Multiple sclerosis in Morocco: Epidemiological, clinical, and therapeutic profile.

OBJECTIVE: This study aims to describe the clinical, therapeutic, and epidemiological profiles of MS patients in Morocco. METHODS: This descriptive study involved 170 patients representing four Morocco regions. We collected the data using an electronic survey. RESULTS: The results show female dominance in patients with MS. Besides, most patients present with relapsing-remitting MS (RRMS). The main clinical symptoms reported by patients are fatigue, cognitive issues, spasticity, bowel or bladder complaints, and visual issues. Furthermore, the findings show that almost half of the patients use Interferon bêta-1a and azathioprine as disease-modifying therapies; 60.5 % use traditional and complementary medicine, of which 30.6 % use cupping, 30 % recite the Holy Quran, and 28.2 % use apitherapy. The findings show that there is a statistically significant relationship between specific MS factors such as professional activity (p = 0.0071), degree of satisfaction with treatment (p = 0.005), stress (p = 0.014), and the frequency of relapses. CONCLUSIONS: In addition to DMT, patients also use traditional and complementary medicine. There is also a relationship between some epidemiological characteristics and the frequency of relapses in patients with MS.

[Emergency contraception.] / Esemény utáni fogamzásgátlás.

INTRODUCTION: Emergency contraception is an effective and safe solution for preventing unwanted pregnancies. Many methods of emergency contraception are used, which have different mechanisms of action and time frames. OBJECTIVE: Providing information to healthcare professionals and decision-makers based on the literature data about the target populations of emergency contraception, evidence-based modern methods, their effectiveness, and practical application for the purpose of reducing the incidence of unintended pregnancies. METHODS: We conducted a systematic literature search in MEDLINE (PubMed), Embase and Scopus databases based on relevant keywords, for publications that were published between 1960 and 2023. RESULTS: 23 clinical professional publications were selected that examined the effectiveness of oral and long-term usable contraceptives as emergency contraceptives. Our research results were interpreted in terms of weight, breastfeeding, time elapsed since the intercourse and future contraceptive plans, which help to select the most appropriate emergency contraceptive for healthcare professionals. CONCLUSION: Based on the literature data, our systematic review provides assistance for choosing between the available oral levonorgestrel, ulipristal acetate, and intrauterine contraceptive devices available in Hungary based on effectiveness, target population, and accessibility. We support the healthcare governance in creating up-to-date professional guidelines to improve the availability of emergency contraception and, consequently, enhance reproductive health. Orv Hetil. 2023; 164(44): 1736-1748.

A study to assess the severity and risk of COVID-19 breakthrough infection in admitted SARS-CoV-2 vaccinated individual.

Background: No vaccine is 100% effective in prevention of infection. The possibility of breakthrough infection of SARS-CoV-2 also cannot be ruled out. So, our study aimed to find out severity and risk of breakthrough infection and find association between epidemiological factors associated with it. Methodology: A retrospective cross-sectional study was conducted on 148 admitted SARS-CoV-2 vaccinated individual from May 2021 to January 2022 by universal sampling method. A data was collected in the form of socio-demographic, Covid vaccine, clinical details, and outcome of admitted patients. An appropriate statistical test was applied. Results: Out of the total 148 vaccinated individuals, 66 (44.59%) belongs to 30-59 years of age group and maximum, i.e. 95 (64.19%) were males. 64.86% patients were vaccinated with both doses and 98 (66.26%) individuals were mild cases. Only 8 (5.40%) cases were re-infected with Covid-19 infection. 70.27% individual were comorbid. Out of 148 vaccinated individuals, only 11 (7.43%) individuals were died and among those 7 (63.636%) were comorbid. Conclusion: Despite being vaccinated, small percentage of people are still getting infected, requires hospitalization, and die because of COVID-19. As far as pandemic continues, continuous genome sequencing and tracking of SARS-CoV-2 is essential and strategies regarding vaccination should be adjusted accordingly.

Factors associated with unsuccessful treatment outcome for tuberculosis in previously treated patients in Cali, Colombia, during the period 2015-2019 / Factores asociados al tratamiento no exitoso para tuberculosis en pacientes previamente tratados en Cali, Colombia, en el periodo 2015-2019

Introduction. The success rates in the treatment of tuberculosis are suboptimal. Objective. To identify associated factors with the lack of success of antituberculosis treatment in patients with a tuberculosis treatment history. Materials and methods. We performed a retrospective, analytical, observational, and cohort study of patients reentering the Mycobacterium program in Cali, Colombia. We included patients over 15 years old with pulmonary tuberculosis between 2015 and 2019 and a history of tuberculosis treatment. Patients with drug-resistant tuberculosis were excluded. Results. A total of 605 patients with a treatment history were included, 60% due to unfinished treatment and 40% due to relapse. Compared to patients reentering due to relapse (ORa=2.34, CI=1.62-3.38), the independent variables associated with treatment failure at discharge were homelessness (ORa=2.45, CI=1.54-3.89), substance dependence (ORa=1.95, CI=1.24-3.05), tuberculosis/HIV coinfection (ORa=1.69, CI=1.00-2.86), diabetes (ORa=1.89, CI=1.29-2.77), and unfinished previous tuberculosis treatment due to follow-up loss, abandonment, or other causes. Programmatic variables favoring treatment success were voluntary HIV testing counseling (p<0.001) and HIV testing (p<0.001). Conclusion. Homelessness, substance dependence, tuberculosis/HIV coinfection, diabetes, and incomplete previous treatment due to loss to follow-up, abandonment, or treatment failure hindered the success of antituberculosis. These characteristics should be identified and addressed during the initial care of patients reentering treatment for tuberculosis.

Introducción. Las tasas de éxito del tratamiento de la tuberculosis continúan siendo subóptimas. Objetivo. Identificar los factores asociados al tratamiento no exitoso para tuberculosis en pacientes con antecedentes de tratamiento para la tuberculosis. Materiales y métodos. Se realizó un estudio observacional retrospectivo, analítico, de cohorte de pacientes que reingresaron a un programa de micobacterias en Cali, Colombia. Se incluyeron mayores de 15 años con tuberculosis pulmonar entre el 2015 y el 2019 con antecedentes de tratamiento para la tuberculosis. Se excluyeron los pacientes con tuberculosis resistente. Resultados. Ingresaron 605 pacientes con antecedentes de tratamiento, 60 % por tratamiento inconcluso y 40 % por recaída. En comparación con los pacientes que reingresaron por recaída (ORa= 2,34; IC=1,62-3,38), las variables que explicaron de manera independiente el no tener éxito con el tratamiento para la tuberculosis al egreso fueron: estar en situación de calle (ORa = 2,45; IC = 1,54-3,89), ser farmacodependiente (ORa = 1,95; IC=1,24-3,05), tener coinfección tuberculosis/VIH (ORa = 1,69; IC =1,00-2,86) o diabetes (ORa =1,89; IC=1,29-2,77), y el incumplimiento de un tratamiento previo por pérdida de seguimiento, abandono u otras causas. Las variables programáticas que favorecieron el éxito del tratamiento fueron la asesoría de la prueba voluntaria de VIH (p <0,001) y la realización de la prueba de VIH (p < 0,001). Conclusión. Estar en situación de calle, ser farmacodependiente, tener coinfección de tuberculosis y VIH, o diabetes, así como el incumplimiento del tratamiento previo por pérdida del seguimiento, abandono o fracaso del mismo, dificultaron el éxito del tratamiento antituberculoso. En la primera atención al reingreso de los pacientes con tuberculosis se deben identificar y abordar estas características.

Epidemiology and Phylogeny of Anaplasma ovis with a Note on Hematological and Biochemical Changes in Asymptomatic Goats Enrolled from Four Districts in Punjab, Pakistan.

Background: Anaplasma ovis is an intra-erythrocytic gram negative rickettsial bacterium that infects small ruminants, resulting in huge economic losses worldwide. Materials and Methods: The present investigation aims at reporting the molecular prevalence of A. ovis in 1200 asymptomatic goats that were enrolled from 4 districts (Layyah, Lohdran, Dera Ghazi Khan, and Rajanpur) in Punjab, Pakistan by targeting the msp4 gene of bacterium. Risk factors associated with the prevalence of A. ovis and phylogeny of bacterium were also documented. Results: 184 out of 1200 (15%) goat blood samples were infected with A. ovis. The prevalence of the pathogen varied with the sampling sites (p = 0.005), and the highest prevalence was detected in goats from Layyah (19%) followed by Rajanpur (17%), Dera Ghazi Khan (15%), and Lohdran district (9%). The represented partial msp4 gene amplicon was confirmed by Sanger sequencing and deposited to GenBank (OP225957-59). Phylogenetic analysis revealed that the amplified isolates resembled the msp4 sequences reported from Iran, Mangolia, Sudan, and the United States. Sex and age of goats, herd composition and size, and the presence of ticks on goats and dogs associated with herds were the rick factors associated with the prevalence of A. ovis. Red blood cells, lymphocytes (%), neutrophils (%), hemoglobin, and hematocrit levels in blood and Aspartate amino transferase, urea, and creatinine levels in serum were disturbed in A. ovis infected goats when compared with uninfected animals. Conclusion: We are reporting the prevalence of A. ovis in Pakistani goats from four districts of Punjab and these data will help in developing the integrated control policies against this tick-borne pathogen that is infecting our goat breeds.

Risk factors associated with death due to severe fever with thrombocytopenia syndrome in hospitalized Korean patients (2018-2022).

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) has no vaccine or treatment and an extremely high fatality rate. We aimed to analyze and evaluate the risk factors for death associated with SFTS. METHODS: Among reports from 2018 to 2022, we compared and analyzed 1,034 inpatients aged 18 years or older with laboratory-confirmed SFTS who underwent complete epidemiological investigations. RESULTS: Most of the inpatients with SFTS were aged 50 years or older (average age, 67.6 years). The median time from symptom onset to death was 9 days, and the average case fatality rate was 18.5%. Risk factors for death included age of 70 years or older (odds ratio [OR], 4.82); agriculture-related occupation (OR, 2.01); underlying disease (OR, 7.20); delayed diagnosis (OR, 1.28 per day); decreased level of consciousness (OR, 5.53); fever/chills (OR, 20.52); prolonged activated partial thromboplastin time (OR, 4.19); and elevated levels of aspartate aminotransferase (OR, 2.91), blood urea nitrogen (OR, 2.62), and creatine (OR, 3.21). CONCLUSION: The risk factors for death in patients with SFTS were old age; agriculture-related occupation; underlying disease; delayed clinical suspicion; fever/chills; decreased level of consciousness; and elevated activated partial thromboplastin time, aspartate aminotransferase, blood urea nitrogen, and creatine levels.

Involuntary treatment in patients with anorexia nervosa: utilization patterns and associated factors.

BACKGROUND: A subgroup of patients with anorexia nervosa (AN) undergoing involuntary treatment (IT) seems to account for most of the IT events. Little is known about these patients and their treatment including the temporal distribution of IT events and factors associated with subsequent utilization of IT. Hence, this study explores (1) utilization patterns of IT events, and (2) factors associated with subsequent utilization of IT in patients with AN. METHODS: In this nationwide Danish register-based retrospective exploratory cohort study patients were identified from their first (index) hospital admission with an AN diagnosis and followed up for 5 years. We explored data on IT events including estimated yearly and total 5-year rates, and factors associated with subsequent increased IT rates and restraint, using regression analyses and descriptive statistics. RESULTS: IT utilization peaked in the initial few years starting at or following the index admission. A small percentage (1.0%) of patients accounted for 67% of all IT events. The most frequent measures reported were mechanical and physical restraint. Factors associated with subsequent increased IT utilization were female sex, lower age, previous admissions with psychiatric disorders before index admission, and IT related to those admissions. Factors associated with subsequent restraint were lower age, previous admissions with psychiatric disorders, and IT related to these. CONCLUSIONS: High IT utilization in a small percentage of individuals with AN is concerning and can lead to adverse treatment experiences. Exploring alternative approaches to treatment that reduce the need for IT is an important focus for future research.

Epidemiological features of traumatic spinal cord injury in China: A systematic review and meta-analysis.

Background: Traumatic spinal cord injury (TSCI) is a highly fatal and disabling event, and its incidence rate is increasing in China. Therefore, we collated the epidemiological factors of TSCI in different regions of China to update the earlier systematic review published in 2018. Method: We searched four English and three Chinese electronic databases from 1978 to October 1, 2022. From the included reports, information on sample characteristics, incidence, injury characteristics, prognostic factors, and economic burden was extracted. The selection of data was based on the PRISMA statement. The quality of the included studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) tool. The results of the meta-analysis were presented in the form of pooled frequency and forest plots. Results: A total of 59 reports (60 studies) from 23 provinces were included, of which 41 were in the Chinese language. The random pooled incidence of TSCI in China was estimated to be 65.15 per million (95% CI: 47.20-83.10 per million), with a range of 6.7 to 569.7 per million. The pooled male-to-female ratio was 1.95:1. The pooled mean age of the cases at the time of injury was 45.4 years. Motor vehicle accidents (MVAs) and high falls were found to be the leading causes of TSCI. Incomplete quadriplegia and AISA/Frankel grade D were the most common types of TSCI. Cervical level injury was the most prevalent. The pooled in-hospital mortality and complication rates for TSCI in China were 3% (95% CI: 2-4%) and 35% (95% CI: 23-47%). Respiratory problems were the most common complication and the leading cause of death. Conclusion: Compared with previous studies, the epidemiological data on TSCI in China has changed significantly. A need to update the data over time is essential to implement appropriate preventive measures and formulate interventions according to the characteristics of the Chinese population.

Drowning in the United States: Patient and scene characteristics using the novel CARES drowning variables.

INTRODUCTION: Drowning results in more than 360,000 deaths annually, making it the 3rd leading cause of unintentional injury death worldwide. Prior studies examining drowning internationally have reviewed factors surrounding drowning however in the U.S. limited data exists. This study evaluated the novel drowning elements collected in the Cardiac Arrest Registry to Enhance Survival (CARES) during the first 2 years of data collection. METHODS: A retrospective analysis of the CARES database identified cases of drowning etiology for the two years 2020 and 2021. Demographics and incident characteristics were collected. Characteristics included items such as body of water, precipitating event, and who extracted patients. Survival to hospital discharge and neurological outcomes were compared between groups based on who initiated CPR using Pearson's Chi-Squared tests. RESULTS: Among 1,767 drowning cases, 69.7% were male, 47.1% white and 11.9% survived to hospital discharge. Body of water was often natural body (36.2%) or swimming pool (25.9%) and bystanders removed the patient in 42.7% of incidents. Swimming was the most common activity at time of submersion (18.6%) however in 50.2% of cases, activity was unknown or missing. When compared to EMS/First Responder initiating CPR, odds of neurologically favorable survival were significantly higher in the Bystander initiated CPR group (OR = 2.85, 95% confidence interval [CI] 2.02-4.01). CONCLUSION: In this national cohort of drowning patients in cardiac arrest, the novel CARES drowning elements provide additional detail of epidemiological factors. Bystander CPR was associated with improved neurological outcomes. Future studies utilizing the drowning elements can inform injury prevention strategies.

Characterizing the physical and mental health profile of children, adolescents and adults with autism spectrum disorder in Spain.

Introduction: Autistic men and women are more likely to experience health issues than the general population, although the available epidemiological studies addressing co-occurrence conditions are limited. This is the first Spanish epidemiologic study addressing the health profile and poor-health exacerbating factors in individuals of all ages with autism spectrum disorder (ASD). Methods: We analyzed 2,629 registries extracted from Autism Spain's sociodemographic registry (November 2017-May 2020). A descriptive health data analysis was conducted to assess the prevalence of other conditions associated to ASD in the Spanish population. Nervous system disorders (12.9%), mental health diagnoses (17.8%), and other comorbidities (25.4%) were reported. Men-to-women ratio was 4:1. Results: Women, elder individuals and those with intellectual disability (ID) were at an increased risk of health comorbidities and psychopharmacological exposure. Women were also more prone to severe intellectual and functional impairment. Nearly all individuals had difficulties in their adaptative functioning, especially those with ID (50% of the population). Almost half of the sample received psychopharmacological treatments starting from infancy and early childhood, mostly antipsychotics and anticonvulsants. Discussion: This study represents an important first approach to the health status of autistic people in Spain and can contribute to the development of public policies and innovative health strategies.

Clinical-Epidemiological Characteristics and IFITM-3 (rs12252) Variant Involvement in HIV-1 Mother-to-Children Transmission Susceptibility in a Brazilian Population.

Mother-to-children transmission (MTCT) is the main infection route for HIV-1 in children, and may occur during pregnancy, delivery, and/or postpartum. It is a multifactorial phenomenon, where genetic variants play an important role. This study aims at analyzing the influence of clinical epidemiological characteristics and a variant (rs12252) in interferon-induced transmembrane protein 3 (IFITM-3), a gene encoding an important viral restriction factor, on the susceptibility to HIV-1 mother-to-children transmission (MTCT). A case-control study was performed on 209 HIV-1-infected mothers and their exposed infected (87) and uninfected (122) children from Pernambuco, Brazil. Clinical-epidemiological characteristics are significantly associated with MTCT susceptibility. Transmitter mothers have a significantly lower age at delivery, late diagnosis, deficiency in ART use (pregnancy and delivery), and detectable viral load in the third trimester of pregnancy compared with non-transmitter mothers. Infected children show late diagnosis, vaginal delivery frequency, and tend to breastfeed, differing significantly from uninfected children. The IFITM-3 rs12252-C allele and TC/CC genotypes (dominant model) are significantly more frequent among infected than uninfected children, but the statistical significance does not remain when adjusted for clinical factors. No significant differences are observed between transmitter and non-transmitter mothers in relation to the IFITM-3 variant.

Characterization of the population affiliated to the subsidized health insurance scheme in Colombia: a systematic review and meta-analysis.

BACKGROUND: Some reports suggest there are differences in health needs between the population affiliated to the subsidized health insurance scheme (SS) and those affiliated to the contributory health insurance scheme (CS) in Colombia. The objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia and to compare the main epidemiological features of the SS to the CS. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, the search was carried out from 1993, with no other restriction. The information was synthesized into five categories according to the most important risk populations. We estimated combined incidences from epidemiological surveillance data, prevalence ratio, and other measures to estimate the difference between the studied groups. A 95% confidence interval was considered. A random effects model was used weighted by the inverse of the variance of the cumulative incidence calculated for each disease. The risk of bias was assessed using the Joanna Briggs Institute's critical appraisal tools. RESULTS: A total of 16,236 articles were identified; 14,972 were excluded after title and abstract screening, 725 articles were verified as full text, and finally 268 articles were included. The relative risk of non-communicable and communicable diseases was lower in the SS than in the CS (RR: 0.37 and 0.72, respectively, p-value < 0.05). However, the risk of presenting obstetric and maternal conditions in the SS versus the CS was RR 1.55 for frequent conditions during early childhood, and for other diseases it was RR 1.28 with a p-value of < 0.05. The use of health services was different by scheme, with less demand, access, and provision being found in health services in the SS. CONCLUSIONS: This study allowed us to conclude that there are differences in the incidence, prevalence, and use of health services between health affiliation schemes (SS and CS) in Colombia, thereby assisting in decision-making for stakeholders. TRIAL REGISTRATION: PROSPERO Registration number CRD42021279234.

Leisure-time and occupational physical activity demonstrate divergent associations with periodontitis: A population-based study.

AIM: To evaluate the association between leisure-time/occupational physical activity (LTPA/OPA) and periodontitis in a nationally representative sample of the U.S. MATERIALS AND METHODS: Data from 10,679 adults were retrieved from NHANES 2009-2014 database. Physical activity was assessed through the Global Physical Activity Questionnaire, and accordingly, subjects were classified as performing either high or low LTPA/OPA. Periodontal status was assessed through a full-mouth periodontal examination, and subjects were classified according to the AAP/CDC criteria (no, mild, moderate, or severe periodontitis). Simple and multiple regression analyses were applied to study the association between LTPA/OPA and periodontitis/severe periodontitis. RESULTS: Multiple regression analyses identified high LTPA as a protective indicator for periodontitis (odds ratio [OR] = 0.81; 95% confidence interval [CI]: 0.72-0.92), while high OPA was found to be a significant risk indicator (OR = 1.16; 95% CI: 1.04-1.30). The combination low LTPA/high OPA showed a cumulative independent association with periodontitis (OR = 1.47; 95% CI: 1.26-1.72). Moreover, both high LTPA (OR = 0.72; 95% CI: 0.58-0.90) and high OPA (OR = 1.29; 95% CI: 1.09-1.53) were significantly associated with stronger estimates of severe periodontitis; the same was observed for the combination of low LTPA/high OPA (OR = 1.66; 95% CI: 1.29-2.15). CONCLUSIONS: LTPA and OPA showed divergent associations with periodontitis.

Effects of preoperative epidemiological factors on the surgical outcomes of benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To investigate the preoperative epidemiological factors affecting the surgical outcomes of transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) and to evaluate the clinical predictive value. 【Methods】 Patients undergoing TURP at our hospital during Dec.2018 and Sep.2021 whose pathological examination suggestive of BPH were involved. Before operation, the clinical data, International Prostate Symptom Score (IPSS), quality of life (QoL) score, overactive bladder (OAB) score, prostate-specific antigen (PSA), and urological ultrasound results were collected. After operation, all patients were followed up with telephone call or face-to-face interview, and the IPSS, QoL score and OAB score were examined. Patients were divided into effective and ineffective groups according to the efficacy rubrics. The epidemiological factors affecting the efficacy of TURP were identified with univariate analysis, the independent influencing factors were screened with binary logistic regression, and the diagnostic value of each independent influencing factor was evaluated using receiver operating characteristic (ROC) curve. 【Results】 OAB score (OR=0.749, 95%CI: 0.627-0.895, P=0.001), IPSS-V/S (OR=4.919, 95%CI: 1.617-14.963, P=0.005), history of urinary retention (OR=7.513, 95%CI: 2.289-24.656, P=0.001), and history of urinary incontinence (OR=2.656, 95%CI: 1.015-6.950, P=0.047) were independent influencing factors for poor postoperative outcomes. ROC curve revealed that the area under the ROC curve (AUC) showed that AUC of OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were 0.784 (95%CI: 0.718-0.841), 0.686 (95%CI: 0.614-0.751), 0.713 (95%CI: 0.643-0.777), and 0.723 (95%CI: 0.654-0.786), respectively. ROC curve of the regression model showed that the AUC was 0.888 (95%CI: 0.834-0.930), and the sensitivity and specificity were 93.53% and 67.35%, respectively. 【Conclusion】 Preoperative OAB score, IPSS-V/S, history of urinary retention, and history of urinary incontinence were independent epidemiological factors of poor outcomes after TURP in BPH patients. The diagnostic efficacy ranked from the highest to the lowest as regression model >OAB score>history of urinary incontinence >history of urinary retention>IPSS-V/S.

The epidemiologic factors associated with breast density: A review.

In recent years, some studies have evaluated the epidemiologic factors associated with breast density. However, the variant and inconsistent results exist. In addition, breast density has been proved to be a significant risk factor associated with breast cancer. Our review summarized the published studies and emphasized the crucial factors including epidemiological factors associated with breast density. In addition, we also discussed the potential reasons for the discrepant results with risk factors. To decrease the incidence and mortality rates for breast cancer, in clinical practice, breast density should be included for clinical risk models in addition to epidemiological factors, and physicians should get more concentrate on those women with risk factors and provide risk-based breast cancer screening regimens.

Influence of eating disorder psychopathology and general psychopathology on the risk of involuntary treatment in anorexia nervosa.

PURPOSE: We explored associations between clinical factors, including eating disorder psychopathology and more general psychopathology, and involuntary treatment in patients with anorexia nervosa. Our intention was to inform identification of patients at risk of involuntary treatment. METHODS: This was a retrospective cohort study combining clinical data from a specialized eating disorder hospital unit in Denmark with nationwide Danish register-based data. A sequential methodology yielding two samples (212 and 278 patients, respectively) was adopted. Descriptive statistics and regression analyses were used to explore associations between involuntary treatment and clinical factors including previous involuntary treatment, patient cooperation, and symptom-level psychopathology (Eating Disorder Inventory-2 (EDI-2) and Symptom Checklist-90-Revised (SCL-90-R)). RESULTS: Somatization (SCL-90-R) (OR = 2.60, 95% CI 1.16-5.81) and phobic anxiety (SCL-90-R) (OR = 0.43, 95% CI 0.19-0.97) were positively and negatively, respectively, associated with the likelihood of involuntary treatment. Furthermore, somatization (HR = 1.77, 95% CI 1.05-2.99), previous involuntary treatment (HR = 5.0, 95% CI 2.68-9.32), and neutral (HR = 2.92, 95% CI 1.20-7.13) or poor (HR = 3.97, 95% CI 1.49-10.59) patient cooperation were associated with decreased time to involuntary treatment. Eating disorder psychopathology measured by the EDI-2 was not significantly associated with involuntary treatment. CONCLUSIONS: Clinical questionnaires of psychopathology appear to capture specific domains relevant to involuntary treatment. Poor patient cooperation and previous involuntary treatment being associated with shorter time to involuntary treatment raise important clinical issues requiring attention. Novel approaches to acute anorexia nervosa care along with unbiased evaluation upon readmission could mitigate the cycle of repeat admissions with involuntary treatment. LEVEL OF EVIDENCE: Level III, cohort study.

Prevalence, Outcomes, and Risk Factors for Cardiorespiratory Arrest in the Intensive Care Unit: An Observational Study.

Background: Cardiorespiratory arrest is defined as an abrupt halt in the cardiac mechanical activity that is accompanied by the loss of a detectable pulse, the cessation of breathing, and the loss of consciousness. The aim of this study is to create a clinical-epidemiological profile of patients who experienced cardiorespiratory arrest and were admitted to the intensive care unit to evaluate the associated factors and their impact on the prognosis of these patients. Patients and methods: From January to December 2019, the medical records of 135 patients who received cardiopulmonary resuscitation were reviewed for this cross-sectional observational study. The information was collected according to the Utstein model. Results: A low return of spontaneous circulation of 22.2% was observed, with a predominance of females (53.3%) and older patients (68.9%), multiple comorbidities at admission (68.4%), and asystole as the predominant rhythm. Female sex and age >60 years were statistically significant (p = 0.017), as was the association between sex and comorbidities (p = 0.036), with heart disease being the most prevalent in females (p = 0.036). Conclusion: In this study, even though the resuscitation maneuver time (start of resuscitation following arrest) was very short and the defibrillation was performed promptly, there was a high prevalence of cardiac arrest and low survival rates after cardiopulmonary resuscitation. How to cite this article: Menezes da Silva A, Braga AL, Cruvinel de Souza V. Prevalence, Outcomes, and Risk Factors for Cardiorespiratory Arrest in the Intensive Care Unit: An Observational Study. Indian J Crit Care Med 2022;26(6):704-709.

Systemic Multimorbidity Clusters in People with Periodontitis.

This study aimed to identify systemic multimorbidity clusters in people with periodontitis via a novel artificial intelligence-based network analysis and to explore the effect of associated factors. This study utilized cross-sectional data of 3,736 participants across 3 cycles of the National Health and Nutrition Examination Survey (2009 to 2014). Periodontal examination was carried out by trained dentists for participants aged ≥30 y. The extent of periodontitis was represented by the proportion of sites with clinical attachment loss (CAL)≥ 3 mm, split into 4 equal quartiles. A range of systemic diseases reported during the survey were also extracted. Hypergraph network analysis with eigenvector centralities was applied to identify systemic multimorbidity clusters and single-disease influence in the overall population and when stratified by CAL quartile. Individual factors that could affect the systemic multimorbidity clusters were also explored by CAL quartile. In the study population, the top 3 prevalent diseases were hypertension (63.9%), arthritis (47.6%), and obesity (45.9%). A total of 106 unique systemic multimorbidity clusters were identified across the study population. Hypertension was the most centralized disease in the overall population (centrality [C]: 0.50), followed closely by arthritis (C: 0.45) and obesity (C: 0.42). Diabetes had higher centrality in the highest CAL quartile (C: 0.31) than the lowest (C: 0.26). "Hypertension, obesity" was the largest weighted multimorbidity cluster across CAL quartiles. This study has revealed a range of common systemic multimorbidity clusters in people with periodontitis. People with periodontitis are more likely to present with hypertension and obesity together, and diabetes is more influential to multimorbidity clusters in people with severe periodontitis. Factors such as ethnicity, deprivation, and smoking status may also influence the pattern of multimorbidity clusters.

Biological Properties of SARS-CoV-2 Variants: Epidemiological Impact and Clinical Consequences.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that belongs to the coronavirus family and is the cause of coronavirus disease 2019 (COVID-19). As of May 2022, it had caused more than 500 million infections and more than 6 million deaths worldwide. Several vaccines have been produced and tested over the last two years. The SARS-CoV-2 virus, on the other hand, has mutated over time, resulting in genetic variation in the population of circulating variants during the COVID-19 pandemic. It has also shown immune-evading characteristics, suggesting that vaccinations against these variants could be potentially ineffective. The purpose of this review article is to investigate the key variants of concern (VOCs) and mutations of the virus driving the current pandemic, as well as to explore the transmission rates of SARS-CoV-2 VOCs in relation to epidemiological factors and to compare the virus's transmission rate to that of prior coronaviruses. We examined and provided key information on SARS-CoV-2 VOCs in this study, including their transmissibility, infectivity rate, disease severity, affinity for angiotensin-converting enzyme 2 (ACE2) receptors, viral load, reproduction number, vaccination effectiveness, and vaccine breakthrough.

An Updated Epidemiology of Foot and Ankle Fractures in the United States: Complications, Mechanisms, and Risk Factors.

Foot and ankle fractures are prevalent emergent injuries, about which there remains a lack of in-depth epidemiological information. This analysis of the epidemiology of foot and ankle injuries in the United States updates a previously conducted study. Data from the National Trauma Data Bank (2012-2017) were used for analysis. Demographic variables, mechanism of injuries, and comorbidities were analyzed to determine risk factors for complications after foot and ankle injuries. Young adults aged 21 to 30 years had the highest injury rates; however, in general, older individuals were more at risk for complications. Black individuals were more at risk for certain complications, while Asians were at lower risk, when compared to White individuals. The comorbidities of bleeding disorders, diabetes, smoking, hypertension, and chronic obstructive pulmonary disease all increased risk of at least 1 complication. In terms of mechanism, traffic incidents were found to be the most strongly associated with complications.