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4.
BMC Infect Dis ; 20(1): 645, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873242

RESUMO

BACKGROUND: During the outbreak of cutaneous leishmaniasis in the Kurdistan Region of Iraq that started in 2015, the course of the disease and the treatment were not consistent with the available literature. Physicians, particularly dermatologists, faced challenges with treating the cutaneous leishmaniasis lesions with high rates of treatment failure and resistance to treatment. We used Q-methodology to understand the range and diversities of opinions and the practical experiences of dermatologists about the treatment difficulties of cutaneous leishmaniasis. METHODS: This Q-methodology study was carried out in Erbil, Kurdistan Region of Iraq, and involved 37 dermatologists. A set of 40 statements related to different aspects of difficulties and uncertainties of treating cutaneous leishmaniasis was prepared. The dermatologists were requested to distribute the 40 statements into a scaled grid of nine piles from least agree to most agree. We applied by-person factor analysis using PQMethod 2.35 for the data analysis. RESULTS: The analysis revealed two different viewpoints about the treatment of cutaneous leishmaniasis and a consensus viewpoint. The first viewpoint emphasized the use of sodium stibogluconate-based combination therapy, concerns with treatment failure, and lack of compliance with the treatment. The second viewpoint emphasized the lack of standard treatment and advances in the treatment of cutaneous leishmaniasis. There was a consensus between both groups of respondents about many aspects of the treatment of cutaneous leishmaniasis, including considering sodium stibogluconate the first drug of choice for cutaneous leishmaniasis treatment. CONCLUSIONS: This study revealed a diversity of viewpoints and uncertainties about the effectiveness of the available treatment modalities and treatment difficulties and failure. Interrupted supply and poor quality of the available drugs and lack of a standard and advanced treatment are the main problems facing the treatment of cutaneous leishmaniasis. More research is required to determine the best treatment modalities for the different types of cutaneous leishmaniasis. There is a need for the development of treatment guidelines specific to the Iraqi context with a particular focus on the treatment of the resistant and atypical cases of cutaneous leishmaniasis.


Assuntos
Gluconato de Antimônio e Sódio/uso terapêutico , Atitude , Consenso , Dermatologistas/psicologia , Leishmania , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/epidemiologia , Adulto , Terapia Combinada , Análise Fatorial , Feminino , Humanos , Incidência , Iraque/epidemiologia , Leishmaniose Cutânea/parasitologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Falha de Tratamento
5.
J Spec Oper Med ; 20(3): 76-80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969008

RESUMO

BACKGROUND: The United States (US) military utilizes combat wound medication packs (CWMP) to provide analgesia and wound prophylaxis in casualties who are still able to fight. We compared characteristics of combat casualties receiving CWMP to those not receiving CWMP. We also describe the proportions of casualties with injury patterns consistent with Tactical Combat Casualty Care (TCCC) guideline indications for CWMP use who received this intervention. METHODS: This is a secondary analysis of Department of a Defense Trauma Registry (DODTR) dataset of US military personnel from January 2007 to August 2016. We searched for all subjects with documented use of at least one medication from the CWMP (acetaminophen, meloxicam, moxifloxacin). RESULTS: Within our dataset, 11,665 casualties were US military Servicemembers. Overall, <1% (84) of our study population received the CWMP. The median age and mechanism of injuries were similar between CWMP nonrecipients versus recipients. Median composite injury scores were higher for nonrecipients than recipients (6 versus 4, P < .001). Proportions of casualties with injury patterns meeting TCCC guideline CWMP indications who received this intervention were low: gunshot wound, <1% (14 of 1805), tourniquet applied, <1% (11 of 1912), major amputation, <1% (5 of 803), and open fracture, <1% (10 of 2425). Based on serious injuries by body region, we had similar findings for the thorax (<1%; 3 of 1122), abdomen (<1%; 1 of 736), and extremities (<1%; 11 of 2699). CONCLUSIONS: Subjects receiving the CWMP were less severely injured compared to those who did not receive this intervention. The CWMP had very infrequent use among those casualties with injury patterns meeting indications specified in the TCCC Guidelines for use of this intervention.


Assuntos
Serviços Médicos de Emergência , Medicina Militar , Militares , Ferimentos por Arma de Fogo , Campanha Afegã de 2001- , Afeganistão/epidemiologia , Humanos , Iraque/epidemiologia , Guerra do Iraque 2003-2011 , Sistema de Registros , Estados Unidos/epidemiologia
6.
Infez Med ; 28(3): 357-366, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920571

RESUMO

The current COVID-19 pandemic needs unconventional therapies to tackle the resulted high morbidity and mortality. Convalescent plasma is one of the therapeutic approaches that might be of benefit. Forty nine early-stage critically-ill COVID-19 patients residing in Respiratory Care Units (RCU) of three hospitals in Baghdad, Iraq, were included: 21 received convalescent plasma while 28, namely control group, did not receive it. Recovery or death, length of stay in hospital, and improvement in the clinical course of the disease were monitored clinically along with laboratory monitoring through SARS-CoV-2 RNA detection via PCR, and SARS-CoV-2 IgG and IgM serological monitoring. Patients who received convalescent plasma showed reduced duration of infection in about 4 days and showed less death rate [1/21 versus 8/28 in control group]. In addition, all the patients who were given convalescent plasma showed high levels of SARS-CoV-2 IgG and IgM three days after plasma transfusion. Plasma from donors with high levels of SARS-CoV-2 IgG and donors with positive SRAS-CoV-2 IgM showed better therapeutic results than other donors. Convalescent plasma therapy is an effective therapy if donors with high level of SARS-Cov2 antibodies are selected and if recipients are at their early stage of critical illness, being no more than three days in RCUs.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/terapia , Plasma/imunologia , Pneumonia Viral/terapia , Anticorpos Antivirais/sangue , Estudos de Casos e Controles , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Estado Terminal/terapia , Feminino , Humanos , Imunização Passiva/métodos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Iraque/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia
7.
PLoS One ; 15(8): e0237714, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804961

RESUMO

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem. There is limited information regarding the genetics of MRSA strains among the native Iraqi and incoming Syrian refugee communities. We aimed to characterize the genotypes and different virulence factors of MRSA in strains isolated from these two communities. Frozen MRSA strains (125) isolated from the native Iraqi and Syrian refugee communities were used in this study. PCR (singleplex and multiplex) and agr typing was used for the genotypic analysis of different virulence genes. We tested for the presence of virulence genes including pvl, arcA, tst, lukE/lukD, hla, hlb, eta, etb and agr. Prevalence of arcA MRSA in the Iraqi community (56.58%) was significantly higher (p = 0.008) than that in the Syrian refugee community (32.66%). Prevalence of lukE-lukD was also significantly higher (p = 0.001) in the Iraqi (82.89%) compared to that in the Syrian refugee community (57.14%). Further, prevalence of hla MRSA in the Iraqi community was (93.4%) and in the Syrian refugee community was (71.4%); (p = 0.0008). No significant differences were observed in the prevalence of pvl, tst, eta, etb and hlb. The most dominant agr types in both Iraqi (76.1% and 10.5%) and Syrian refugee (44.9% and 18.37%) communities were I and III. To sum up, no significant differences were observed between the groups for a majority of virulence factors. This is the first investigation of MRSA genotypes and virulence in both these communities. These results could be useful for further studies that assess the genetic relatedness of strains in the region for epidemiological and monitoring purposes, which would be crucial to limiting the spread of MRSA.


Assuntos
Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Refugiados , Infecções Estafilocócicas/microbiologia , Fatores de Virulência/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/isolamento & purificação , Cidades/epidemiologia , Exotoxinas/genética , Exotoxinas/isolamento & purificação , Genes Bacterianos/genética , Técnicas de Genotipagem , Humanos , Iraque/epidemiologia , Meticilina/farmacologia , Meticilina/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Prevalência , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Síria , Transativadores/genética , Transativadores/isolamento & purificação , Fatores de Virulência/isolamento & purificação
8.
J Environ Public Health ; 2020: 9171027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774395

RESUMO

Heavy metal poisoning is a worldwide problem that is caused by different human industrial activities such as battery and painting manufacturing and occupational exposure of those working at petrol stations. Wastewater is known to contain higher amounts of heavy metals such as lead (Pd) and cadmium (Cd) and might be sources of exposure for workers at the wastewater treatment plant. However, to our best knowledge, no studies were done to evaluate the level of cadmium and lead in blood of workers at wastewater treatment plants and evaluate the subsequent effect of lead and cadmium on delta-aminolevulinic acid dehydratase (δ-ALAD), urinary delta-aminolevulinic acid (Uδ-ALA), and 8-hydroxy-2'-deoxyguanosine (8-OHdG) as markers of lead and cadmium toxicity. In this case-control study, 79 workers at the Al-Rustumiya wastewater plant in Baghdad, Iraq, and 40 control subjects were included. The levels of lead and cadmium were measured in blood of the study subjects using the atomic absorption spectroscopy (AAS) method. 8-OHdG was analysed using enzyme-linked immunosorbent assay (ELISA) technique. δ-ALAD and Uδ-ALA were estimated using spectrophotometry-based methods. Our work showed that workers had a significantly higher level of lead and cadmium when compared with the control group (P < 0.05), yet, still within the World Health Organization permissible limit. The level of both metals was positively associated with duration of work at the plant (P < 0.01). The activity of δ-ALAD was inversely associated with the lead level, while both Uδ-ALA and 8-OHdG were positively correlated with the lead level (P < 0.05). These three markers lacked any statistically significant association with the cadmium level (P > 0.05). To sum up, working at the wastewater treatment plant was associated with a higher blood level of lead and cadmium and their possible health hazard. Health and occupational safety authorities are required to set up tighter regulations and protocols to minimize these hazards and ensure a safe working environment.


Assuntos
Cádmio/toxicidade , Chumbo/toxicidade , Mutagênicos/toxicidade , Exposição Ocupacional/efeitos adversos , Águas Residuárias/toxicidade , Adulto , Biomarcadores/sangue , Cádmio/sangue , Estudos de Casos e Controles , Feminino , Humanos , Iraque/epidemiologia , Chumbo/sangue , Masculino , Pessoa de Meia-Idade , Mutagênicos/análise , Exposição Ocupacional/análise , Águas Residuárias/análise , Adulto Jovem
9.
J Environ Public Health ; 2020: 7693891, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32831856

RESUMO

Background: Occupational and environmental exposure to several pollutant factors such as petroleum products containing benzene has toxic effects on different body systems. The hematopoietic system and immune system are among the affected systems. This study aims to investigate the effect of benzene exposure on some blood parameters of workers at several fuel stations in Basra city, as well as to reveal if the continuous exposure may induce an inflammatory response, which is reflected by changes in some hematological and inflammatory markers. Methods: The study included two groups of males. The first group consists of 72 exposed workers at petrol stations in different locations in the Basra city. The other group is the control group, which consists of 75 nonexposed subjects (students and faculty members of the college). Different hematological parameters (WBC, RBC, HGB, MCV, MCHC, and MCH) have been evaluated. Serum concentrations of IL-6 and hs-CRP were estimated in all workers and nonexposed using enzyme-linked immunosorbent assay (ELISA). Results: Data showed significant hematological changes in the exposed workers, and that anemia was a common disorder among them. Furthermore, there was a significant decline in WBC and different types of WBC including lymphocytes, monocytes, and neutrophils in the exposed workers. Erythrocyte sedimentation rate and serum levels of interleukin-6 and hs-CRP were significantly higher in exposed workers than in nonexposed. A significant correlation was identified among blood parameters, while a strong inverse correlation was identified between both MCHC and ESR. The most significant inverse correlation was found between RBC and IL-6 and MCH with hs-CRP. In addition, a significant negative correlation was found between monocytes and IL-6. Conclusion: The changes in all hematology and inflammatory parameters refer to damage in the hematopoietic system due to continuous exposure to vapors of petrol products, which also result in a significant increase in interleukin-6.


Assuntos
Interleucina-6/sangue , Doenças Profissionais/sangue , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Petróleo/toxicidade , Adulto , Anemia/sangue , Anemia/epidemiologia , Anemia/etiologia , Biomarcadores/sangue , Humanos , Inflamação/sangue , Inflamação/epidemiologia , Inflamação/etiologia , Iraque/epidemiologia , Masculino , Doenças Profissionais/epidemiologia , Adulto Jovem
10.
PLoS One ; 15(7): e0235862, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645099

RESUMO

Brucellosis is an endemic disease in food-producing animals in Mosul, Iraq. The objectives of the study reported here were: (i) to identify and assess the evidence and knowledge gaps in published studies that have examined brucellosis in different food-producing animals in Mosul, Iraq; using systematic review approach, and (ii) to quantify the seroprevalence of brucellosis in the city using meta-analysis approach. Google Scholar was used as a search engine to track pertinent peer-reviewed research reports. The search was conducted on November 24, 2019. Keywords used were: brucella, animal, Mosul, Iraq. Peer-reviewed published studies, MSc theses, and PhD dissertations written in Arabic or English were included. Duplicate records were removed, and the screening process was conducted at three levels: titles, abstracts, and full-text articles. Identified studies that have reported the seroprevalence of brucellosis were included in a meta-analysis to calculate an overall prevalence. A total of 214 records were initially identified. Seventeen research reports were added from personal contact and qualified articles' references list. Thirty six articles were qualified for review after removing 35 duplicate records, 155 titles, 11 abstracts, and 5 full text articles. Seventeen studies reported the prevalence of brucellosis, 11 studies assessed different serological tests for diagnosis of brucellosis, 9 studies isolated Brucella spp. from animal specimens and/or animal products, and 4 studies assessed vaccination procedures against brucellosis. The overall seroprevalence of brucellosis in food-producing animals in Mosul over a period of 40 years was 14.14%, including 14.46% for sheep, 12.99% for goats, 11.69% for cattle, and 22.64% for buffalo. The study concluded that the disease is evident in the city with increasing trends over the years, buffalo shows high seroprevalence, the degree of agreement of Rose-Bengal test as a screening test is fair compared to more accurate serological tests such as ELISA; and the disease constitutes a public health concern in the city. Additional studies are important to identify the overlooked predisposing factors, estimate the abortion rate attributable to brucellosis in food-producing animals, and evaluate efficacy of vaccination programs in reducing the prevalence of brucellosis and/or abortion rate.


Assuntos
Brucelose/veterinária , Doenças dos Bovinos/epidemiologia , Doenças das Cabras/epidemiologia , Doenças dos Ovinos/epidemiologia , Animais , Brucella/isolamento & purificação , Brucelose/epidemiologia , Búfalos , Bovinos , Doenças dos Bovinos/microbiologia , Doenças das Cabras/microbiologia , Cabras , Humanos , Iraque/epidemiologia , Estudos Soroepidemiológicos , Ovinos , Doenças dos Ovinos/microbiologia
11.
PLoS Negl Trop Dis ; 14(6): e0007880, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32511233

RESUMO

The SEN virus (SENV) has been linked to transfusion-associated non-A-E hepatitis; however, information regarding SENV infections in patients with thalassemia, particularly in those with hepatitis virus co-infections, remains limited. This study investigated the frequency of SENV (genotypes D and H) infections in Iraqi patients with thalassemic patients infected and not infected with hepatitis C virus. The study involved 150 ß-thalassemia patients (75 with HCV infections and 75 without) and 75 healthy blood donors. Patient levels of vitamins C and E, liver function markers, and glutathione peroxidase (GPX) were determined. Recovered viral nucleic acids were amplified using the conventional polymerase chain reaction (SENV DNA) or the real-time polymerase chain reaction (HCV RNA) techniques. Only 10% of healthy donors had evidence of SENV infection. Among patients with thalassemia, 80% and 77% of patients with and without concurrent HCV infections, respectively, had SENV infections. DNA sequencing analyses were performed on blood samples obtained from 29 patients. Patients with thalassemia, particularly those with SENV infections, had higher levels of several enzymatic liver function markers and total serum bilirubin (P < 0.05) than did healthy blood donors. Among the examined liver function markers, only gamma-glutamyl transferase demonstrated significantly higher levels in HCV-negative patients infected with SENV-H than in those infected with SENV-D (P = 0.01). There were significantly lower vitamin C, vitamin E, and glutathione peroxidase levels in patients than in healthy donors (P < 0.05), but only glutathione peroxidase levels were significantly lower in HCV-negative thalassemia patients infected with SENV than in those without SENV infections (P = 0.04). The SENV-H genotype sequences were similar to the global standard genes in GenBank. These results broaden our understanding the nature of the SENV-H genotype and the differential role of SENV-H infections, compared to SENV-D infections, in patients with thalassemia, in Iraq.


Assuntos
Doadores de Sangue , Infecções por Vírus de DNA/epidemiologia , Genótipo , Hepatite Viral Humana/epidemiologia , Torque teno virus/classificação , Torque teno virus/isolamento & purificação , Talassemia beta/complicações , Adolescente , Adulto , Criança , Pré-Escolar , Infecções por Vírus de DNA/virologia , Feminino , Hepatite Viral Humana/virologia , Humanos , Iraque/epidemiologia , Testes de Função Hepática , Masculino , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Análise de Sequência de DNA , Torque teno virus/genética , Adulto Jovem
12.
PLoS One ; 15(6): e0233681, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579560

RESUMO

BACKGROUND: There is unreliable, and negligible information on the mental health and trauma-exposure of asylum-seekers and displaced refugees in the Iraqi Kurdistan region. OBJECTIVES: To evaluate how responsible the ethno-religious origins are, for the prevalence of trauma exposure and post-traumatic stress disorder (PTSD) in displaced Iraqi asylum-seekers and refugees residing in the Iraqi Kurdistan region. METHODS: Structured interviews with a cross-sectional sample of 150 individuals, comprised of three self-identified ethno-religious groups (50 participants in each): Christians, Muslims, and Yazidis. RESULTS: 100% prevalence of trauma exposure and 48.7% of current PTSD among refugees, 70% PTSD rate of Yazidi participants, which is significantly higher (p < 0.01) compared to 44% of Muslim participants and 32% of Christian participants. These findings were corroborated using the self-rated PTSD, DSM-5 Checklist, with more severe PTSD symptom scores (p < 0.001) obtained among Yazidis (43.1; 19.7), compared to Muslims (31.3; 20.1) and Christians (29.3; 17.8). Self-rated depressive symptoms (Patient Health Questionnaire-9) were also higher (p < 0.007) among Yazidis (12.3; 8.2) and Muslims (11.7; 5.9), compared to Christians (8.1; 7).


Assuntos
Depressão/epidemiologia , Saúde Mental/etnologia , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Idoso , Cristianismo/psicologia , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Povos Indígenas/psicologia , Povos Indígenas/estatística & dados numéricos , Iraque/epidemiologia , Islamismo/psicologia , Masculino , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Refugiados/psicologia , Autorrelato/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto Jovem
13.
J Med Internet Res ; 22(5): e19556, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32369026

RESUMO

BACKGROUND: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and affected the mental health of social media users. OBJECTIVE: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. METHODS: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. RESULTS: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people's mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. CONCLUSIONS: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual's gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan.


Assuntos
Transtornos de Ansiedade/psicologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/psicologia , Mídias Sociais , Adolescente , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Internet , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Mídias Sociais/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
14.
MMWR Morb Mortal Wkly Rep ; 69(20): 618-622, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32437343

RESUMO

Ceftriaxone-resistant Salmonella enterica serotype Typhi (Typhi), the bacterium that causes typhoid fever, is a growing public health threat. Extensively drug-resistant (XDR) Typhi is resistant to ceftriaxone and other antibiotics used for treatment, including ampicillin, chloramphenicol, ciprofloxacin, and trimethoprim-sulfamethoxazole (1). In March 2018, CDC began enhanced surveillance for ceftriaxone-resistant Typhi in response to an ongoing outbreak of XDR typhoid fever in Pakistan. CDC had previously reported the first five cases of XDR Typhi in the United States among patients who had spent time in Pakistan (2). These illnesses represented the first cases of ceftriaxone-resistant Typhi documented in the United States (3). This report provides an update on U.S. cases of XDR typhoid fever linked to Pakistan and describes a new, unrelated cluster of ceftriaxone-resistant Typhi infections linked to Iraq. Travelers to areas with endemic Typhi should receive typhoid vaccination before traveling and adhere to safe food and water precautions (4). Treatment of patients with typhoid fever should be guided by antimicrobial susceptibility testing whenever possible (5), and clinicians should consider travel history when selecting empiric therapy.


Assuntos
Ceftriaxona/farmacologia , Surtos de Doenças , Resistência Microbiana a Medicamentos , Salmonella typhi/efeitos dos fármacos , Doença Relacionada a Viagens , Febre Tifoide/epidemiologia , Febre Tifoide/microbiologia , Adolescente , Adulto , Idoso , Ceftriaxona/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Febre Tifoide/tratamento farmacológico , Estados Unidos/epidemiologia , Adulto Jovem
15.
BMC Infect Dis ; 20(1): 336, 2020 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-32397998

RESUMO

BACKGROUND: Enterobius vermicularis is an intestinal helminthic parasite that causes a gastrointestinal infection called enterobiasis. Children are more susceptible to infection than adults. The current study aimed to explore the prevalence of E. vermicularis infection among children in Erbil City concerning demographic factors and certain blood parameters. METHODS: A cross-sectional and analytical study was conducted on 505 children (3-10 years). Cellophane tape samples and blood samples were taken from participants. The cellophane tape samples were examined microscopically, whereas blood samples were examined using the auto-analyzer and Cobas. RESULTS: The overall prevalence of E. vermicularis infection was 27.13%, and the infection rate was non-significantly (P = 0.371) higher in females (28.85%) than in males (25.31%). The incidence of enterobiasis was directly proportional to family size. This study demonstrated that the mean serum total protein and iron levels were significantly decreased in infected children, while other trace element levels were not significantly affected. CONCLUSIONS: The prevalence of E. vermicularis is relatively lower than that in previous studies. Serum total protein and iron levels significantly decreased in the enterobiasis-positive group.


Assuntos
Proteínas Sanguíneas/análise , Enterobíase/sangue , Enterobíase/epidemiologia , Enterobius/isolamento & purificação , Ferro/sangue , Fatores Etários , Animais , Criança , Pré-Escolar , Estudos Transversais , Testes Diagnósticos de Rotina , Características da Família , Feminino , Humanos , Incidência , Iraque/epidemiologia , Masculino , Prevalência , Fatores Sexuais
16.
Diabetes Metab Syndr ; 14(4): 547-554, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32408119

RESUMO

INTRODUCTION: On March 11, 2020, the novel coronavirus was declared a global pandemic. The disease was named COVID-19 standing for coronavirus disease 2019. The objectives were to determine the epidemiological, clinical, laboratory, and radiological characteristics of COVID-19 patients. METHODS: In this prospective descriptive study, 15 confirmed hospitalized cases of COVID-19 between 18th March and April 7, 2020 were followed-up till discharge. RESULTS: There were 15 reported patients infected by 3 imported index cases from Europe. The mean age of the patients was 28.06 (SD: 16.42 years). The patients' age stratification was as follows: 0-5 (2, 13.3%); 6-18 (2, 13.3); 19-50 (10, 66.7%), and 51-64 years (1, 6.7%). The patients were male (9, 60.0%) and female (6, 40.0%). Most of the patients had mild disease severity (13, 86.7%), followed by mild-moderate (1, 6.7%) and moderate-severe (1, 6.7%). The study revealed that 6 patients were asymptomatic, and 9 patients were symptomatic. The most common symptoms were: fever (n = 8; 53.3%), cough (n = 7; 46.7%), shortness of breath (n = 3; 20.0%), fatigue (n = 3; 20.0%), and taste and smell disorders (n = 4; 26.7%). All patients were recovered and discharged over a median of 8 between 8 and 21 days. The mean and Std. deviation values of the hematological were: WBC: 6.57 (1.86); neutrophil count: 3.75 (1.26); lymphocyte count: 1.87 (0.41); Hb: 13.89 (1.26); platelet count: 207.67 (52.21). CONCLUSION: All COVID-19 cases were linked to foreign visits with few local transmissions to close contacts without community transmission. The majority of cases were mild illnesses with full recovery.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Azitromicina/uso terapêutico , Betacoronavirus/patogenicidade , Criança , Pré-Escolar , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Tosse/virologia , Fadiga/virologia , Feminino , Febre/virologia , Seguimentos , Humanos , Hidroxicloroquina/uso terapêutico , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/virologia , Oseltamivir/uso terapêutico , Educação de Pacientes como Assunto , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Estudos Prospectivos , Radiografia Torácica , Índice de Gravidade de Doença , Distúrbios do Paladar/virologia , Doença Relacionada a Viagens , Resultado do Tratamento , Adulto Jovem
17.
J Craniofac Surg ; 31(5): e486-e488, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32371712

RESUMO

PURPOSE: The aim of this retrospective study was to study the effects of the war against ISIS during period (2014-2018) on the incidence of cleft lip and palate and the appearance of different congenital anomalies. MATERIALS AND METHODS: The collected sample consists of 320 newborn babies (160 patients and 160 infants as a control). The examined patients and controls were all included in this study, while the authors exclude those who born to relative parents, and if the mothers had taken any medications during pregnancy.All newborn cases and controls were physically examined by the research team, and a questionnaire was completed after obtaining the informed consent of mothers and/or fathers. RESULTS: In this study, the authors found that 160 patients out of 40,500 live births were born with cleft lip and/or cleft palate, so their percentage was 0.39% from population, that is mean approximately 4 infants affected per each 1000 live births. The risk of cleft development among children who born to fathers who participated in long fighting against the terrorists was (OR = 44.333, 95% CI: 20.176-97.417). The associated combined anomalies were found in 88 patients (79%) especially among those whom fathers participated in the war CONCLUSION:: From this study the authors can conclude that the dramatic increase in the incidence of cleft lip and palate and the appearance of different associated anomalies in the south of Iraq is due to the direct effect and impact of the war and the used toxic bombs on the chromosomal changes of the parents and the developing fetus.


Assuntos
Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Feminino , Humanos , Incidência , Recém-Nascido , Iraque/epidemiologia , Masculino , Estudos Retrospectivos
18.
Int J Infect Dis ; 96: 97-104, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32243917

RESUMO

BACKGROUND: The objectives were to estimate the prevalence of latent tuberculosis infection (LTBI) among household contacts (HHCs) with active TB patients, and to identify their risk factors. METHODS: A prospective, cross sectional study was conducted from May to October 2018. All HHCs with active TB cases were included. The subjects underwent two tests: Quantiferon TB-Gold plus assay (QFT-Plus) and tuberculin skin test (TST). Data were analyzed using the Statistical Package for Social Sciences 25. RESULTS: Among 521 HHCs, 101 (24.05%) revealed positive TST and 80 (19.85%) positive QFT-Plus. The significant risk factors associated with positive TST individuals were ≥ 15 years, immunosuppressive therapy, and pulmonary TB (PTB) patients; whereas, those with QFT-Plus positive were ≥ 45 years, alcohol consumption, and immunosuppressive therapy. The concordance rate among 309 individuals who performed both tests was 0.88 %; the kappa value showed good agreement (k = 0.679) and significant correlation (P < 0.001). CONCLUSIONS: The overall rate of LTBI was intermediate. Screening of LTBI should be routine among HHCs, regardless of the site of the disease. Age ≥ 15 years, alcoholics, immunosuppressive therapy, and PTB were potential risk factors. There was a good concordance between TST and QFT-Plus. A QFT-Plus can overcome the limitation of a BCG vaccinated individual, especially in early life.


Assuntos
Tuberculose Latente/epidemiologia , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Imunossupressão , Lactente , Iraque/epidemiologia , Tuberculose Latente/diagnóstico , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Teste Tuberculínico , Tuberculose , Tuberculose Pulmonar/complicações , Adulto Jovem
19.
Prev Vet Med ; 176: 104911, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32066025

RESUMO

There is limited literature concerning the types of injuries that military working dogs (MWDs) face while in a deployed theater of operations and associated risk factors. To summarize injuries and identify injury risk factors in MWDs during their first deployments to Iraq, demographic and medical data were collected for 794 MWDs from the U.S. Army, Air Force, Navy, and Marine Corps that deployed to Iraq between March 20, 2003 and December 31, 2007. Sixty-two percent (n = 490) had a medical encounter during deployment. Injuries were categorized as traumatic or musculoskeletal. MWD demographics, characteristics, and injury types were summarized. Injury risk factors were assessed using multivariable logistic regression. A majority of the population were German Shepherds (56 %), intact males (49 %), and dogs certified in both patrol and explosives detection (73 %). During their first deployment to Iraq, 20 % (n = 156) experienced an injury. Risk factors included breed, age, and occupational certification. Belgian Malinois and Labrador Retriever dogs had greater odds of injury compared to German Shepherds (p = 0.04 and p = 0.02) and the oldest MWDs had about a 50 % higher risk of injury compared to the youngest (p = 0.01), especially for musculoskeletal injuries. MWDs with Specialized Search certification were at increased injury risk (p = 0.02). Training, equipment, and supplies for veterinary service personnel, MWD handlers, and MWDs should be tailored with consideration of the injury risks of the MWD population. Further study is needed to investigate chronic injuries in military working dogs to better understand causation and prevention.


Assuntos
Cães/lesões , Militares/estatística & dados numéricos , Ferimentos e Lesões/veterinária , Animais , Iraque/epidemiologia , Fatores de Risco , Estados Unidos , Ferimentos e Lesões/epidemiologia
20.
J Trauma Acute Care Surg ; 88(5): 696-703, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32068717

RESUMO

INTRODUCTION: The United States and United Kingdom (UK) had differing approaches to the surgical skill mix within deployed medical treatment facilities (MTFs) in support of the military campaigns in Iraq and Afghanistan. METHODS: The US and UK combat trauma registries were scrutinized for patients with penetrating neck injury (PNI) at deployed coalition MTF between March 2003 and October 2011. A multivariate mixed effects logistic regression model (threshold, p < 0.05) was used stratified by MTF location and year of injury. The dependent variable was fatality on leaving Role 3, and the independent variables were ISS on arrival, nationality, MTF nationality, and presence of head and neck surgeon. RESULTS: A total of 3,357 (4.9%) of 67,586 patients who arrived alive at deployed military MTF were recorded to have sustained neck injuries; of which 2,186 (83%) were PNIs and the remainder were blunt injuries. When service members killed in action were included, the incidence of neck injury rose from 4.9% to 10%. Seven hundred nine (32%) of 2,186 patients with PNI underwent neck exploration; 555 patients were recorded to have sustained cervical vascular injury, 230 (41%) of 555 underwent vascular ligation or repair. Where it was recorded, PNI directly contributed to death in 64 (28%) of 228 of patients. Fatality status was positively associated with ISS on arrival (odds ratio, 1.05; 95% confidence interval, 1.04-1.06; p < 0.001) and the casualty being a local national (odds ratio, 1.74; 95% confidence interval, 1.28-2.38; p < 0.001). CONCLUSION: Significant differences in the treatment and survival of casualties with PNI were identified between nations in this study; this may reflect differing cervical protection, management protocols, and surgical capability and is worthy of further study. In an era of increasing specialization within surgery, neck exploration remains a skill that must be retained by military surgeons deploying to Role 2 and Role 3 MTF. LEVEL OF EVIDENCE: Retrospective cohort study, level III.


Assuntos
Medicina Militar/métodos , Lesões do Pescoço/terapia , Lesões Relacionadas à Guerra/terapia , Ferimentos Penetrantes/terapia , Adolescente , Adulto , Campanha Afegã de 2001- , Afeganistão/epidemiologia , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Iraque/epidemiologia , Guerra do Iraque 2003-2011 , Masculino , Pessoa de Meia-Idade , Medicina Militar/estatística & dados numéricos , Lesões do Pescoço/etiologia , Lesões do Pescoço/mortalidade , Sistema de Registros/estatística & dados numéricos , Análise de Sobrevida , Reino Unido/epidemiologia , Estados Unidos/epidemiologia , Lesões Relacionadas à Guerra/etiologia , Lesões Relacionadas à Guerra/mortalidade , Guerra/estatística & dados numéricos , Ferimentos Penetrantes/etiologia , Ferimentos Penetrantes/mortalidade , Adulto Jovem
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