Pediatric Rheumatological Diseases in a Tertiary Care Hospital of Central India: A Retrospective Clinico-Epidemiological Profile.

Introduction: Infectious diseases account for the major health problem in developing countries like India. Though non-infectious diseases like rheumatological disorders are not very common, the burden of these disorders as a group is high in society due to the huge population size. The rheumatological disorders have varied presentations which may mimic other infectious pathologies leading to a significant time lag in the diagnosis. There is inadequate data on the exact burden of these diseases. The spectrum of rheumatological disorders in developing countries is different as compared to the Western world. Hence this study was carried out with the aim of studying the clinical, epidemiological, and laboratory profile of rheumatological disorders in the pediatric age group in a tertiary care hospital. Methods: It was a retrospective study. Data of patients admitted with the diagnosis of rheumatological disorder in the age group of one month to 15 years during the period from June 2018 to December 2022 were reviewed. Results: A total of 35 patients were identified with 20 being female. The mean age of the patients was 8.42± 3.95 years. The most common disease was juvenile idiopathic arthritis (JIA)- 10(28.57%) with an equal proportion of polyarticular JIA and systemic-onset JIA, followed by systemic lupus erythematosus (SLE) nine (25.71%) and Kawasaki Disease (KD)- eight (22.85%). The commonest presenting complaint was fever followed by a rash, whereas the most common findings were pallor and rash. Anemia was present in 25 (71.42%). C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were high in 20 (57.14%) and 22 (62.85%), respectively. Antinuclear antibodies (ANA) were positive in 10 (28.57%) and rheumatoid factor (RA) factor in only one (2.85%) case. Conclusions: The most common rheumatological disorder identified was JIA. Fever and rash were the common presenting complaints. Pallor was the commonest sign whereas anemia was the commonest hematological abnormality.

Epidemiological and Histological Characteristics of Differentiated Thyroid Carcinoma: A Case of the Department of Nuclear Medicine at Ibn Rochd Hospital, Casablanca, Morocco.

BACKGROUND: Thyroid carcinoma (TC) represents the most frequent type of endocrine cancers, with its incidence steadily increasing worldwide. Our study aimed to describe the epidemiological and histological characteristics of differentiated thyroid carcinoma (DTC) at the Department of Nuclear Medicine in Ibn Rochd University Hospital, Casablanca, Morocco. METHODS: This was a cross-sectional study of DTC cases treated between 2004 and 2012 in the Department of Nuclear Medicine at Ibn Rochd University Hospital. We retrospectively reviewed medical records at this department, focusing on sociodemographic characteristics, such as age, gender, geographic origin, family history of cancer, and clinical information related to tumor features, including histological type, tumor size, and multifocality. The data were statistically analyzed using the jamovi 2.3.17 software (released September 2022, the jamovi project, retrieved from https://www.jamovi.org), considering the characteristics of the variables. RESULTS: The findings revealed that 89% of the patients were females, and 78.7% were under the age of 55, ranging from 14 to 85 years. Married status represented 75.25% of our cases. Personal history of cancer and a family history of thyroid carcinoma were present in 0.9% and 1.17%, respectively. Concerning histological characteristics, the main histological type was papillary thyroid carcinoma (PTC) at 93%. Within these 1,283 cases, the follicular variant was the most frequent (42.89%). In addition, the tumor size was less than 2 cm in 43.80%, and it was encapsulated in 21.60%. Moreover, we staged our data according to the 8th edition of the American Joint Committee on Cancer staging system, revealing that at the time of diagnosis, 94.13% were in stage I. CONCLUSION: This study provides an overview of the epidemiological and histological characteristics of DTC in Morocco. The findings highlight the diversity and differences between clinical presentation and epidemiological profile in Moroccan patients, contributing to a better understanding of the disease and facilitating adapted management.

Perfil sociodemográfico y clínico de mujeres con cáncer de mama en hospital de tercer nivel / Sociodemographic and clinical profile of women with breast cancer at a tertiary hospital

Objetivo: describir el perfil clínico y sociodemográfico de mujeres con cáncer de mama (CM) en un hospital de tercer nivel del Bajío, México. Métodos: estudio descriptivo transversal con recogida de datos retrospectivos. Se revisaron 262 expedientes clínicos de mujeres con CM, seleccionados mediante muestreo probabilístico. Variables de estudio: edad, lugar de residencia, nivel de estudios, antecedentes familiares y personales de cáncer, comorbilidades, tabaquismo, alcoholismo, tiempo transcurrido desde el diagnóstico, variables clínicas y de tratamiento del CM. Resultados: la media de edad fue de 58,07 años. El 45,8% no tenía antecedentes de cáncer, pero en quienes sí lo tenían, madre y hermana eran los más frecuentes (10,7% y 10,3% respectivamente). El 42,4% de las pacientes presentaba obesidad y el 23,3% tenía más de dos enfermedades crónico-degenerativas. El 87% de las mujeres no presentó metástasis. Un 19,8% se detectó en la etapa IIA. El grado G0 de invasión a ganglios linfáticos fue el más frecuente (35%). La combinación de dos o más tratamientos fue la forma de abordaje terapéutico más común (95,8%). La mayoría de los pacientes fueron dadas de alta por presentar mejoría (71%). Conclusiones: conocer las características sociodemográficas y clínicas de las pacientes con CM puede ayudar a establecer estrategias específicas para la prevención y el manejo en este grupo de pacientes, brindando una atención holística.(AU)

Objective: to describe the clinical and sociodemographic profile of women with breast cancer (BC) in a tertiary hospital from the Bajío area, Mexico. Methods: a descriptive cross-sectional study with retrospective data collection. There was a review of 262 clinical records of women with BC, selected through probability sample. The study variables were age, place of residence, level of studies, family and personal history of cancer, comorbidities, smoking, use of alcohol, time since diagnosis, clinical and BC treatment variables. Results: the mean age was 58.07 years; 45.8% had no history of cancer, but in those who had it, the most frequent were mother and sister (10.7% and 10.3% respectively). 42.4% of the patients presented obesity, and 23.3% had over two chronic degenerative conditions. 87% of women did not present metastasis; 19.8% were detected in the IIA stage; G0 was the most frequent level of invasion of lymph nodes (35%). The most common treatment approach was the combination of two or more treatments (95.8%). The majority of patients were discharged due to improvement (71%). Conclusions: knowing the sociodemographic and clinical characteristics of BC patients can help to establish specific strategies for prevention and management in this group, thus offering holistic care.(AU)

The Pattern of Admission, Clinical Characteristics, and Outcomes Among Patients Admitted to the Intensive Care Unit of a Tertiary Hospital in Tanzania: A 5-Year Retrospective Review.

Introduction: Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery. Material and Methods: A single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients' outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality. Results: Medical records of 717 patients were reviewed. The cohort was male (n=472,65.8%) and African predominant (n=471,65.7%) with a median age of 58 years (IQR 45.0-71.0). 17.9% of patients did not survive. The highest mortality was noted amongst patients with septic shock (29.3%). The lowest survival was noted amongst patients requiring three organ support (n=12,2.1%). Advanced age (OR 1.02,CI 1.00-1.04), having more than three underlying comorbidities (OR 2.50,CI 1.96-6.60), use of inotropic support (OR 3.58,CI 1.89-6.80) and mechanical ventilation (OR 9.11,CI 4.72-18.11) showed association with increased risk for mortality in ICU. Conclusion: The study indicated a much lower ICU mortality rate compared to similar studies conducted in other parts of Sub-Saharan Africa. Advanced age, underlying multiple comorbidities and organ support were associated with ICU mortality. Large multi-center studies are needed to highlight the true burden of critical care illness in Tanzania.

Clinico-Epidemiological Profile and Short-Term Outcomes of Patients with Acute Poisoning Presenting to an Emergency of a Tertiary Care Center in Western Rajasthan.

Background: This research aimed to evaluate the clinico-epidemiological profile and short-term outcomes of patients admitted to the emergency department of a tertiary hospital. Materials and Methods: This prospective observational cross-sectional study was conducted between January 1, 2021, and June 30, 2022, in the Emergency Department of a tertiary hospital. Patients of either gender of any age attending the emergency department with acute poisoning were included. These cases were analyzed for their epidemiological profiles, poisoning characteristics, and various clinical variables influencing patient outcomes. Results: Out of a total of 236 patients, 190 patients (80.5%) were aged more than 18 years. Comorbidities were present in 32 (13.5%) patients, and psychiatric illness was the most common comorbidity. The intention of poisoning was suicidal in 185 patients (78.4%) and accidental in 51 patients (21.6%). Organophosphate was the most common poisoning seen in 55 patients (23.3%), followed by drug ingestion seen in 44 patients (18.6%). Twenty-eight patients (11.8%) were transferred to the intensive care unit. Nineteen patients (8.1%) required mechanical ventilation. There were ten deaths (4.2%) in the study population. Aluminum phosphide poisoning was associated with the highest mortality rate, followed by organophosphate poisoning. Conclusions: This study indicates that most poisoning cases involved young people, mainly males. Organophosphorus poisoning was one of the most common poisonings, followed by the ingestion of drugs in this part of the world. Aluminum phosphide had the highest fatality rate.

The epidemiological profile associated with lifestyle risk factors and nutritional status for COVID-19 patients in the Iraqi population.

Objectives: To determine the prevalence of COVID-19 infection and to identify the lifestyle factors and nutritional status associated with the epidemiological profile of COVID-19 patients. Materials and Methods: This cross-sectional survey was carried out in the eighteen Iraqi governorates, from 1st August to 20th of October 2020. At the end of this study, 433 participants were recruited. Results: The prevalence of coronavirus infection was 37.18%. Smoking and active physical activity were relatively higher for COVID-19 patients who are male, and belonged to the under-45 age range were 91.3%. It notices that COVID-19 patients who smoked and had active physical activity were married, residents in urban, and worked. Likewise, COVID-19 patients who had equal or more than an institute/college level of education are smokers and had active physical activity. Obesity prevalence was higher for patients aged <45 (92.2%), and higher for females (51%). The proportion of obesity was generally higher for married and for those living in urban areas (92.2%). Obesity was significantly more common among those in worked (70.6%). Conclusions: Of note is the high prevalence of COVID-19 infection observed. A strong correlation between the prevalence of active physical activity among COVID-19 patients and gender, marital status, residence, education, and occupation. Unexpectedly, the prevalence rate of obesity among COVID-19 patients correlating with socio-demographic status did not yield a significant difference.

Seasonality of sporotrichosis in Brazil: A modelled analysis of the epidemic in São Paulo, 2011-2020.

BACKGROUND: Sporotrichosis is an endemic subcutaneous mycosis classically caused by the Sporothrix schenckii species complex. Recently, sporotrichosis has emerged in Brazil as a cat-transmitted epidemic caused by a new species, Sporothrix brasiliensis. OBJECTIVES: To survey the clinical-epidemiological profile of all sporotrichosis cases diagnosed between 2011 and 2020 at a reference hospital in São Paulo metropolitan area and evaluate the annual distribution of cases in relation to seasonality. METHODS: Patients' demographic and clinical-epidemiological data were surveyed. A generalized linear model was fitted to relate the quarterly number of sporotrichosis cases detected between 2015 and 2019 with precipitation and temperature series. Prediction of the number of cases from 2011 to 2014 was attempted based on the fitted model without the trend component that appears from 2015. RESULTS: Among 271 suspected cases admitted during 2011-2020, 254 were confirmed by fungal isolation and/or clinical-epidemiological criteria. We observed that 2015 onwards the number of cases regularly increased during Autumn and Winter, the driest and coldest stations of the year. We verified that temperature series affected the number of cases (p = .005) because an increase of 1°C in the temperature series was associated with a 14.24% decrease in the average cases number, with the average number of cases increasing by 10.96% (p < .0001) every quarter, corresponding to an annual increase of 52%. Between 2011 and 2014, the predicted number of sporotrichosis cases averaged 10-12 per year, with 33%-38% occurring in the winter. CONCLUSION: We hypothesize that sporotrichosis seasonality is associated with the felines' oestrus cycle, which may provide alternative, cat-directed approaches to the sporotrichosis epidemic control.

Epidemiological profile and risk factors associated with death in patients receiving invasive mechanical ventilation in an adult intensive care unit from Brazil: a retrospective study.

Introduction: Understanding the epidemiological profile and risk factors associated with invasive mechanical ventilation (IMV) is essential to manage the patients better and to improve health services. Therefore, our objective was to describe the epidemiological profile of adult patients in intensive care that required IMV in-hospital treatment. Also, to evaluate the risks associated with death and the influence of positive end-expiratory pressure (PEEP) and arterial oxygen pressure (PaO2) at admission in the clinical outcome. Methods: We conducted an epidemiological study analyzing medical records of inpatients who received IMV from January 2016 to December 2019 prior to the Coronavirus Disease (COVID)-19 pandemic in Brazil. We considered the following characteristics in the statistical analysis: demographic data, diagnostic hypothesis, hospitalization data, and PEEP and PaO2 during IMV. We associated the patients' features with the risk of death using a multivariate binary logistic regression analysis. We adopted an alpha error of 0.05. Results: We analyzed 1,443 medical records; out of those, 570 (39.5%) recorded the patients' deaths. The binary logistic regression was significant in predicting the patients' risk of death [X2(9) = 288.335; p < 0.001]. Among predictors, the most significant in relation to death risk were: age [elderly ≥65 years old; OR = 2.226 (95%CI = 1.728-2.867)]; male sex (OR = 0.754; 95%CI = 0.593-0.959); sepsis diagnosis (OR = 1.961; 95%CI = 1.481-2.595); need for elective surgery (OR = 0.469; 95%CI = 0.362-0.608); the presence of cerebrovascular accident (OR = 2.304; 95%CI = 1.502-3.534); time of hospital care (OR = 0.946; 95%CI = 0.935-0.956); hypoxemia at admission (OR = 1.635; 95%CI = 1.024-2.611), and PEEP >8 cmH2O at admission (OR = 2.153; 95%CI = 1.426-3.250). Conclusion: The death rate of the studied intensive care unit was equivalent to that of other similar units. Regarding risk predictors, several demographic and clinical characteristics were associated with enhanced mortality in intensive care unit patients under mechanical ventilation, such as diabetes mellitus, systemic arterial hypertension, and older age. The PEEP >8 cmH2O at admission was also associated with increased mortality since this value is a marker of initially severe hypoxia.

Perfil clínico-epidemiológico de pacientes con covid-19 hospitalizados en un hospital universitario de referencia / Clinical-epidemiological profile of patients with covid-19 admitted to a university hospital reference

Objetivo: Caracterizar el perfil epidemiológico de los pacientes hospitalizados con COVID-19 en una unidad de emergencia de referencia en el norte de Paraná; analizar el perfil de los pacientes afectados por COVID-19 en términos de: sexo, color/raza, edad, estado civil, procedencia y tipo de derivación; medir el promedio de estancia hospitalaria, desde la fecha de ingreso hasta el alta del paciente, determinar el porcentaje de los principales resultados hospitalarios. Método: Se trata de una investigación de campo con abordaje cuantitativo, observacional, unicéntrica, descriptiva, exploratoria y retrospectiva, realizada en el Hospital Universitario de la Universidad Estadual de Londrina, ubicado en el norte de Paraná. La población de estudio estuvo constituida por los datos de 2.800 pacientes ingresados y hospitalizados con diagnóstico confirmado de COVID-19 en el Servicio de Urgencias del hospital en cuestión, según registros del núcleo de epidemiología y el Servicio de Estadísticas y Archivo Médico, desde enero de 2021 hasta julio de 2021. de 2021. Resultados: Se observó que la mayoría de los afectados eran del sexo masculino, de raza blanca, solteros y tenían entre 58 y 67 años. La estancia hospitalaria media fue de 16 días. El Servicio Móvil de Atención de Urgencias presentó los mayores registros de derivaciones y los desenlaces de alta y muerte tuvieron valores muy similares. Conclusión: Se concluye que la segunda ola de COVID-19 fue devastadora en todos los seguimientos, reflejando el cambio en el perfil etario de los afectados, el aumento de las tasas de hospitalización, las altas tasas de mortalidad y la estrecha relación entre el período de hospitalización y progresión a la muerte. (AU)

Objetivo: Caracterizar o perfil epidemiológico dos pacientes internados com COVID-19 em uma unidade de pronto socorro referência do norte do Paraná; analisar o perfil dos pacientes acometidos por COVID-19 quanto ao: gênero, cor/raça, idade, estado civil, procedência e tipo de encaminhamento; mensurar o tempo médio de internação hospitalar, desde a data da admissão do paciente até sua alta, determinar o percentual dos principais desfechos hospitalares. Método: Tratou-se de uma pesquisa de campo com abordagem quantitativa, do tipo observacional, unicêntrica, descritiva, exploratória e retrospectiva, realizada no Hospital Universitário da Universidade Estadual de Londrina, localizado no norte do Paraná. A população do estudo consistiu dos dados de 2.800 pacientes admitidos e internados com diagnóstico confirmado de COVID-19 no Pronto Socorro do hospital em questão, conforme registros do núcleo de epidemiologia e Serviço de Arquivo Médico e Estatística, no período de janeiro de 2021 a julho de 2021. Resultados: Observou-se que maioria dos acometidos eram do sexo masculino, possuíam cor branca, eram solteiros e tinham entre 58 e 67 anos. O tempo médio de internação foi de 16 dias. O Serviço de Atendimento Móvel de Urgência obteve os maiores registros de encaminhamentos e os desfechos de alta e óbito possuíram valores muito próximos. Conclusão: Conclui-se que a segunda onda da COVID-19 se mostrou devastadora em todos os seguimentos, refletindo na mudança do perfil etário dos acometidos, no aumento das taxas de internação, nos altos índices de mortalidade e na a estreita relação entre o período de internação e a evolução ao óbito. (AU)

Objective: To characterize the epidemiological profile of patients hospitalized with COVID-19 in a referral emergency unit in northern Paraná; analyze the profile of patients affected by COVID-19 regarding gender, color/race, age, marital status, origin and type of referral; measure the average length of hospital stay, from the date of admission of the patient until discharge, determine the percentage of the main hospital outcomes. Method: It was field research with a quantitative, observational, unicentric, descriptive, exploratory and retrospective approach, carried out at the University Hospital of the State University of Londrina, located in the north of the Paraná. The study population consisted of data from 2,800 patients admitted and hospitalized with a confirmed diagnosis of COVID-19 in the Emergency Room of the hospital in question, according to records of the epidemiology center and Medical and Statistical Archive Service, from January 2021 to July 2021. Results: It was observed that most of those affected were male, had a white color, were single and were between 58 and 67 years old. The mean length of hospitalization was 16 days. The Mobile Emergency Care Service obtained the highest referral records and the discharge and death outcomes had very close values. Conclusion: It is concluded that the second wave of COVID-19 was devastating in all segments, reflecting the change in the age profile of those affected, the increase in hospitalization rates, high mortality rates and the close relationship between the hospitalization period and the evolution to death. (AU)

Clinical and histopathology characteristics of Castleman disease: a multicenter study of 51 Brazilian patients.

Castleman's disease (CD) is a rare and heterogeneous lymphoproliferative disorder, with limited available clinical information in Brazil. A retrospective study was carried out through information contained in the medical records of 51 patients, between July 1999 and June 2020. Seven patients were excluded, and 44 were analyzed in total. The average age of unicentric CD (UCD) patients was 35 years old and of multicentric CD (MCD) patients was 49 years old (p = 0.013). Regarding gender, there was a predominance of females among patients with UCD (68.4%) and males in patients with MCD (57.9%) (p = 0.103). The most common site of involvement in UCD was the cervical region (36.8%). A total of 73.7% of patients with UCD and 68.4% of patients with MCD presented the histological form hialyne-vascular (HV) (p = 0.499). Most patients with laboratory abnormalities had MCD. A total of 78% of the patients were asymptomatic, with the majority of symptomatic patients with MCD (p = 0.042). Only two of the 27 patients evaluated for the presence of human immunodeficiency virus (HIV) had positive serology. HHV-8 was evaluated in 14 cases, being positive in two. Of the patients with UCD, 94.7% underwent excisional biopsy, against only 41.2% of patients with MCD (p = 0.01). The mean follow-up was 61 months. We observed similarities in the clinical profile between patients in our study and patients described in the literature, such as gender, mean age, B symptoms, visceromegaly, fluid accumulation, and treatment. Unlike the literature, the cervical region was the most affected site, besides the greater association of the HV histological subtype among patients with MCD.

Epidemiological Profile among Greek CrossFit Practitioners.

CrossFit (CF) is a popular and rapidly expanding training program in Greece and worldwide. However, there is a lack of scientific evidence on the risk of musculoskeletal injuries related to CF in the Greek population. A self-administered survey of 1224 Greek CF practitioners aged 18 to 59 was conducted and analyzed using the Statistical Package for Social Sciences (SPSS) software. The highest percentage of the participants (34%) practiced 5 days per week for 60 min (42.2%) and had 2 days per week of rest (41.7%). A total of 273 individuals (23%) participated in CF competitions and 948 (77%) did not. The results showed that the most common injuries were muscle injuries (51.3%), followed by tendinopathies (49.6%) and joint injuries (26.6%). The shoulders (56.6%; n = 303), knees (31.8%; n = 170), and lumbar spine (33.1%; n = 177) were the most commonly injured locations. The logistic regression model showed that participation in competitions (p = 0.001), rest per week (p = 0.01), duration of training per session (p = 0.001), and frequency of training per week (p = 0.03) were statistically significant factors for injury. Training level was not a statistically significant factor for injury (p = 0.43). As CF continues to gain popularity on a global scale and the number of athletes gradually increases, it is important to monitor the safety of practitioners. Clinicians should consider participation in competitions, rest, training duration, and frequency in order to make CF safer.

Disease profile of rheumatoid arthritis and its complications in hispanic population.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease that is associated with functional disability and reduced quality of life. The central pathology of RA is the inflammation of diarthrodial joints, but approximately 40% of patients experience extra-articular manifestations of RA. Extra-articular manifestations are complications of RA that constitute multisystem disorders, associated with genetic and environmental conditions, and increase mortality in RA patients. Observational studies of RA patients have suggested ethnic disparities exist for minority populations; however, less is known about the distribution and prevalence of RA complications and drug-related problems (DRPs). Our objective was to construct a disease profile of RA-related complications in the Hispanic Mexican-American population compared to the non-Hispanic population of El Paso, Texas. METHODS: A retrospective study was conducted in a Texas Tech University Health Science Center El Paso from 2009 to 2019 to assess the prevalence of RA-related complications in the Hispanic vs non-Hispanic population. The primary parameters were RA diagnosis, serological status, RA-treatment modalities, and history of associated complications. Data were extracted by chart review and correlated to disease-related and treatment-related complications. STATA was used to perform statistical analyses. A p-value of < 0.05 determined statistical significance. RESULTS: One thousand five hundred five (N=1505) patients, diagnosed with RA, were included in this study. Of the cohort, 82.52% of patients were females, 76.81% were Hispanic, and 64.12% had no smoking history. From the total cohort, seven hundred fifty-six (N=756) patients had documentation of serological markers (Rheumatoid factor (RF) and/or Anti-cyclic citrullinated peptide (Anti-CCP)); 78.44% of patients whose serological status was documented, were positive for RF and/or Anti-CCP. Multivariate regression analysis revealed Hispanics have 15% and 17% less risk of overall RA complications and drug-related side-effects, respectively, compared to non-Hispanics (p-value <0.0001). However, within the entire cohort, those with a family history of RA had a 44% more risk of complications compared to those without family history (p-value <0.0001). Additionally, modifiable risk factors, i.e., active smoking and alcohol use had a higher complication risk, 19% and 21%, respectively (p-value <0.0001). Significantly, all patients seropositive for RF, and/or anti-CCP had a lower prevalence of RA-related and drug-related complications. However, non-Hispanic patients seropositive for RF or anti-CCP had a higher prevalence of specific complications of RA and DRPs compared to Hispanic patients. CONCLUSION: In our retrospective review, analysis of sociodemographic characteristics reveals that Hispanic patients paradoxically have less risk of disease-related and treatment-related complications compared to non-Hispanic populations in El Paso, Texas. Genetic predisposition, modifiable environment/lifestyle factors had a higher prevalence of RA complications, congruent with established studies. Further analysis reveals that seropositive RA-patients have decreased complication prevalence compared to seronegative cohorts.

Epidemiological and Clinical Profile of Newly Diagnosed HIV/AIDS Patients: A Retrospective Analysis of Changing Trends Over 16 Years.

OBJECTIVE: To evaluate the epidemiological profile and clinical findings of newly diagnosed HIV-infected patients in terms of changing trends over 16 years. METHODS: A total of 748 patients (mean ± SD age: 34 ± 11.6 years, 88.9% were males) newly diagnosed with HIV/AIDS at a tertiary care hospital located in Istanbul province between 2002 and 2017 were included in this retrospective study. Data on sociodemographic characteristics, potential routes of transmission, the reason for HIV testing, time from diagnosis to treatment onset, and the HIV RNA values and CD4+ T cell count (at diagnosis and treatment onset) were recorded in each patient and compared between the diagnoses made within the 2002-2009 (n = 141) vs. 2010-2017 (n = 607) periods. RESULTS: When compared to HIV diagnoses within the 2002-2009 period, the diagnoses made within the 2010-2017 period were associated with a significantly higher percentage of males (78.7 vs. 91.3%, p < 0.001), 18-29 years age group (23.6% vs. 35.5%, p = 0.029), singles (34.0 vs. 49.6%, p = 0.004), university graduates (9.9 vs. 23.4%, p < 0.001) and students (0.7 vs. 8.2%, p < 0.001) along with an increased likelihood of voluntary testing (6.4 vs. 15.2%, p = 0.048) and a lower percentage of heterosexual individuals (63.8 vs. 47.0%, p < 0.001). Sexual contact (88.0%) was the leading transmission route, and the presence of complaints (44.3%) was the leading reason for HIV testing. Overall, the time from diagnosis to treatment onset was a median 1 month (range, 1 to 97 months), and the median HIV RNA level at the time of diagnosis was 208065 copies/mL with no significant difference between study periods. The diagnoses within the 2010-2017 vs. 2002-2009 period were associated with significantly higher median (min-max) CD4+ T cell counts (378(0-2522) vs. 319(4-1270) cells/mm3, p < 0.001) and a lower percentage of patients with CD4+ T cell count < 200 cells/mm3 (22.1 vs. 39.0%, p = 0.002) at the time of diagnosis. CONCLUSION: In conclusion, our findings on the epidemiological profile and clinical characteristics of newly diagnosed HIV patients over 16 years (2002-2017) in a tertiary care center in Turkey revealed a considerable increase in the number of new diagnoses, an improved earlier diagnosis and a change in epidemiologic profile over the years with increased likelihood of disease to be more commonly diagnosed among males, 18-29 years age group and MSM.

Perfil Epidemiológico de Gatos com Esporotricose no Município de São Paulo (SP), 2011 a 2022 / Epidemiological Profile of Cats with Sporotrichosis in the City of São Paulo (SP), 2011 to 2022

Objetivo: este estudo se propôs a caracterizar o perfil epidemiológico da esporotricose felina no município de São Paulo (SP) no período de 2011 a 2022. Métodos: estudo descritivo dos casos de esporotricose felina registrados entre 2011 e 2022. Foram utilizados dados secundários, provenientes dos bancos de dados da vigilância do município. Resultados: o perfil predominante dos animais é composto por machos, 71,4% (n=2.644), com idade inferior a 4 anos 70,1% (n=1.137) e com livre acesso à rua 51,0% (n=1.348). Foram registrados 811 óbitos, entre os quais foi informado o sexo para 381, sendo estes 77,4% (n=295) machos e 22,6% (n=86) fêmeas. Conclusão: diante dos achados deste estudo, compreende-se que a situação epidemiológica da doença requer ações conjuntas das vigilâncias epidemiológica e ambiental para serem desenvolvidas medidas de prevenção e controle embasadas em uma perspectiva de saúde única.

Objective: this study aimed to characterize the epidemiological profile of feline sporotrichosis in the city of São Paulo (SP) from 2011 to 2022. Methods: this is a descriptive study of feline sporotrichosis cases reported between 2011 and 2022. The data were obtained from a secondary database of the São Paulo Health Surveillance System. Results: the predominant profile of the animals is composed of males 71.4% (n=2,644), under the age of four years old 70.1% (n=1,137), and with free access to streets 51.0% (n=1,348). Furthermore, of the 811 deaths registered, 381 had the gender identified, 77.4% (n=295) were males, and 22.6% (n=86) were females. Conclusion: given the findings of this study, it is understood that the epidemiological situation of the disease requires joint actions by epidemiological and environmental surveillance in order to develop prevention and control measures based on one health perspective.

Epidemiological profile of spinal cord injury in Brazil.

OBJECTIVE: To identify and analyze the biosocioeconomic profile associated with the occupation and education of persons with spinal cord injury (SCI) from Brazil. DESIGN: Analytical, quantitative, descriptive, cross-sectional. PARTICIPANTS: Sample composed of 618 Brazilian adults with SCI and access to the internet. SETTING: Community-based, Brazil. METHODS: An online form was developed and publicized on Brazilian social media to voluntarily register for participation in research. Pearson's Chi-squared test was used to analyze the association between categorical variables and the Kruskal Wallis test was used for comparisons and adjusted Odds Ratio with a 95% Confidence Interval. RESULTS: Among the 618 participants, 68.9% were men, with mean age of 38.04 years (SD = 9.85); 58.7% were people with paraplegia and most injuries were traumatic (78.5%), most caused by road traffic accidents (40.8%) and weapons (17.5%). The majority were graduates or post-graduates (49.5%) and received an income of up to US$ 749.58 (55.1%); 70.9% of the participants were beneficiaries of social welfare (63.6%) or unemployed (7.3%). There was a reduction in the employment rate from 91.3% to 15.2% after SCI. An association was found between education and current occupation (P ≥ 0.001). Participants with higher education had higher odds (7.48) to being employed relative to those with elementary education. CONCLUSION: A serious employment situation after SCI was found, with high unemployment and dependence on social welfare. This shows the need for investment in public policies for the rehabilitation, focused on participation, return to the labor market, and ending dependence on social welfare.

Perfil epidemiológico de pacientes vítimas de trauma torácico em um hospital de urgência e trauma / Epidemiological profile of patients victims of thoracic trauma in an emergency and trauma hospital

O trauma é responsável por significativos impactos na sociedade. De acordo com dados da Organização Mundial de Saúde (OMS), mais de nove pessoas morrem por minuto, vítimas de trauma. Entre os principais tipos de trauma, o torácico representa na atualidade cerca de 25% dos mortos em politraumatizados, constituindo um problema complexo, tendo em vista os elevados índices de mortalidade e sequelas incapacitantes permanentes. Objetivo: Descrever o perfil epidemiológico dos pacientes atendidos em um hospital de urgências da região centro-oeste, vítimas de trauma torácico. Método: Estudo quantitativo, de caráter transversal e retrospectivo, realizado a partir de coleta de dados efetuada em prontuário eletrônico no período de março a maio de 2022. Resultados: Identificou-se 73 pacientes vítimas de trauma torácico, com maior acometimento de pessoas do sexo masculino, com idade entre 26 e 35 anos. Como causa mais frequente, se destacaram os acidentes motociclísticos, resultando principalmente em lesões do tipo hemopneumotórax. Conclusão: o perfil epidemiológico dos pacientes vítimas de trauma torácico foi representado com maior frequência pelo sexo masculino, com idade entre 26 a 35 anos, causados predominantemente por acidentes motociclísticos, resultando na maioria das vezes em lesões do tipo hemopneumotórax

Trauma is responsible for significant impacts on society. According to data from the World Health Organization (WHO), more than nine people die per minute victims of trauma. Among the main types of trauma, thoracic trauma currently represents about 25% of polytrauma deaths, constituting a complex problem, in view of the high rates of mortality and sequelae permanent disabling. Objective: To describe the epidemiological profile of patients treated at an emergency hospital in the Midwest region, victims of thoracic trauma. Method: Quantitative, cross-sectional and retrospective study carried out from data collection of electronic medical records in the period from March to May of 2022. Results: We identified 73 patients who were victims of chest trauma with higher affecting males aged between 26 and 35 years. As the most frequent cause motorcycle accidents stood out, resulting mainly in lesions of the hemopneumothorax type. Conclusion: the profile epidemiology of patients victims of thoracic trauma was represented with greater frequency by males, aged between 26 and 35 years, caused predominantly by motorcycle accidents, often resulting in hemopneumothorax lesions

Parasitoses intestinais no nordeste entre 2012 e 2021: uma revisão integrativa de literatura / Intestinal parasitosis in the northeast between 2012 and 2021: an integrative literature review / Parasitosis intestinales en el noreste entre 2012 y 2021: una revisión bibliográfica integradora

As parasitoses intestinais ainda constituem um problema de saúde pública no Brasil, especialmente nas regiões onde o saneamento básico e condições socioeconômicas são frágeis, como na região Nordeste. São um conjunto de doenças causadas por parasitas helmínticos ou protozoários, que acometem o intestino humano, causando sintomas, como diarreia, dor abdominal, astenia, náuseas, vômitos, entre outros. Seu diagnóstico é feito pelo parasitológico de fezes e o tratamento é baseado no uso de anti-protozoários ou anti-helmínticos. Objetivo: analisar os principais aspectos das parasitoses intestinais presentes no Nordeste, identificando aquelas mais prevalentes e as populações de maiores riscos. Metodologia: o estudo foi do tipo descritivo, utilizando-se uma revisão integrativa de literatura do período de 2012 a 2021, nas bases de dados eletrônicas Scielo, BVS e Google Acadêmico. Para o processo de busca e análise dos artigos, foi utilizado o diagrama flow. Todos os dados da pesquisa foram analisados no Microsoft Word e, posteriormente os resultados foram transformados em quadros e tabelas para melhor organização e interpretação das informações colhidas. Resultados: observou-se, a partir da análise dos 10 artigos, uma variação de 26,00% a 92,85% na taxa de infecções por parasitas intestinais na região Nordeste, em diversas populações, desde pré-escolares, escolares e adultos. Os fatores de risco que estiveram associados ao desenvolvimento, foram: falta de higiene pessoal e dos alimentos, ausência ou precariedade dos serviços de saneamento básico, baixa escolaridade e renda dos pais, qualidade da água de beber e práticas de andar descalço por parte das crianças. Considerações finais: Os resultados apontam para a necessidade de medidas preventivas e tratamento das enteroparasitoses, como mudanças de hábitos de higiene e melhorias nas condições de vida, como o acesso à água tratada e saneamento básico adequado. Além disso, é importante que surjam mais estudos epidemiológicos para subsidiar medidas de controle e prevenção adequadas e eficazes.

Intestinal parasites are still a public health problem in Brazil, especially in regions where basic sanitation and socioeconomic conditions are fragile, as in the Northeast region. They are a set of diseases caused by helminthic or protozoan parasites, which affect the human intestine, causing symptoms such as diarrhea, abdominal pain, asthenia, nausea, vomiting, among others. Its diagnosis is made by fecal parasitology and treatment is based on the use of anti-protozoal or anthelmintic agents. Objective: to analyze the main aspects of intestinal parasites present in the Northeast, identifying the most prevalent ones and the populations at greatest risk. Methodology: the study was descriptive, using an integrative literature review from 2012 to 2021, in the electronic databases Scielo, BVS and Google Scholar. For the process of searching and analyzing the articles, the flow diagram was used. All survey data were analyzed in Microsoft Excel and, later, the results were transformed into graphs and tables for better interpretation of the collected information. RESULTS: from the analysis of the 10 articles, a variation from 26.00% to 92.85% was observed in the rate of infections by intestinal parasites in the Northeast region, in different populations, from preschoolers, schoolchildren and adults. The risk factors that were associated with development were: lack of personal hygiene and food, absence or precariousness of basic sanitation services, low parental education and income, quality of drinking water and practices of walking barefoot by children. Final Considerations: The results point to the need for preventive measures and treatment of intestinal parasites, such as changes in hygiene habits and improvements in living conditions, such as access to treated water and adequate basic sanitation. In addition, it is important that more epidemiological studies appear to support appropriate and effective control and prevention measures.

Las parasitosis intestinales siguen siendo un problema de salud pública en Brasil, especialmente en regiones donde el saneamiento básico y las condiciones socioeconómicas son frágiles, como en la región Nordeste. Son un conjunto de enfermedades causadas por parásitos helmínticos o protozoarios, que afectan el intestino humano, causando síntomas como diarrea, dolor abdominal, astenia, náuseas, vómitos, entre otros. Su diagnóstico se realiza mediante parasitología fecal y el tratamiento se basa en el uso de agentes antiprotozoarios o antihelmínticos. Objetivo: analizar los principales aspectos de los parásitos intestinales presentes en el Nordeste, identificando los más prevalentes y las poblaciones de mayor riesgo. Metodología: el estudio fue descriptivo, utilizando una revisión bibliográfica integradora de 2012 a 2021, en las bases de datos electrónicas Scielo, BVS y Google Scholar. Para el proceso de búsqueda y análisis de los artículos, se utilizó el diagrama de flujo. Todos los datos de la encuesta fueron analizados en Microsoft Excel y, posteriormente, los resultados fueron transformados en gráficos y tablas para una mejor interpretación de la información recogida. Resultados: a partir del análisis de los 10 artículos, se observó una variación de 26,00% a 92,85% en la tasa de infecciones por parásitos intestinales en la región Nordeste, en diferentes poblaciones, desde preescolares, escolares y adultos. Los factores de riesgo que se asociaron al desarrollo fueron: falta de higiene personal y alimentaria, ausencia o precariedad de servicios de saneamiento básico, baja escolaridad e ingresos de los padres, calidad del agua de consumo y prácticas de caminar descalzo por parte de los niños. Consideraciones Finales: Los resultados apuntan a la necesidad de medidas preventivas y de tratamiento de los parásitos intestinales, como cambios en los hábitos de higiene y mejoras en las condiciones de vida, como el acceso a agua tratada y a un saneamiento básico adecuado. Además, es importante que aparezcan más estudios epidemiológicos que respalden medidas de control y prevención adecuadas y eficaces.

Análise da prevalência de internações por dengue no estado do Tocantins entre 2017 e 2022 / The prevalence of hospitalizations and deaths for dengue in the state of Tocantins between 2017 and 2022 / Prevalencia de hospitalizaciones y muertes por dengue en el estado de Tocantins entre 2017 y 2022

O Tocantins é um Estado endêmico para dengue devido aos elevados índices pluviométricos e do saneamento básico escasso. Esta pesquisa objetivou investigar o número de internações por dengue no Estado do Tocantins entre 2017 e 2022. O estudo consiste em um delineamento transversal retrospectivo quantitativo, realizado a partir de dados coletados no Tabnet/DataSUS. Os resultados encontrados foram compilados no programa Microsoft Excel®, e por meio de gráficos e tabelas, foram evidenciados 28.355 casos de dengue confirmados, dos quais apenas 1.798 (6%) necessitaram de hospitalizações, com maior incidência em 2019, tendo Palmas como município mais acometido. Conclui-se, portanto, que a dengue segue sendo uma doença prevalente no Estado, de modo a demandar atenção de gestores de saúde com vistas a reduzir os números altos de casos por meio de vigilância epidemiológica ativa como, também, fornecer o melhor cuidado para os pacientes diagnosticados com dengue, quer seja no âmbito ambulatorial quer no hospitalar.

Tocantins is an endemic state for dengue due to high rainfall rates and poor sanitation. This research aimed to investigate the number of dengue hospitalizations in the State of Tocantins between 2017 and 2022. The study consists of a retrospective quantitative cross-sectional design, performed from data collected in Tabnet/DataSUS. The results found were compiled in Microsoft Excel® program, and by means of graphs and tables, 28,355 confirmed dengue cases were evidenced, of which only 1,798 (6%) required hospitalizations, with a higher incidence in 2019, with Palmas as the most affected municipality. It is concluded, therefore, that dengue remains a prevalent disease in the state, so as to demand attention from health managers with a view to reducing the high numbers of cases through active epidemiological surveillance as well as providing the best care for patients diagnosed with dengue, whether in the outpatient or hospital setting.

Tocantins es un estado endémico para el dengue debido a las altas tasas de precipitación y al saneamiento deficiente. Esta investigación tuvo como objetivo investigar el número de hospitalizaciones por dengue en el Estado de Tocantins entre 2017 y 2022. El estudio consiste en un diseño cuantitativo transversal retrospectivo, realizado a partir de datos recogidos en Tabnet/DataSUS. Los resultados encontrados fueron compilados en el programa Microsoft Excel®, y por medio de gráficos y tablas, se evidenciaron 28.355 casos confirmados de dengue, de los cuales sólo 1.798 (6%) requirieron hospitalizaciones, con mayor incidencia en 2019, siendo Palmas el municipio más afectado. Se concluye, por lo tanto, que el dengue continúa siendo una enfermedad prevalente en el estado, por lo que demanda la atención de los gestores de salud con miras a reducir las altas cifras de casos a través de la vigilancia epidemiológica activa, así como brindar la mejor atención a los pacientes diagnosticados con dengue, ya sea en el ámbito ambulatorio u hospitalario.

Prevalência de Blastocystis sp. em moradores de uma comunidade quilombola na região pantaneira do estado de Mato Grosso / Prevalence of Blastocystis sp. in inhabitants of a quilombola community in the pantanal region of Mato Grosso state / Prevalencia de Blastocystis sp. en habitantes de una comunidad quilombola de la región del pantanal del estado de Mato Grosso

Introdução: Blastocystis sp. é o parasito mais comum encontrado nos estudos de prevalência de parasitas intestinais em diferentes populações. Objetivo: determinar a prevalência do parasita intestinal Blastocystis sp. em moradores da comunidade quilombola Distrito Nossa Senhora Aparecida do Chumbo localizada em uma área rural do Município de Poconé-MT. Método: Trata-se de um estudo epidemiológico descritivo e quantitativo que determinou a prevalência do parasita intestinal Blastocystis sp. que ocorreu nos meses de dezembro de 2021 a maio de 2022. A amostra final foi composta por 114 participantes. Na identificação das formas evolutivas dos parasitas intestinais nas amostras fecais foi empregado o método de Hoffman. As amostras foram analisadas com auxílio do microscópio óptico e as lâminas foram coradas com lugol, para identificação das formas evolutivas dos parasitos. Para análise descritiva foi realizado a frequência absoluta e percentual. Foram realizados cálculos para determinar a prevalência total de parasitos intestinais e a prevalência por tipo de parasitas. Resultados: A prevalência total foi de 75%, deste a maior ocorrência foi apresentada por Blastocystis sp. Conclusão: Sugerimos, que a alta prevalência deste parasito que tem por via de contaminação fecal- oral, esteja associada à falta de um saneamento adequado, bem como ao acesso da água de qualidade.

Introduction: Blastocystis sp. is the most common parasite found in studies of intestinal parasite prevalence in different populations. Objective: To determine the prevalence of the intestinal parasite Blastocystis sp. in residents of the quilombola community of Distrito Nossa Senhora Aparecida do Chumbo located in a rural area of the Municipality of Poconé-MT. Method: This is a descriptive and quantitative epidemiological study that determined the prevalence of the intestinal parasite Blastocystis sp. that occurred in the months from December 2021 to May 2022. The final sample consisted of 114 participants. The Hoffman method was used to identify the evolutionary forms of the intestinal parasites in the fecal samples. The samples were analyzed with the aid of an optical microscope and the slides were stained with lugol to identify the evolutive forms of the parasites. For descriptive analysis, absolute and percentage frequency was performed. Calculations were performed to determine the total prevalence of intestinal parasites and the prevalence by type of parasites. Results: The total prevalence was 75%, of this the highest occurrence was presented by Blastocystis sp. Conclusion: We suggest, that the high prevalence of this parasite that has a fecal-oral contamination route, is associated with the lack of proper sanitation, as well as access to quality water.

Introducción: Blastocystis sp. es el parásito más común encontrado en estudios de prevalencia de parásitos intestinales en diferentes poblaciones. Objetivo: Determinar la prevalencia del parásito intestinal Blastocystis sp. en residentes de la comunidad quilombola del Distrito Nossa Senhora Aparecida do Chumbo localizada en una zona rural del Municipio de Poconé-MT. Método: Se trata de un estudio epidemiológico descriptivo y cuantitativo que determinó la prevalencia del parásito intestinal Blastocystis sp. ocurrida en los meses de diciembre de 2021 a mayo de 2022. La muestra final estuvo compuesta por 114 participantes. Se utilizó el método Hoffman para identificar las formas evolutivas de los parásitos intestinales en las muestras fecales. Las muestras se analizaron con la ayuda de un microscopio óptico y los portaobjetos se tiñeron con lugol para identificar las formas evolutivas de los parásitos. Para el análisis descriptivo se calcularon las frecuencias absolutas y porcentuales. Se realizaron cálculos para determinar la prevalencia total de parásitos intestinales y la prevalencia por tipo de parásitos. Resultados: La prevalencia total fue de 75%, de esta la mayor ocurrencia la presentó Blastocystis sp. Conclusión: Sugerimos, que la alta prevalencia de este parásito que tiene por vía de contaminación fecal-oral, está asociada a la falta de saneamiento adecuado, así como al acceso a agua de calidad.

Critérios éticos para a eutanásia em animais de experimentação no Brasil

The use of animals for scientific research began in antiquity and has followed its historical course until the present day. Euthanasia has been a relevant topic in several sectors of science and teaching, it is defined as “good death”, the term is used for the cessation of an individual's life in the finitude of life. Experimental animals are often used in scientific studies, as they represent an important resource in scientific research, offering opportunities for new discoveries of treatments for various diseases, favoring both animals and humans, scientific research on animals is essential for the improvement of techniques for organ transplants and for the feasibility of using anesthetic drugs, but all the requirements of the federal constitution for the use of animals, the normal techniques for using them must be followed.

O uso de animais para pesquisa científica teve início na Antiguidade e seguiu seu curso histórico até os dias atuais. Eutanásia tem sido um tema relevante em vários setores da ciência e do ensino, é definida como “boa morte”, o termo é utilizado para a cessação da vida de um indivíduo na finitude da vida.Os animais de experimentação são freqüentemente utilizados em estudos científicos, por representar como um recurso importante em pesquisas cientificas oferecendo oportunidades de novas descobertas de tratamentos de várias doenças, favorecendo tanto os animais quanto os humanos , as pesquisas cientificas em animais são essenciais para o aperfeiçoamento de técnicas de transplantes de órgãos e para a viabilidade do uso de medicamentos anestésicos, porém deve ser seguido todas as exigências da constituição federal para uso de animais , as normais técnicas para utilização dos mesmos.