The ongoing challenge of ventilator-associated pneumonia: epidemiology, prevention, and risk factors for mortality in a secondary care hospital intensive care unit.

Background: Ventilator-associated pneumonia (VAP) is a leading cause of morbidity and mortality among intensive care unit infections. Despite various preventive measures, the incidence of VAP remains high. Aims: This study aimed to explore the epidemiology and risk factors for VAP associated mortality in a secondary care hospital, comparing outcomes before and after implementing a VAP prevention bundle. Methods: This retrospective study was conducted from July 1, 2021, to June 30, 2023, at a secondary care hospital. Patients over 18 years old who underwent mechanical ventilation for more than 48 hours were included. The study compared the incidence, microbiological etiology, and outcomes of VAP before and after implementing the VAP prevention bundle and analyzed risk factors for mortality from VAP. Results: A total of 83 patients diagnosed with VAP were included. Despite concerted efforts to implement the VAP prevention bundle, there was no significant decrease in the VAP rate per 1000 ventilator days, early-onset VAP, secondary bloodstream infections, acute respiratory distress syndrome, and 30-day mortality. The microbiological etiology of VAP remained consistent between the two periods. A decrease in lymphocyte count and albumin level were identified as independent risk factors for 30-day mortality. Conclusions: Concerted efforts to implement a VAP prevention bundle did not significantly reduce the incidence or improve outcomes of VAP in this secondary care hospital setting. The microbiological etiology remained unchanged. Monitoring lymphocyte count and albumin level may help identify patients at high mortality risk. Further research is needed to develop more effective VAP prevention and management strategies.

Evaluation of YouTube videos on HIV/AIDS: a critical analysis of content quality and reliability

Introduction: HIV and AIDS remain as significant global health issues, with misinformation and stigma surrounding the diseases still being prevalent. Accurate and reliable information is crucial for promoting prevention, early detection, and effective management of the disease. YouTube has emerged as a popular platform for sharing and consuming health-related content, but the quality and reliability of its videos on various health topics have been questioned. Objective: This study aims to systematically review and evaluate the quality and reliability of YouTube videos on HIV/AIDS. Methods: We searched for videos on YouTube using two search terms, "HIV" and "AIDS," and evaluated the top 100 videos for each search term. We recorded video features such as length, likes, comments, views, and upload date. Two independent evaluators assessed the videos' quality and reliability using the Global Quality Scale and the modified DISCERN tool. We classified the videos into two groups based on the source that uploaded the video, professional and non-professional, and analyzed the data using statistical methods. Results: Of the 159 videos evaluated, the most common content categories were HIV transmission routes, basic information and definition of HIV, and HIV/AIDS activism and awareness. Non-professional videos tended to be shorter, but there were no significant differences in views, likes, and likes per day counts. Comments were significantly higher in non-professional videos. Professional videos had higher quality and reliability scores than non-professional videos. Conclusion: Accurate and reliable information on HIV/AIDS is critical for promoting prevention, early detection, and effective management of the disease. YouTube has the potential to disseminate this information, but the quality and reliability of its videos must be improved. Our study highlights the need to prioritize professional, high-quality, and reliable video content on HIV/AIDS on YouTube to improve the public health outcome

Introdução: O HIV e a AIDS continuam a ser problemas significativos de saúde global, e a desinformação e o estigma em torno dessas doenças ainda prevalecem. Informações precisas e confiáveis são cruciais para promover a prevenção, a detecção precoce e o gerenciamento eficaz da doença. O YouTube surgiu como uma plataforma popular para compartilhar e consumir conteúdo relacionado à saúde, mas a qualidade e a confiabilidade de seus vídeos sobre vários tópicos de saúde têm sido questionadas. Objetivo: Este estudo tem como objetivo revisar e avaliar sistematicamente a qualidade e a confiabilidade dos vídeos do YouTube sobre HIV/AIDS. Métodos: Pesquisamos vídeos no YouTube usando dois termos de pesquisa, "HIV" e "AIDS", e avaliamos os cem principais vídeos para cada termo de pesquisa. Registramos os recursos do vídeo, como duração, curtidas, comentários, visualizações e data de upload. Dois avaliadores independentes avaliaram a qualidade e a confiabilidade dos vídeos usando a Escala de Qualidade Global e a ferramenta DISCERN modificada. Classificamos os vídeos em dois grupos com base na fonte que fez o upload do vídeo, profissional e não profissional, e analisamos os dados usando métodos estatísticos. Resultados: Dos 159 vídeos avaliados, as categorias de conteúdo mais comuns foram rotas de transmissão do HIV, informações básicas e definição de HIV e ativismo e conscientização sobre HIV/AIDS. Os vídeos não profissionais tenderam a ser mais curtos, mas não houve diferenças significativas nas contagens de visualizações, curtidas e curtidas por dia. Os comentários foram significativamente maiores nos vídeos não profissionais. Os vídeos profissionais tiveram pontuações de qualidade e confiabilidade mais altas do que os vídeos não profissionais. Conclusão: Informações precisas e confiáveis sobre HIV/AIDS são essenciais para promover a prevenção, a detecção precoce e o gerenciamento eficaz da doença. O YouTube tem o potencial de disseminar essas informações, mas a qualidade e a confiabilidade de seus vídeos devem ser aprimoradas. Nosso estudo destaca a necessidade de priorizar conteúdo de vídeo profissional, de alta qualidade e confiável sobre HIV/AIDS no YouTube para melhorar o resultado da saúde pública

Prognostic factors for COVID-19 patients.

INTRODUCTION: Determining prognostic factors in patients with coronavirus disease (COVID-19) can have great impact on treatment planning and follow-up strategies. Herein, we aimed to evaluate prognostic factors and clinical scores for confirmed COVID-19 patients in a tertiary-care hospital in the Bursa region of Turkey. METHODOLOGY: Patients who had been diagnosed with COVID-19 microbiologically and/or radiologically between March and October 2020 in a tertiary-care university hospital were enrolled retrospectively. Adult patients (≥ 18 years) with a clinical spectrum of moderate, severe, or critical illness were included. The dependent variable was 30-day mortality and logistic regression analysis was used to evaluate any variables with a significant p value (< 0.05) in univariate analysis. RESULTS: A total of 257 patients were included in the study. The mortality rate (30-day) was 14.4%. In logistic regression analysis, higher scores on sequential organ failure assessment (SOFA) (p < 0.001, odds ratio (OR) = 1.86, 95% CI = 1.42-2.45) and CURB-65 pneumonia severity criteria (p = 0.001, OR = 2.60, 95% CI = 1.47-4.57) were found to be significant in predicting mortality at admission. In deceased patients, there were also significant differences between the baseline, day-3, day-7, and day-14 results of D-dimer (p = 0.01), ferritin (p = 0.042), leukocyte (p = 0.019), and neutrophil (p = 0.007) counts. CONCLUSIONS: In our study of COVID-19 patients, we found that high SOFA and CURB-65 scores on admission were associated with increased mortality. In addition, D-dimer, ferritin, leukocyte and neutrophil counts significantly increased after admission in patients who died.