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1.
BMJ Open ; 11(11): e051070, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34732483

RESUMO

INTRODUCTION: The worldwide rising levels of physical inactivity especially in the United Arab Emirates (UAE) and the Eastern Mediterranean region are alarming. The UAE reports one of the highest rates of non-communicable disease mortality and insufficient physical activity (PA) is a major underlying cause. Therefore, action is required to reduce physical inactivity using evidence-based strategies. This study aimed to evaluate the efficacy of a worksite exercise intervention on cardiometabolic health in the UAE. METHODS AND ANALYSIS: This is a protocol for a pragmatic parallel randomised controlled trial with a 1:1 allocation ratio to the intervention group and delayed intervention group. A total of 150 participants will be recruited from a semigovernment telecommunications company in Dubai (UAE) after meeting the eligibility criteria. The intervention group will receive 2 hours of exercise per week during working hours for 12 weeks (maximum 1 hour/day). The intervention group will be assigned to attend personal trainer sessions in the workplace gym throughout the intervention period. After the intervention is completed, the delayed intervention group will also receive 2 hours of exercise time per week from working hours for 4 weeks. The main outcome measure is the change in the cardiometabolic risk components, that is, systolic or diastolic blood pressure, waist circumference, glycated haemoglobin, fasting plasma glucose, low-density lipoprotein cholesterol from baseline to the end of the intervention. The secondary outcome is to examine whether the workplace exercise intervention improves PA levels 4 weeks postintervention. ETHICS AND DISSEMINATION: The study has been approved by the Dubai Scientific Research Ethics Committee (DSREC-SR-08/2019_02). The results will be disseminated as follows: at various national and international scientific conferences; as part of a PhD thesis in Public Health at the College of Medicine and Health Sciences, UAE University; and in a manuscript submitted to a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT04403789.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34769927

RESUMO

The study aim was to understand the availability of personal protective equipment (PPE) and the levels of anxiety, depression, and burnout of healthcare workers (HCWs) in the United Arab Emirates (UAE). This study was an online-based, cross-sectional survey during July and August 2020. Participants were eligible from the entire country, and 1290 agreed to participate. The majority of HCWs were females aged 30-39 years old, working as nurses, and 80% considered PPE to be available. Twelve percent of respondents tested positive for SARS-CoV-2. Half of HCWs considered themselves physically tired (52.2%), reported musculoskeletal pain or discomfort (54.2%), and perceived moderate-to-high levels of burnout on at least one of three burnout domains (52.8%). A quarter of HCWs reported anxiety (26.3%) or depression (28.1%). HCWs reporting not having musculoskeletal pain, having performed physical activity, and higher scores of available PPE reported lower scores of anxiety, depression, and burnout. UAE HCWs experienced more access to PPE and less anxiety, depression, and burnout compared with HCWs in other countries. Study findings can be used by healthcare organizations and policymakers to ensure adequate measures are implemented to maximize the health and wellbeing of HCWs during the current COVID-19 and future pandemics.


Assuntos
COVID-19 , Saúde do Trabalhador , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Pandemias , SARS-CoV-2 , Emirados Árabes Unidos/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-34536221

RESUMO

Despite the association between tobacco use and the harmful effects on general health as well as male fertility parameters, smoking remains globally prevalent. The main content of tobacco smoke is nicotine and its metabolite cotinine. These compounds can pass the blood-testis barrier, which subsequently causes harm of diverse degree to the germ cells. Although controversial, smoking has been shown to cause not only a decrease in sperm motility, sperm concentration, and an increase in abnormal sperm morphology, but also genetic and epigenetic aberrations in spermatozoa. Both animal and human studies have highlighted the occurrence of sperm DNA-strand breaks (fragmentation), genome instability, genetic mutations, and the presence of aneuploids in the germline of animals and men exposed to tobacco smoke. The question to be asked at this point is, if smoking has the potential to cause all these genetic aberrations, what is the extent of damage? Hence, this review aimed to provide evidence that smoking has a mutagenic effect on sperm and how this subsequently affects male fertility. Additionally, the role of tobacco smoke as an aneugen will be explored. We furthermore aim to incorporate the epidemiological aspects of the aforementioned and provide a holistic approach to the topic.

4.
Environ Int ; 157: 106828, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34433115

RESUMO

BACKGROUND: The World Health Organization (WHO) has an ongoing project to assess potential health effects of exposure to radiofrequency electromagnetic fields (RF-EMF) in the general and working population. Here we present the protocol for a systematic review of the scientific literature on cancer hazards from exposure to RF-EMF in humans, commissioned by the WHO as part of that project. OBJECTIVE: To assess the quality and strength of the evidence provided by human observational studies for a causal association between exposure to RF-EMF and risk of neoplastic diseases. ELIGIBILITY CRITERIA: We will include cohort and case-control studies investigating neoplasia risks in relation to three types of exposure to RF-EMF: near-field, head-localized, exposure from wireless phone use (SR-A); far-field, whole body, environmental exposure from fixed-site transmitters (SR-B); near/far-field occupational exposures from use of handheld transceivers or RF-emitting equipment in the workplace (SR-C). While no restriction on tumour type will be applied, we will focus on selected neoplasms of the central nervous system (brain, meninges, pituitary gland, acoustic nerve) and salivary gland tumours (SR-A); brain tumours and leukaemias (SR-B, SR-C). INFORMATION SOURCES: Eligible studies will be identified through Medline, Embase, and EMF-Portal. RISK-OF-BIAS ASSESSMENT: We will use a tailored version of the OHAT's tool to evaluate the study's internal validity. DATA SYNTHESIS: We will consider separately studies on different tumours, neoplasm-specific risks from different exposure sources, and a given exposure-outcome pair in adults and children. When a quantitative synthesis of findings can be envisaged, the main aims of the meta-analysis will be to assess the strength of association and the shape of the exposure-response relationship; to quantify the degree of heterogeneity across studies; and explore the sources of inconsistency (if any). When a meta-analysis is judged inappropriate, we will perform a narrative synthesis, complemented by a structured tabulation of results and appropriate visual displays. EVIDENCE ASSESSMENT: Confidence in evidence will be assessed in line with the GRADE approach. FUNDING: This project is supported by the World Health Organization. Co-financing was provided by the New Zealand Ministry of Health; the Istituto Superiore di Sanità in its capacity as a WHO Collaborating Centre for Radiation and Health; ARPANSA as a WHO Collaborating Centre for Radiation Protection. REGISTRATION: PROSPERO CRD42021236798.


Assuntos
Neoplasias Encefálicas , Telefone Celular , Adulto , Criança , Campos Eletromagnéticos/efeitos adversos , Exposição Ambiental , Humanos , Metanálise como Assunto , Ondas de Rádio/efeitos adversos
5.
Emerg Infect Dis ; 27(9): 2471-2474, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34424177

RESUMO

We previously detected a potentially novel reassortant of Crimean-Congo hemorrhagic fever virus in camels at the largest livestock market in the United Arab Emirates. A broader survey of large mammals at the site indicated zoonotic transmission is associated with dromedaries and camel ticks. Seroprevalence in cattle, sheep, and goats is minimal.


Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo , Carrapatos , Animais , Camelus , Bovinos , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Estudos Soroepidemiológicos , Ovinos , Emirados Árabes Unidos/epidemiologia
6.
iScience ; 24(9): 103030, 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34458692

RESUMO

Understanding host cell heterogeneity is critical for unraveling disease mechanism. Utilizing large-scale single-cell transcriptomics, we analyzed multiple tissue specimens from patients with life-threatening COVID-19 pneumonia, compared with healthy controls. We identified a subtype of monocyte-derived alveolar macrophages (MoAMs) where genes associated with severe COVID-19 comorbidities are significantly upregulated in bronchoalveolar lavage fluid of critical cases. FCGR3B consistently demarcated MoAM subset in different samples from severe COVID-19 cohorts and in CCL3L1-upregulated cells from nasopharyngeal swabs. In silico findings were validated by upregulation of FCGR3B in nasopharyngeal swabs of severe ICU COVID-19 cases, particularly in older patients and those with comorbidities. Additional lines of evidence from transcriptomic data and in vivo of severe COVID-19 cases suggest that FCGR3B may identify a specific subtype of MoAM in patients with severe COVID-19 that may present a novel biomarker for screening and prognosis, as well as a potential therapeutic target.

7.
Transbound Emerg Dis ; 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34463031

RESUMO

The recent COVID-19 pandemic has demonstrated again the global threat posed by emerging zoonotic coronaviruses. During the past two decades alone, humans have experienced the emergence of several coronaviruses, such as SARS-CoV in 2003, MERS-CoV in 2012, and SARS-CoV-2 in 2019. To date, MERS-CoV has been detected in 27 countries, with a case fatality ratio of approximately 34.5%. Similar to other coronaviruses, MERS-CoV presumably originated from bats; however, the main reservoir and primary source of human infections are dromedary camels. Other species within the Camelidae family, such as Bactrian camels, alpacas, and llamas, seem to be susceptible to the infection as well, although to a lesser extent. In contrast, susceptibility studies on sheep, goats, cattle, pigs, chickens, and horses obtained divergent results. In the present study, we tested nasal swabs and/or sera from 55 sheep, 45 goats, and 52 cattle, collected at the largest livestock market in the United Arab Emirates, where dromedaries are also traded, for the presence of MERS-CoV nucleic acid by RT-qPCR, and for specific antibodies by immunofluorescence assay. All sera were negative for MERS-CoV-reactive antibodies, but the nasal swab of one sheep (1.8%) repeatedly tested positive for MERS-CoV nucleic acid. Next generation sequencing (NGS) of the complete N gene of the sheep-derived MERS-CoV revealed >99% nucleotide identity to MERS-CoV sequences of five dromedaries in nearby pens and to three reference sequences. The NGS sequence of the sheep-derived MERS-CoV was confirmed by conventional RT-PCR of a part of the N gene and subsequent Sanger sequencing. All MERS-CoV sequences clustered within clade B, lineage 5. In conclusion, our study shows that noncamelid livestock, such as sheep, goats, and cattle do not play a major role in MERS-CoV epidemiology. The one sheep that tested positive most likely reflects an accidental viral spillover event from infected dromedaries in nearby pens.

8.
Int J Health Plann Manage ; 36(5): 1830-1846, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34176157

RESUMO

The rapid modernization and economic developments in Kuwait, have been accompanied by substantial lifestyle changes such as unhealthy diet and physical inactivity. These modifiable behaviours have contributed to increased rates of non-communicable diseases including diabetes and cardiovascular diseases. Delphi Consensus Method was implemented in the current study to draw stakeholders from all sectors together to develop a consensus on the major public health priorities, barriers and solutions. The process involves administration of a series of questions to selected stakeholders through an iterative process that ends when a consensus has been reached among participants. Results of the iteration process identified obesity, diabetes, cardiovascular diseases along with lack of enforcement of laws and regulation as priority health issues. Results also identified lack of national vision for the development of a public health system, lack of multidisciplinary research investigating sources of disease and methods of prevention and improving efficiency with existing resources in implementation and efficiency as the main barriers identified were. Solutions suggested included investing in healthcare prevention, strengthening communication between all involved sectors through intersectoral collaboration, awareness at the primary healthcare setting and use of electronic health records. The results offer an important opportunity for stakeholders in Kuwait to tackle these priority health issues employing the suggested approaches and solution.


Assuntos
Prioridades em Saúde , Saúde Pública , Consenso , Técnica Delfos , Humanos , Kuweit
9.
Cells ; 10(6)2021 05 23.
Artigo em Inglês | MEDLINE | ID: mdl-34070971

RESUMO

The recent SARS-CoV-2 pandemic has refocused attention to the betacoronaviruses, only eight years after the emergence of another zoonotic betacoronavirus, the Middle East respiratory syndrome coronavirus (MERS-CoV). While the wild source of SARS-CoV-2 may be disputed, for MERS-CoV, dromedaries are considered as source of zoonotic human infections. Testing 100 immune-response genes in 121 dromedaries from United Arab Emirates (UAE) for potential association with present MERS-CoV infection, we identified candidate genes with important functions in the adaptive, MHC-class I (HLA-A-24-like) and II (HLA-DPB1-like), and innate immune response (PTPN4, MAGOHB), and in cilia coating the respiratory tract (DNAH7). Some of these genes previously have been associated with viral replication in SARS-CoV-1/-2 in humans, others have an important role in the movement of bronchial cilia. These results suggest similar host genetic pathways associated with these betacoronaviruses, although further work is required to better understand the MERS-CoV disease dynamics in both dromedaries and humans.


Assuntos
Imunidade Adaptativa/genética , Camelus/virologia , Doenças Transmissíveis Emergentes/imunologia , Infecções por Coronavirus/imunologia , Imunidade Inata/genética , Zoonoses/imunologia , Animais , Anticorpos Antivirais , Brônquios/citologia , Brônquios/fisiologia , COVID-19/genética , COVID-19/imunologia , COVID-19/virologia , Camelus/genética , Camelus/imunologia , Cílios/fisiologia , Doenças Transmissíveis Emergentes/genética , Doenças Transmissíveis Emergentes/transmissão , Doenças Transmissíveis Emergentes/virologia , Infecções por Coronavirus/genética , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Reservatórios de Doenças/virologia , Feminino , Predisposição Genética para Doença , Interações entre Hospedeiro e Microrganismos/genética , Interações entre Hospedeiro e Microrganismos/imunologia , Humanos , Masculino , Coronavírus da Síndrome Respiratória do Oriente Médio/imunologia , Coronavírus da Síndrome Respiratória do Oriente Médio/isolamento & purificação , Coronavírus da Síndrome Respiratória do Oriente Médio/patogenicidade , Mucosa Respiratória/citologia , Mucosa Respiratória/fisiologia , SARS-CoV-2/imunologia , SARS-CoV-2/patogenicidade , Emirados Árabes Unidos , Replicação Viral/genética , Replicação Viral/imunologia , Zoonoses/genética , Zoonoses/transmissão , Zoonoses/virologia
10.
Transbound Emerg Dis ; 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33960696

RESUMO

Knowledge of the level and duration of protective immunity against SARS-CoV-2 after primary infection is of crucial importance for preventive approaches. Currently, there is a lack of evidence on the persistence of specific antibodies. We investigated the generation and maintenance of neutralizing antibodies of convalescent SARS-CoV-2-afflicted patients over a ten-month period post-primary infection using an immunofluorescence assay, a commercial chemiluminescent immunoassay and an in-house enzyme-linked neutralization assay. We present the successful application of an improved version of the plaque-reduction neutralization assay which can be analysed optometrically to simplify data interpretation. Based on the results of the enzyme-linked neutralization assay, neutralizing antibodies were maintained in 77.4% of convalescent individuals without relevant decay over ten months. Furthermore, a positive correlation between severity of infection and antibody titre was observed. In conclusion, SARS-CoV-2-afflicted individuals have been proven to be able to develop and maintain neutralizing antibodies over a period of ten months after primary infection. Findings suggest long-lasting presumably protective humoral immune responses after wild-type infection.

11.
Artigo em Inglês | MEDLINE | ID: mdl-33800896

RESUMO

The SEIR (Susceptible-Exposed-Infected-Removed) model is widely used in epidemiology to mathematically model the spread of infectious diseases with incubation periods. However, the SEIR model prototype is generic and not able to capture the unique nature of a novel viral pandemic such as SARS-CoV-2. We have developed and tested a specialized version of the SEIR model, called SEAHIR (Susceptible-Exposed-Asymptomatic-Hospitalized-Isolated-Removed) model. This proposed model is able to capture the unique dynamics of the COVID-19 outbreak including further dividing the Infected compartment into: (1) "Asymptomatic", (2) "Isolated" and (3) "Hospitalized" to delineate the transmission specifics of each compartment and forecast healthcare requirements. The model also takes into consideration the impact of non-pharmaceutical interventions such as physical distancing and different testing strategies on the number of confirmed cases. We used a publicly available dataset from the United Arab Emirates (UAE) as a case study to optimize the main parameters of the model and benchmarked it against the historical number of cases. The SEAHIR model was used by decision-makers in Dubai's COVID-19 Command and Control Center to make timely decisions on developing testing strategies, increasing healthcare capacity, and implementing interventions to contain the spread of the virus. The novel six-compartment SEAHIR model could be utilized by decision-makers and researchers in other countries for current or future pandemics.


Assuntos
COVID-19 , Previsões , Humanos , Pandemias , SARS-CoV-2 , Emirados Árabes Unidos
12.
Clin Microbiol Infect ; 27(9): 1330-1335, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33618013

RESUMO

OBJECTIVES: The high diagnostic accuracy indices for saliva severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase PCR (RT-PCR) reported in adults has not been demonstrated in children, and adequately powered studies focused on the paediatric population are lacking. This study was carried out to determine the diagnostic accuracy of saliva for SARS-CoV-2 RT-PCR in ambulatory children. METHODS: During 1 to 23 October 2020, we recruited a population-based sample of children presenting for coronavirus disease 2019 (COVID-19) screening in Dubai, United Arab Emirates. Each child provided paired nasopharyngeal (NP) swab and saliva for SARS-CoV-2 RT-PCR N, E and RdRp gene detection. RESULTS: Paired NP swab and saliva samples were obtained from 476 children with mean ± standard deviation age of 10.8 ± 3.9 years, and 58.2% were male (277/476). Nine participants were sampled twice, so 485 pairs of NP swab/saliva were tested. Virus detection in at least one specimen type was reported in 17.9% (87/485), with similar detection in NP swab (16.7%, 81/485) and saliva (15.9%, 77/485). Sensitivity and specificity of saliva RT-PCR was 87.7% (95% confidence interval (CI) 78.5-93.9) and 98.5% (95% CI 96.8-99.5). The positive and negative predictive values were 92.2% (95% CI 84.2-96.3) and 97.6% (95% CI 95.7-98.6), with a kappa coefficient of 0.879 (95% CI 0.821-0.937). Concordance of findings between NP swab and saliva did not differ by age (p 0.67) or gender (p 0.29). Cycle threshold (Ct) values were significantly higher in NP swab/saliva pairs with discordant findings compared to those with both specimens positive. CONCLUSIONS: In light of these findings, we recommend saliva as a diagnostic specimen for COVID-19 screening in children.


Assuntos
COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , Saliva/virologia , Adolescente , Instituições de Assistência Ambulatorial , COVID-19/virologia , Criança , Pré-Escolar , Estudos de Coortes , Testes Diagnósticos de Rotina , Feminino , Humanos , Masculino , Nasofaringe/virologia , Estudos Prospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/genética , Instituições Acadêmicas , Sensibilidade e Especificidade , Manejo de Espécimes
13.
Transbound Emerg Dis ; 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33506644

RESUMO

The geographic location and heterogeneous multi-ethnic population of Dubai (United Arab Emirates; UAE) provide a unique setting to explore the global molecular epidemiology of SARS-CoV-2 and relationship between different viral strains and disease severity. We systematically selected (i.e. every 100th individual in the central Dubai COVID-19 database) 256 patients by age, sex, disease severity and month to provide a representative sample of laboratory-confirmed COVID-19 patients (nasopharyngeal swab PCR positive) during the first wave of the UAE outbreak (January to June 2020). Sociodemographic and clinical data were extracted from medical records and full SARS-CoV-2 genome sequences extracted from nasopharyngeal swabs were analysed. Older age was significantly associated with COVID-19-associated hospital admission and mortality. Overweight/obese or diabetic patients were 3-4 times more likely to be admitted to hospital and intensive care unit (ICU). Sequencing data showed multiple independent viral introductions into the UAE from Europe, Iran and Asia (29 January-18 March), and these early strains seeded significant clustering consistent with almost exclusive community-based transmission between April and June 2020. Majority of sequenced strains (N = 60, 52%) were from the European cluster consistent with the higher infectivity rates associated with the D614G mutation carried by most strains in this cluster. A total of 986 mutations were identified in 115 genomes, 272 were unique (majority were missense, n = 134) and 20/272 mutations were novel. A missense (Q271R) and synonymous (R41R) mutation in the S and N proteins, respectively, were identified in 2/27 patients with severe COVID-19 but not in patients with mild or moderate disease (0/86; p = .05, Fisher's Exact Test). Both patients were women (51-64 years) with no significant underlying health conditions. The same two mutations were identified in a healthy 37-year-old Indian man who was hospitalized in India due to COVID-19. Our findings provide evidence for continued community-based transmission of the European strains in the Dubai population and highlight new mutations that might be associated with severe disease in otherwise healthy adults.

14.
Comput Struct Biotechnol J ; 19: 153-160, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33425248

RESUMO

Characterizing key molecular and cellular pathways involved in COVID-19 is essential for disease prognosis and management. We perform shotgun transcriptome sequencing of human RNA obtained from nasopharyngeal swabs of patients with COVID-19, and identify a molecular signature associated with disease severity. Specifically, we identify globally dysregulated immune related pathways, such as cytokine-cytokine receptor signaling, complement and coagulation cascades, JAK-STAT, and TGF- ß signaling pathways in all, though to a higher extent in patients with severe symptoms. The excessive release of cytokines and chemokines such as CCL2, CCL22, CXCL9 and CXCL12 and certain interferons and interleukins related genes like IFIH1, IFI44, IFIT1 and IL10 were significantly higher in patients with severe clinical presentation compared to mild and moderate presentations. Differential gene expression analysis identified a small set of regulatory genes that might act as strong predictors of patient outcome. Our data suggest that rapid transcriptome analysis of nasopharyngeal swabs can be a powerful approach to quantify host molecular response and may provide valuable insights into COVID-19 pathophysiology.

15.
Scand J Work Environ Health ; 47(2): 95-107, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33258478

RESUMO

Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.

16.
Int J Womens Health ; 12: 1171-1179, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33324118

RESUMO

Purpose: To estimate the prevalence of recurrent miscarriage (RM) and investigate the association between RM and adverse maternal outcomes in subsequent pregnancies. Participants and Methods: This is an interim analysis of a prospective study of 1737 pregnant women with gravidity of two or more prior to the current pregnancy. These women joined the Mutaba'ah Study between May 2017 and April 2019 and were followed up until they delivered. Hospital medical records were used to extract data on past pregnancy history and the progress and outcomes of the current pregnancy, such as gestational diabetes, preeclampsia, mode of delivery, preterm delivery, and complications at birth. Results: Amongst pregnant women with at least two previous pregnancies (n=1737), there were 234 (13.5%) women with a history of two or more consecutive miscarriages. Women with RM were slightly older, more parous, and more likely to have had previous infertility treatment (all p-values <0.05). Women with a history of RM had independently significant increased odds of cesarean section (adjusted odds ratio (aOR) 1.81, 95% CI 1.24-2.65) and preterm (<37 weeks, aOR: 2.52, 95% CI 1.56-4.08) or very preterm delivery (<32 weeks, aOR: 7.02 95% CI 2.41-20.46) in subsequent pregnancies than women who did not have a history of RM. Conclusion: Women with a history of RM were twice as likely to undergo cesarean section and seven times more likely to deliver prior to 32 weeks of gestation than women without a history of RM. The study findings support the need for early pregnancy monitoring or assessment units to ensure better follow-up and customized care for at-risk pregnant women with a history of RM.

17.
BMJ Open ; 10(12): e040166, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334833

RESUMO

Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE. DESIGN, SETTINGS AND PARTICIPANTS: This cross-sectional study recruited a representative sample (n=1375) of male South Asian expatriates aged ≥18 years in Al Ain, UAE. Sociodemographic, anthropometric and lifestyle data were obtained using a pilot-tested adapted version of the WHO STEPS instrument. MAIN OUTCOME MEASURES: Duration of residence was used as a marker for acculturation. Type 2 diabetes was defined as a self-reported physician diagnosis of diabetes or a glycosylated haemoglobin blood level ≥6.5%. RESULTS: Mean (±SD) age of participants was 34.0±9.9 years. Overall, the prevalence of type 2 diabetes was 8.3% (95% CI 6.8% to 9.8%). Diabetes prevalence was positively associated with longer duration of residence in the UAE, 2.7%, <5 years; 8.2%, 5-10 years; and 18.8%, >10 years. After adjusting for age, nationality, and income and age, expatriates were more likely to develop diabetes if residing in the UAE for 5-10 years (OR=2.18; 95% CI 1.02 to 4.67) or >10 years (OR=3.23; 95% CI 1.52 to 6.85) compared with those residing for <5 years. CONCLUSIONS: After controlling for potential confounding factors, longer duration of residence was significantly associated with a higher prevalence of type 2 diabetes in male South Asian expatriate workers in the UAE.


Assuntos
Diabetes Mellitus Tipo 2 , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Masculino , Prevalência , Emirados Árabes Unidos/epidemiologia , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-33374611

RESUMO

BACKGROUND: The rate of cesarean section (CS) is growing in the United Arab Emirates (UAE). Pregnant women's knowledge on the mode of delivery, factors associated with lack of adequate knowledge, and preference towards CS delivery were investigated. METHODS: Baseline cross-sectional data from 1617 pregnant women who participated in the Mutaba'ah Study between September 2018 and March 2020 were analyzed. A self-administered questionnaire inquiring about demographic and maternal characteristics, ten knowledge-based statements about mode of delivery, and one question about preference towards mode of delivery was used. Knowledge on the mode of delivery was categorized into "adequate (total score 6-10)" or "lack of adequate (total score 0-5)" knowledge. Crude and multivariable models were used to identify factors associated with "lack of adequate" knowledge on the mode of delivery and factors associated with CS preference. RESULTS: A total of 1303 (80.6%) pregnant women (mean age 30.6 ± 5.8 years) completed the questionnaire. The majority (57.1%) were ≥30 years old, in their third trimester (54.5%), and had at least one child (76.6%). In total, 20.8% underwent CS delivery in the previous pregnancy, and 9.4% preferred CS delivery for the current pregnancy. A total of 78.4% of pregnant women lacked adequate knowledge on the mode of delivery. The level of those who lacked adequate knowledge was similar across women in different pregnancy trimesters. Young women (18-24 years) (adjusted odds ratios (aOR), 3.07, 95% confidence interval (CI), 1.07-8.86) and women who had CS delivery in the previous pregnancy (aOR, 1.90, 95% CI, 1.06-3.40) were more likely to be classified with a lack of adequate knowledge. Age (aOR, 1.08, 95% CI, 1.02-1.14), employment (aOR, 1.96, 95% CI, 1.13-3.40), or previous CS delivery (aOR, 31.10, 95% CI, 17.71-55.73) were associated with a preference towards CS delivery. CONCLUSION: This study showed that pregnant women may not fully appreciate the health risks associated with different modes of delivery. Therefore, antenatal care appointments should include a balanced discussion on the potential benefits and harms associated with different delivery modes.


Assuntos
Parto Obstétrico/métodos , Conhecimentos, Atitudes e Prática em Saúde , Preferência do Paciente , Gestantes/psicologia , Adolescente , Adulto , Cesárea , Estudos Transversais , Feminino , Humanos , Gravidez , Emirados Árabes Unidos , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-33374764

RESUMO

Gestational diabetes mellitus (GDM) increases the risk of adverse pregnancy outcomes in any pregnancy and recurrence rates are high in future pregnancies. This study aims to investigate the effect of self-reported history of previous GDM on behaviors in a future pregnancy. This is an interim cross-sectional analysis of the pregnant women who participated in the Mutaba'ah Study between May 2017 and March 2020 in the United Arab Emirates. Participants completed a baseline self-administered questionnaire on sociodemographic and pregnancy-related information about the current pregnancy and previous pregnancies. Regression models assessed the relationships between self-reported history of GDM and pre-pregnancy and pregnancy behaviors in the current pregnancy. Out of 5738 pregnant parous women included in this analysis, nearly 30% (n = 1684) reported a history of GDM in a previous pregnancy. Women with a history of previous GDM were less likely to plan their current pregnancies (adjusted odds ratio (aOR): 0.84, 95% confidence interval (CI) 0.74-0.96) and more likely to be worried about childbirth (aOR: 1.18, 95% CI 1.03-1.36). They had shorter interpregnancy intervals between their previous child and current pregnancy (aOR: 0.88, 95% CI 0.82-0.94, per SD increase). There were no significant differences between women with and without a history of GDM in supplement use, sedentary behavior, or physical activity before and during this current pregnancy. Nearly a third of parous pregnant women in this population had a history of GDM in a previous pregnancy. Pregnant women with a previous history of GDM were similar to their counterparts with no history of GDM in the adopted pre-pregnancy and prenatal health behaviors. More intensive and long-term lifestyle counseling, possibly supported by e-health and social media materials, might be required to empower pregnant women with a history of GDM. This may assist in adopting and maintaining healthy prenatal behaviors early during the pregnancy or the preconception phase to minimize the risk of GDM recurrence and the consequential adverse maternal and infant health outcomes.


Assuntos
Diabetes Gestacional , Comportamentos Relacionados com a Saúde , Resultado da Gravidez , Adulto , Estudos Transversais , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/prevenção & controle , Exercício Físico , Feminino , Humanos , Estilo de Vida , Paridade , Gravidez , Comportamento Sedentário , Emirados Árabes Unidos
20.
Sci Rep ; 10(1): 17720, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33082405

RESUMO

International travel played a significant role in the early global spread of SARS-CoV-2. Understanding transmission patterns from different regions of the world will further inform global dynamics of the pandemic. Using data from Dubai in the United Arab Emirates (UAE), a major international travel hub in the Middle East, we establish SARS-CoV-2 full genome sequences from the index and early COVID-19 patients in the UAE. The genome sequences are analysed in the context of virus introductions, chain of transmissions, and possible links to earlier strains from other regions of the world. Phylogenetic analysis showed multiple spatiotemporal introductions of SARS-CoV-2 into the UAE from Asia, Europe, and the Middle East during the early phase of the pandemic. We also provide evidence for early community-based transmission and catalogue new mutations in SARS-CoV-2 strains in the UAE. Our findings contribute to the understanding of the global transmission network of SARS-CoV-2.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Idoso , Ásia/epidemiologia , Betacoronavirus/classificação , Betacoronavirus/isolamento & purificação , COVID-19 , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Pandemias , Filogenia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , SARS-CoV-2 , Análise Espaço-Temporal , Viagem , Emirados Árabes Unidos/epidemiologia , Sequenciamento Completo do Genoma , Adulto Jovem
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