Prevention of Postdental Procedure Bacteremia: A Network Meta-analysis.

Postdental procedure bacteremia is common and troublesome. The comparative efficacy of multiple prophylactic interventions is unclear. We compared the efficacy of interventions for the prevention of postdental procedure bacteremia. We conducted a review of ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov from inception to December 4, 2018. Randomized controlled trials that evaluated prophylactic interventions for the prevention of postdental procedure bacteremia were eligible. The primary outcome was the incidence of postdental procedure bacteremia. A total of 24 trials were included with 2,147 participants. Our network meta-analysis demonstrated that intravenous administration of 1,000/200 mg of amoxicillin/clavulanate provided the least incidence of postdental procedure bacteremia among all the prophylactic interventions (odds ratio = 0.03, 95% CI = 0.00 to 0.63) as compared with the placebo/controls. Oral 3 g of amoxicillin had the least incidence of postdental procedure bacteremia among all oral or topical forms of prophylactic interventions (odds ratio = 0.10, 95% CI = 0.02 to 0.44) as compared with the placebo/controls. No serious adverse events, such as anaphylactic shock, mortality, and the development of antibiotic-resistant bacteria, were reported. None of the included subjects were of high risk of infectious endocarditis. Our network meta-analysis demonstrates that intravenous amoxicillin/clavulanate and oral amoxicillin might be the best prophylactic interventions in preventing postdental procedure bacteremia among all the oral/topical forms of interventions for the overall populations.

Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and middle-income countries.

BACKGROUND: Despite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs). METHOD: Cross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity. RESULTS: Overall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98-3.57). CONCLUSIONS: Our large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.

[Helminth and pinworm control for primary school and kindergarten children by periodical mass-examination and treatment in Suan-Yuan District, Taipei (author's transl)].

The mass pre-control survey was done in fall semester 1978 by both methods that Kato's thick smear for helminthic infection and cellophane tape perianal swab for pinworm infection. There are about 19,000 primary school children and around 5,000 kindergarten children in Suan-yuan District, being the subjects. The helminthic positive rates (%) obtained were 5.18 and 3.81, respectively. The rates for pinworm were found 28.68% former and 29.00% for the latter. Drug was given to the egg-positive persons after mass examination, in each semester, for three consecutive years. Two broad-spectrum anthelmintics, pyrantel pamoate and mebendazole were used. The children who harbored Ascaris, hookworm or pinworm were given pyrantel tablet as a single dose of 10 mg/kg body weight, and whipworm positives were given a standard course of 100 mg of mebendazole twice daily for three days. After three-year operation, in accordance with the results of examination in Spring semester 1981, the egg positive rates were sharply dropped to 0.56% for the primary school children and 0.50% for the kindergarten. The pinworm infection rates for the above-mentioned group were also reduced to 13.05% and 18.68%, respectively.

Prevalence of intestinal parasitic infections among inhabitants of Tan-nan village, Nantou County, Taiwan.

The pork infected with cysticerci was sent to our laboratory in June 1971. Microscopic examination revealed the infection of Cysticercus cellulosae. Subsequently, the source of the pork was traced, and the survey of intestinal parasitism was carried out among inhabitants at Tan-nan village, Hsin-I District, Nantou County, Taiwan, in August 1973. Results obtained only indicated the presence rather than endemic of taeniasis solium in this village. The parasites and infection rates found in the present study from 417 individuals by means of direct smear and formalin-ether sedimentation technic of stool specimens are as follows: Ascaris lumbricoides (81.3%), hookworm (30.9%), Trichuris trichiura (73.6%), Strongyloides stercoralis (0.5%), Clonorchis sinensis (2.9%), Hymenolepis diminuta (0.7%), Taenia solium (0.2%), Taenia saginata (0.2%), Entamoeba histolytica (3.1%), Entamoeba coli (8.4%), Endolimax nana (2.6%), and Giardia lamblia (4.3%).

Japanese encephalitis surveillance in China (Province of Taiwan) during 1968-1971. II. Age-secific incidence in connection with Japanese encephalitis vaccination program.

A baseline age/morbidity pattern for Japanese encephalitis (JE) epidemic in China (Province of Taiwan) in the 1960s was sought in JE surveillance. The pattern is characterized by: (1) high incidence in age groups 2-4 years, (2) moderately high incidence in age groups 5-7 years, (3) negligible incidence in children under 1 year of age as well as in adults, and (4) the variability of relative height of peak incidence co-incident with the JE-epidemic size in situ. Concurrently with surveillance, a JE-vaccination program was implemented by the Government. The children of target age groups received two doses of vaccine each during April. Vigilant supervision was given to the campaign to achieve a high coverage rate with two-dose vaccination and meticulous record-keeping. During 1969-1972, 2-year olds were the exclusive target; 52.2% (1969), 71.5% (1970), 74.5% (1971), and 83.0% (1972) of the target age group were covered. A considerable change from the baseline age/morbidity pattern seen in 1968 occurred during the above period. The comparison of epidemicity-adjusted incidence by year indications that incidence reduction in the 2- and 3-year old children in 1971 were substantial and suggests the possible impact of vaccination. The total JE incidence for the period 1968-1971 appears to be much lower in vaccinated population (23 reported and 8 confirmed/0.9 million) than in unvaccinated population (1,330 reported and 679 confirmed/2.2 million).

Japanese encephalitis surveillance in China (Province of Taiwan) during 1968-1971. I. Geographical and seasonal features of case outbreaks.

During 1968-1971 Japanese encephalitis (JE) surveillance was conducted with WHO-assisted programs in Taiwan area. Emphasis was placed on: (1) active case-finding by hospital visits; (2) blood collection from every patient at the suitable time; and (3) the enforcement of standard diagnostic criteria on the results of hemagglutination-inhibition tests. Each year, approximately 90% of reported patients were etiologically examined. JE virus etiology was established in 277 (1968), 279 (1969), 269 (1970) and 158 (1971) cases. Despite the apparent concentration of cases in several cities, practically all the cultivated plains and basins were established as potentially endemic for JE. JE outbreak is found to have been clearly associated with season, not only in subtropical but also in tropical Taiwan. Each year it occurred consistently in mid-July in the southernmost county, 2-3 weeks after the peak of rice transplantation and its duration was a few weeks. On the western side of the island, although less consistently, JE outbreak seems to occur one to three weeks later than in the south. Outbreak in eastern Taiwan was a mid-September phenomenon for 3 years. Observed seasonal lag, which was significant between two neighboring localities on same latitude, suggests that paddy water management is more directly related to date of outbreak than local climate. Seasonal characteristics further suggests that the area may be separated into eight ecologic subdivisions. JE-virus transmission to a man during April at temperatures below the average of 20 C was discussed.

Rates of infection with Japanese encephalitis virus of two culicine species of mosquito in Taiwan.

The role of Culex annulus as a Japanese-encephalitis (JE) vector has been drawing increasing attention recently. In this small trial, the rate of JE virus infection in C. annulus was compared with that in C. tritaeniorhynchus summorosus in the north-western coastal area of Taiwan, where both species are common as JE vectors. In order to increase the recovery rate of the virus, the mosquitos were artificially incubated at 26-28 degrees C for 10 days after collection. Two out of 6 C. t. summorosus pools and 7 out of 31 C. annulus pools, collected during a 17-day period in June 1969, were positive for JE virus. The results strongly suggest that one of the factors determining the severity of virus emergence in Taiwan is the total density of both species during the critical period of emergence of viraemic amplifiers: the relative prevalence of the two species of mosquito seems to be less important.