Among 19,802 participants, we found that those who were front-line medical personnel, suffered from chronic disease, with present symptoms of SARS-CoV-2 infection or contact history had 112, 93, 40 and 15% increased risk of higher anxiety level; while those with knowledge about personal protective measures or wore masks had 75 and 29% lower risk of higher anxiety level respectively. We developed a risk score by calculating the sum of single score of 17 factors. Each one increase of the risk score was associated with a 297% increase in anxiety index score. In categorical analysis, low risk (the risk score between 1 to 2), the moderate risk group (the risk score of 3) and high risk group (the risk score ≥ 4) had - 0.40 (95% CI: - 1.55, 0.76), 1.44 (95% CI: 0.27, 2.61) and 9.18 (95% CI: 8.04, 10.33) increase in anxiety index score, and 26% (95% CI: - 7, 72%), 172% (95% CI: 100, 270%), and 733% (95% CI: 516, 1026%) higher risk of anxiety respectively, when compared with the very low risk group (the risk score of 0). The AUC was 0.73 (95% CI, 0.72, 0.74) for the model fitted the developed risk score, with the cut-off point of 3.5. CONCLUSIONS: These findings revealed protective and risk factors associated with anxiety, and developed a simple method of identifying people who are at an increased risk of anxiety during COVID-19 pandemic.


Asunto(s)
COVID-19 , Pandemias , Ansiedad/epidemiología , China/epidemiología , Estudios Transversales , Depresión , Humanos , Pandemias/prevención & control , Factores Protectores , Factores de Riesgo , SARS-CoV-2 , Encuestas y Cuestionarios
10.
BMC Public Health ; 21(1): 1060, 2021 06 04.
Artículo en Inglés | MEDLINE | ID: mdl-34088306

RESUMEN

BACKGROUND: COVID-19 has been a major human threat for a year. A large number of people have been infected and killed globally, including hill tribe people living in remote and border areas between Thailand and Myanmar. Different expectations of and experiences with the implemented disease prevention and control measures by local, national and international organizations have been widely reported. This study aimed to understand the experiences and expectations regarding the disease prevention and control measures that were implemented among hill tribe people in Thailand. METHODS: Qualitative data were collected from participants aged 20 and older who belonged to the hill tribes living on the border of northern Thailand and Myanmar. A semistructured questionnaire was used to guide interviews. Information was extracted for thematic analysis by the NVivo program. RESULTS: Fifty-seven participants (36 female, 21 male) were interviewed; 27 participants were Thai Yai, 14 participants were Yunnan Chinese, 8 participants were Akha, and 8 participants were from other tribes. The average age was 45.8 years (min = 20 years, max = 90 years). Thirty participants had never attended school, and the other 27 participants had received education at different levels, from primary school to higher education. Forty participants were unemployed, 13 worked as agriculturists, and the other 4 were attending school. Both positive experiences, such as improving personal hygiene practices, maintaining close contact and increasing relationships among family members and demonstrating the leadership of the villager leaders, and negative experiences, including interruption of social interactions, family financial problems, poor access to medical care services, and invisible people to the government, were found. Different expectations were observed regarding organizations at the local, national, and international levels. Expectations at the local level included villagers and community leaders taking action to strongly contribute to prevention and control measures and to prevent unscreened people from entering the village. Obtaining accurate information about the disease and being financially supported were expectations at the national level, while closing borders to protect cases from overflowing into their villages was an international-level expectation. CONCLUSION: Although hill tribes reside in very remote rural areas, they experience both positive and negative effects of the disease prevention and control measures implemented by organizations. Their expectations are formally and informally voiced to policy makers at the local, national and international levels.


Asunto(s)
COVID-19 , Motivación , China , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mianmar , Factores de Riesgo , SARS-CoV-2 , Tailandia
11.
BMJ Open ; 11(6): e046931, 2021 06 04.
Artículo en Inglés | MEDLINE | ID: mdl-34088708

RESUMEN

OBJECTIVE: To assess the impact of the COVID-19 outbreak on cardiovascular disease (CVD) related mortality and hospitalisation. DESIGN: Community-based prospective cohort study. SETTING: The UK Biobank. PARTICIPANTS: 421 372 UK Biobank participants who were registered in England and alive as of 1 January 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome of interest was CVD-related death, which was defined as death with CVD as a cause in the death register. We retrieved information on hospitalisations with CVD as the primary diagnosis from the UK Biobank hospital inpatient data. The study period was 1 January 2020 to June 30 2020, and we used the same calendar period of the three preceding years as the reference period. In order to control for seasonal variations and ageing of the study population, standardised mortality/incidence ratios (SMRs/SIRs) with 95% CIs were used to estimate the relative risk of CVD outcomes during the study period, compared with the reference period. RESULTS: We observed a distinct increase in CVD-related deaths in March and April 2020, compared with the corresponding months of the three preceding years. The observed number of CVD-related deaths (n=218) was almost double in April, compared with the expected number (n=120) (SMR=1.82, 95% CI 1.58 to 2.07). In addition, we observed a significant decline in CVD-related hospitalisations from March onwards, with the lowest SIR observed in April (0.45, 95% CI 0.41 to 0.49). CONCLUSIONS: There was a distinct increase in the number of CVD-related deaths in the UK Biobank population at the beginning of the COVID-19 outbreak. The shortage of medical resources for hospital care and stress reactions to the pandemic might have partially contributed to the excess CVD-related mortality, underscoring the need of sufficient healthcare resources and improved instructions to the public about seeking healthcare in a timely way.


Asunto(s)
COVID-19 , Bancos de Muestras Biológicas , Brotes de Enfermedades , Inglaterra/epidemiología , Humanos , Estudios Prospectivos , Factores de Riesgo , SARS-CoV-2 , Reino Unido/epidemiología
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 507-509, 2021 Jun 09.
Artículo en Chino | MEDLINE | ID: mdl-34098664

RESUMEN

The common chronic disorders in the world, such as cardiovascular diseases, diabetes mellitus, cancers, etc., are all the multi-factorial diseases. They are caused by the interactions of various risk factors among which inflammation plays an important role in the pathogenesis of all these chronic disorders. Any factor which contributes or enhances systemic inflammatory burdens may serve as the risk factors of these diseases. During periodontitis, the bacteremia and subsequent systemic dispersal of periodontal pathogens and bacterial components may elicit production of pro-inflammatory immune mediators, and the pro-inflammatory immune mediators produced locally at the periodontal lesion may also enter the systemic circulation. Behaving as a potential source for increased chronic systemic inflammatory challenge, periodontitis contributes as the risk factor of these systemic inflammation associated chronic diseases.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus , Periodontitis , Humanos , Inflamación , Factores de Riesgo
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 584-590, 2021 Jun 09.
Artículo en Chino | MEDLINE | ID: mdl-34098676

RESUMEN

Periodontitis is closely related to systemic health, especially cardiovascular disease. Periodontal pathogens from periodontal infection actively participate in the formation and development of coronary atherosclerosis. At present, accumulcted evidences show that periodontal pathogen infection is an independent risk factor for cardiovascular events, which promotes the deepening of atherosclerosis through a variety of immune inflammation and metabolism-related molecular mechanisms. The present article reviews multipal aspects of the correlation between periodontitis and periodontal pathogens and cardiovascular disease, and the mechanism of periodontal pathogens affecting the occurrence and development of atherosclerosis.


Asunto(s)
Aterosclerosis , Enfermedades Cardiovasculares , Periodontitis , Humanos , Inflamación , Factores de Riesgo
14.
Zhonghua Yi Xue Za Zhi ; 101(21): 1572-1582, 2021 Jun 08.
Artículo en Chino | MEDLINE | ID: mdl-34098684

RESUMEN

Objective: To explore the risk factors for carbapenem-resistant Enterobacterales (CRE) infection and death. Methods: A case-control analysis of 482 inpatients in 18 secondary or tertiary hospitals in Beijing in 2018 was conducted. Patients infected by CRE were selected as the case group (n=247), and infected by carbapenem susceptible Enterobacterales (CSE) as the control group (n=235). The risk factors and clinical prognosis of CRE infection were analyzed by single factor analysis and multivariate logistic regression analysis. Results: CRE were resistant to most antimicrobials, but were highly sensitive to colistin and tigecycline, with sensitivity of 94.0% and 99.5%, respectively. Multivariate analysis showed that prior 30-day tracheal intubation (OR=2.607, 95%CI: 1.655-4.108, P<0.001), empirical treatment using third or fourth generation cephalosporins (OR=2.339, 95%CI: 1.438-3.803, P=0.001), carbapenems (OR=2.468, 95%CI: 1.610-3.782, P<0.001) and quinolones (OR=2.042, 95%CI: 1.268-3.289, P=0.003) were independent risk factors for CRE infection. Mechanical ventilation (OR=3.390, 95%CI: 1.454-7.904, P=0.005), heart failure (OR=4.679, 95%CI: 1.975-11.083, P<0.001), moderate or severe liver disease (OR=3.057, 95%CI: 1.061-8.806, P=0.038), prior 30-day quinolones exposure (OR=2.882, 95%CI: 1.241-6.691, P=0.014) and septic shock (OR=7.772, 95%CI: 3.505-17.233, P<0.001) were independent risk factors for death after CRE infection. Conclusions: Reducing the use of antimicrobials and invasive procedures such as prior 30-day tracheal intubation may reduce the probability of CRE infection. Grading the severity of the underlying disease in patients with CRE infection, as well as predicting and preventing the occurrence of septic shock will help reduce the risk of death.


Asunto(s)
Enterobacteriaceae Resistentes a los Carbapenémicos , Infección Hospitalaria , Infecciones por Enterobacteriaceae , Antibacterianos/uso terapéutico , Carbapenémicos , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/epidemiología , Humanos , Pronóstico , Factores de Riesgo
15.
Zhonghua Yan Ke Za Zhi ; 57(6): 426-432, 2021 Jun 11.
Artículo en Chino | MEDLINE | ID: mdl-34098691

RESUMEN

Objective: To identify factors associated with persistent subretinal fluid (SRF) after scleral buckling and to evaluate surgical outcomes of patients with primary rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study and cohort study. This study included 104 patients (104 eyes) who underwent scleral buckling for repair of RRD between January 2016 and June 2017. Several statistically significant risk factors associated with SRF were screened out with univariate analysis. Then independent risk factors were determined with multivariate stepwise logistic regression analysis. Examinations were taken preoperatively, at 1, 3, 6, and 12 months postoperatively, and thereafter every six months. Patients were divided into two groups depending on the presence or absence of persistent SRF on optical coherence tomography at 1 month. Results: Persistent SRF occurred in 69.2% (72/104) of patients. In multivariate analysis, younger age (OR=32.860, 95%CI=3.636-296.986, P=0.002), high myopia (OR=7.229, 95%CI=1.217-42.94, P=0.03) and macula-involving retinal detachment (OR=357.397, 95%CI=29.761-4292.0, P=0.000) were associated with persistent SRF. Best corrected visual acuity in patients with SRF at 1 month (0.71±0.18 vs. 0.58±0.11; t=4.047, P<0.01) and 3 months (0.55±0.15 vs. 0.43±0.12; t=3.914, P<0.01) was worse than that in patients with absence of SRF. Best corrected visual acuity in patients with SRF was 0.44±0.16 at 6 months, 0.37±0.12 at 12 months and 0.36±0.10 at the last follow-up, with no significant difference from patients without SRF at the three time points (0.39±0.13, 0.38±0.12 and 0.35±0.09; t=1.643, -0.202, 0.464; P>0.05). Conclusions: RRD patients with younger age, high myopia and macular involvement were more likely to develop persistent SRF after scleral buckling. The presence of persistent SRF slowed visual recovery but did not influence the final visual outcomes. (Chin J Ophthalmol, 2021, 57: 426-432).


Asunto(s)
Desprendimiento de Retina , Líquido Subretiniano , Estudios de Cohortes , Estudios Transversales , Humanos , Modelos Logísticos , Desprendimiento de Retina/cirugía , Estudios Retrospectivos , Factores de Riesgo , Curvatura de la Esclerótica , Tomografía de Coherencia Óptica , Agudeza Visual
16.
Soins Gerontol ; 26(149): 34-38, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34083013

RESUMEN

The objective of this study was to compare three hierarchical intervention strategies of an educational program for the prevention of falls in elderly people in a follow-up and rehabilitation care facility, and to evaluate the compliance with the recommendations related to extrinsic risk factors for falls, behavioral and environmental.


Asunto(s)
Estudios de Seguimiento , Anciano , Humanos , Factores de Riesgo
17.
Curr Oncol ; 28(3): 2007-2013, 2021 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-34073214

RESUMEN

The COVID-19 situation is a worldwide health emergency with strong implications in clinical oncology. In this viewpoint, we address two crucial dilemmas from the ethical dimension: (1) Is it ethical to postpone or suspend cancer treatments which offer a statistically significant benefit in quality of life and survival in cancer patients during this time of pandemic?; (2) Should we vaccinate cancer patients against COVID-19 if scientific studies have not included this subgroup of patients? Regarding the first question, the best available evidence applied to the ethical principles of Beauchamp and Childress shows that treatments (such as chemotherapy) with clinical benefit are fair and beneficial. Indeed, the suspension or delay of such treatments should be considered malefic. Regarding the second question, applying the doctrine of double-effect, we show that the potential beneficial effect of vaccines in the population with cancer (or those one that has had cancer) is much higher than the potential adverse effects of these vaccines. In addition, there is no better and less harmful known solution.


Asunto(s)
COVID-19/prevención & control , Toma de Decisiones Clínicas/ética , Neoplasias/tratamiento farmacológico , Selección de Paciente/ética , Tiempo de Tratamiento/ética , Antineoplásicos/administración & dosificación , COVID-19/epidemiología , COVID-19/inmunología , COVID-19/virología , Vacunas contra la COVID-19/administración & dosificación , Vacunas contra la COVID-19/efectos adversos , Humanos , Oncología Médica/ética , Neoplasias/inmunología , Neoplasias/mortalidad , Neoplasias/psicología , Pandemias/prevención & control , Calidad de Vida , Factores de Riesgo , SARS-CoV-2/inmunología , Factores de Tiempo , Vacunación/efectos adversos , Vacunación/ética
18.
Wiad Lek ; 74(5): 1099-1103, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34090271

RESUMEN

OBJECTIVE: The aim: Of the work was to study and evaluate the risk factors and the level of primary medical care for children with overweight and obesity. PATIENTS AND METHODS: Materials and methods: A sociological survey was conducted in main (413 persons) and control group (396 persons) and the copying from the history of the child's development (f.112/a) of 280 obese children was conducted. RESULTS: Results: It was defined that on the development of excess weight in children and adolescents, biological and social and hygienic factors had a significant impact (η ≥ 3%; p<0,001) and that the level of primary medical care for obese children (proved diagnosis of obesity in the history of the child (f. №.112/а) had only 61,7±2,7% of patients) was insufficient. CONCLUSION: Conclusions: Identification of comprehensive priority activities for solving problem of children overweight and obesity based on the results of conducted research were done.


Asunto(s)
Obesidad Pediátrica , Adolescente , Niño , Humanos , Sobrepeso , Obesidad Pediátrica/epidemiología , Obesidad Pediátrica/terapia , Factores de Riesgo , Encuestas y Cuestionarios , Aumento de Peso
19.
J Pak Med Assoc ; 71(5): 1438-1441, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34091630

RESUMEN

OBJECTIVE: To determine the prevalence and determinants of prediabetes among adolescents. METHODS: The cross-sectional study was conducted at a public-sector medical university in Quetta, Pakistan, from December 2019 to February 2020, and comprised students aged 16-19 years. A self-administered questionnaire was used to gather socio-demographic data. Fasting blood sample was taken to measure the fasting plasma glucose level, lipid profile and glycated haemoglobin levels. Height, weight, neck circumference and waist circumference were also measured. Data was analysed using SPSS 21. RESULTS: Of the 351 subjects, 158(45%) were males and 193(55%) were females. The overall mean age was 18.81±0.41 years. Of the total, 81(23.1%) participants were found to have prediabetes. Neck circumference was identified as the strongest predictor for prediabetes, followed by high level of triglycerides, high systolic blood pressure, low levels of high-density lipoproteins, high levels of low-density lipoproteins, high diastolic blood pressure, waist circumference and body mass index (p<0.05). There was no significant difference in the prevalence of prediabetes among male and female students (p>0.05). CONCLUSIONS: There was no significant difference in the prevalence of prediabetes among male and female medical students. Neck circumference, Waist circumference, Body mass index, systolic blood pressure, Diastolic blood pressure, Triglyceride and High density Lipoprotein were strong predictors of prediabetes in adolescent population.


Asunto(s)
Epidemias , Estado Prediabético , Estudiantes de Medicina , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Pakistán/epidemiología , Estado Prediabético/epidemiología , Factores de Riesgo , Universidades , Adulto Joven
20.
J Pak Med Assoc ; 71(5): 1446-1449, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34091632

RESUMEN

OBJECTIVE: To perform a clinical audit of the practices related to the management of third and fourth degree perineal tears. METHODS: The retrorspective study was conducted in 2019 at the Aga Khan University Hospital, Karachi, and comprised medical records from January 2008 to December 2018 of women having singleton term vaginal delivery and sustaining obstetric anal sphincter injuries. The change in practices regarding tear management was compared with a previous audit done at the same institution in 2008. Data was analysed using SPSS 20. RESULTS: Of the 25,370 deliveries, 142(0.56%) sustained obstetric anal sphincter injuries. There was a significant increase compared to the previous audit in terms of documentation of the method of repair, use of delayed absorbable suture material for the repair of external anal sphincter and follow-up at 6 weeks to see the success of repair and plan the next delivery (p<0.05). The use of vacuum vaginal delivery increased to 27(19%) from 5(4%), but there was decrease in injuries complicated by instrumental vaginal deliveries (p<0.05). CONCLUSIONS: Despite the increase in the number of deliveries, the frequency of obstetric anal sphincter injuries remained similar to the previous audit, indicating that regular clinical audits are integral to keeping clinical practice in accordance with the established standards.


Asunto(s)
Laceraciones , Complicaciones del Trabajo de Parto , Auditoría Clínica , Femenino , Humanos , Laceraciones/epidemiología , Laceraciones/cirugía , Complicaciones del Trabajo de Parto/epidemiología , Complicaciones del Trabajo de Parto/cirugía , Embarazo , Estudios Retrospectivos , Factores de Riesgo
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