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1.
Work ; 63(2): 261-268, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156207

RESUMO

BACKGROUND: In the US, as the demands for rehabilitation services increase, work-related musculoskeletal disorders (WMSDs) have increased among rehabilitation practitioners. This trend has been noticed among physical therapists (PTs) in the State of Kuwait. OBJECTIVE: The purpose of this study was to determine the prevalence and risk factors associated with WMSDs among PTs in Kuwait over a 12-month period. In addition, the result compared across countries and health care professions. METHODS: A descriptive cross-sectional design was used in this study. A self-administered questionnaire was distributed to the PT departments at Kuwait government hospitals and schools. A total of 312 returned questionnaires (69.3% response rate) were received. RESULTS: Results showed that 149 (48%) PT respondents experienced WMSDs. The lower back and muscle spasm were the most common area of the body injured and type of injury, respectively. Manual therapy techniques and patient transfers were most common activities associated with injuries. CONCLUSIONS: The prevalence of PTs with WMSDs in Kuwait was high and similar to other studies of PTs with WMSDs working in other countries. The performance of work activities was the leading risk factor for WMSDs, and WMSDs were prevalent among industrialized, industrially developing, and underdeveloped countries. Education of PTs regarding ergonomic and biomechanical principles as well as hands-on training of patient handling are the key tools to help prevent WMSDs.


Assuntos
Traumatismos Ocupacionais/diagnóstico , Fisioterapeutas/estatística & dados numéricos , Trabalho/fisiologia , Adulto , Estudos Transversais , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/epidemiologia , Traumatismos Ocupacionais/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Trabalho/normas
2.
BMC Infect Dis ; 19(1): 375, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046696

RESUMO

BACKGROUND: This study was undertaken to determine the distribution of type-specific human papillomavirus (HPV) in external anogenital warts, and the correlation with clinical presentation of warts and demographic data of patients. METHODS: Genital warts specimens were obtained from 129 men and 27 women attending a dermatology clinic, who had been advised surgical excision. The tissues were fixed and screened for HPV DNA by using real-time PCR. HPV genotype was determined by PCR-based sequencing. RESULTS: Sixteen different HPV genotypes were detected, comprising 4 oncogenic HPV genotypes (16, 18, 33, 38), 2 low-risk HPV types (LR) (6, 81), HPV 9, and other types associated with common warts (1a, 2, 4, 7, 27b, 27, 57b, 57c, 65). Oncogenic HPV types were found in 34.62% of patients, LR HPV types in 14.4%, HPV 9 in 0.64%, and common warts type in 50.6%. The prevalence of HPV infection with a single type was 88.4, 9.0% for two types, and 2.6% for three types. Multiple logistic regression model showed that age, gender, nationality, number of warts, size of each wart, and positive history of wart in sexual partner, were not predictors of HPV type. However, patients with anogenital warts of one to six months duration were three times more likely to have oncogenic HPV infection compared to those with less than one month. CONCLUSIONS: This study shows that oncogenic HPV types are detected in around 35% of patients with genital warts, and are prevalent in warts of one to six months duration.


Assuntos
Condiloma Acuminado/diagnóstico , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Adolescente , Adulto , Condiloma Acuminado/virologia , Estudos Transversais , DNA Viral/genética , DNA Viral/metabolismo , Feminino , Genótipo , Humanos , Kuweit/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Prevalência , Adulto Jovem
3.
J Diabetes Res ; 2019: 9136250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30944829

RESUMO

Objective: Gestational diabetes mellitus (GDM) is a growing global public health problem that can have short- and long-term health consequences for the mother and the child. Despite its criticalness, many countries still do not have the epidemiological data which could guide them in responding to the problem. Due to the lack of knowledge on GDM and the fact that diabetes and obesity are high in Kuwait, this study sought to estimate the prevalence of GDM and determine its risk factors and outcomes. Methods: This cross-sectional study enrolled 947 mothers living in Kuwait, who had given birth within the previous four years. Participants were recruited from primary health care clinics and public hospitals. GDM status was self-reported by the mother. Associations between exposures and outcomes were evaluated using logistic regression, and adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. Results: Of the 868 mothers with no prior history of diabetes mellitus, 109 (12.6%, 95% CI: 10.4, 14.8) reported having been given a GDM diagnosis during their last pregnancy. The prevalence of GDM increased with maternal age and prepregnancy body mass index. GDM was positively associated with caesarean section delivery (aOR = 1.76, 95% CI: 1.17, 2.66) and fetal macrosomia (aOR = 2.36, 95% CI: 1.14, 4.89). Conclusion: GDM is prevalent in Kuwait and is associated with poor maternal, fetal, and neonatal outcomes. To date, GDM has received little attention, and there is a need for more research to identify and respond to individual and public health implications of GDM in Kuwait.


Assuntos
Cesárea/estatística & dados numéricos , Diabetes Gestacional/epidemiologia , Macrossomia Fetal/epidemiologia , Adulto , Peso ao Nascer , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Kuweit/epidemiologia , Mães , Razão de Chances , Gravidez , Resultado da Gravidez , Prevalência , Análise de Regressão , Projetos de Pesquisa , Fatores de Risco , Adulto Jovem
4.
PLoS Negl Trop Dis ; 13(4): e0007293, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30986214

RESUMO

Non-typhoidal Salmonella (NTS) bacteremia is a significant cause of morbidity and mortality worldwide. It is considered to be an emerging and neglected tropical disease in Africa. We studied this in two tertiary hospitals-Al Farwaniya and Al Amiri-in Kuwait, a subtropical country, from April 2013-May 2016. NTS bacteremia was present in 30 of 53,860 (0.75%) and 31 of 290,36 (1.33%) blood cultures in the two hospitals respectively. In Al Farwaniya hospital, one-third of the patients were from some tropical developing countries of Asia. About 66% of all patients (40/61) had diarrhea, and of these, 65% had the corresponding blood serovar isolated from stool culture. A few patients had Salmonella cultured from urine. Patients were either young or old. Most of the patients had co-morbidities affecting the immune system. Two patients each died in both hospitals. The number of different serovars cultured in each hospital was 13, and most infections were due to S. Enteritidis (all sequence type [ST]) 11) and S. Typhimurium (all ST19) except in a subgroup of expatriate patients from tropical developing countries in Al Farwaniya hospital. About a quarter of the isolates were multidrug-resistant. Most patients were treated with a cephalosporin with or without other antibiotics. S. Enteritidis and S. Typhimurium isolates were typed by pulsed field-gel electrophoresis (PFGE) and a selected number of isolates were whole-genome sequenced. Up to four different clades were present by PFGE in either species. Whole-genome sequenced isolates showed antibiotic-resistance genes that showed phenotypic correlation, and in some cases, phenotypes showed absence of specific genes. Whole-genome sequenced isolates showed presence of genes that contributed to blood-stream infection. Phylogeny by core genome analysis showed a close relationship with S. Typhimurium and S. Enteritidis from other parts of the world. The uniqueness of our study included the finding of a low prevalence of infection, mortality and multidrug-resistance, a relatively high prevalence of gastrointestinal infection in patients, and the characterization of selected isolates of S. Typhimurium and S. Enteritidis serovars by whole-genome sequencing that shed light on phylogeny, virulence and resistance. Similarities with studies from developing countries especially Africa included infection in patients with co-morbidities affecting the immune system, predominance of S. Typhimurium and S. Enteritidis serovars and presence of drug-resistance in isolates.


Assuntos
Bacteriemia/microbiologia , Bacteriemia/patologia , Infecções por Salmonella/microbiologia , Infecções por Salmonella/patologia , Salmonella/classificação , Salmonella/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bacteriemia/epidemiologia , Sangue/microbiologia , Pré-Escolar , Farmacorresistência Bacteriana , Fezes/microbiologia , Feminino , Genótipo , Humanos , Lactente , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem Molecular , Prevalência , Infecções por Salmonella/epidemiologia , Sorogrupo , Centros de Atenção Terciária , Urina/microbiologia , Sequenciamento Completo do Genoma , Adulto Jovem
5.
Environ Int ; 126: 476-483, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30844583

RESUMO

BACKGROUND: The health burden from exposure to air pollution has been studied in many parts of the world. However, there is limited research on the health effects of air quality in arid areas where sand dust is the primary particulate pollution source. OBJECTIVE: Study the risk of mortality from exposure to poor air quality days in Kuwait. METHODS: We conducted a time-series analysis using daily visibility as a measure of particulate pollution and non-accidental total mortality from January 2000 through December 2016. A generalized additive Poisson model was used adjusting for time trends, day of week, and temperature. Low visibility (yes/no), defined as visibility lower than the 25th percentile, was used as an indicator of poor air quality days. Dust storm events were also examined. Finally, we examined these associations after stratifying by gender, age group, and nationality (Kuwaitis/non-Kuwaitis). RESULTS: There were 73,748 deaths from natural causes in Kuwait during the study period. The rate ratio comparing the mortality rate on low visibility days to high visibility days was 1.01 (95% CI: 0.99-1.03). Similar estimates were observed for dust storms (1.02, 95% CI: 1.00-1.04). Higher and statistically significant estimates were observed among non-Kuwaiti men and non-Kuwaiti adolescents and adults. CONCLUSION: We observed a higher risk of mortality during days with poor air quality in Kuwait from 2000 through 2016.


Assuntos
Poluição do Ar , Mortalidade , Adolescente , Adulto , Idoso , Poluentes Atmosféricos , Criança , Pré-Escolar , Poeira , Feminino , Humanos , Lactente , Recém-Nascido , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Estações do Ano , Temperatura Ambiente , Adulto Jovem
6.
PLoS One ; 14(3): e0213532, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845213

RESUMO

OBJECTIVES: Candida lusitaniae is an opportunistic yeast pathogen in certain high-risk patient populations/cohorts. The species exhibits an unusual antifungal susceptibility profile with tendency to acquire rapid resistance. Here, we describe prevalence of C. lusitaniae in clinical specimens in Kuwait, its antifungal susceptibility profile and role in neonatal fungemia. METHODS: Clinical C. lusitaniae isolates recovered from diverse specimens during 2011 to 2017 were retrospectively analyzed. All isolates were identified by germ tube test, growth on CHROMagar Candida and by Vitek 2 yeast identification system. A simple species-specific PCR assay was developed and results were confirmed by PCR-sequencing of ITS region of rDNA. Antifungal susceptibility was determined by Etest. Minimum inhibitory concentrations (MICs) were recorded after 24 h incubation at 35°C. RESULTS: Of 7068 yeast isolates, 134 (1.89%) were identified as C. lusitaniae including 25 (2.52%) among 990 bloodstream isolates. Species-specific PCR and PCR-sequencing of rDNA confirmed identification. Of 11 cases of neonatal candidemia, 9 occurred in NICU of Hospital A and are described here. Eight of 9 neonates received liposomal amphotericin B, which was followed by fluconazole in 7 and additionally by caspofungin in 2 cases as salvage therapy. Three of 8 (37.5%) patients died. No isolate exhibited reduced susceptibility to amphotericin B, fluconazole, voriconazole, caspopfungin, micafungin and anidulafungin. The MIC ± geometric mean values for amphotericin B, fluconazole, voriconazole, and caspofungin were as follows: 0.072 ± 0.037 µg/ml, 2.32 ± 0.49 µg/ml, 0.09 ± 0.01 µg/ml and 0.16 ± 0.08 µg/ml, respectively. Only two isolates exhibited reduced susceptibility to fluconazole. CONCLUSIONS: This study describes the prevalence and antifungal susceptibility profile of clinical C. lusitaniae isolates in Kuwait. No isolate showed reduced susceptibility to amphotericin B. The study highlights the emerging role of C. lusitaniae as a healthcare-associated pathogen capable of causing fungemia in preterm neonates and causing significant mortality.


Assuntos
Antifúngicos/farmacologia , Candida , Candidíase/epidemiologia , Doenças do Recém-Nascido/epidemiologia , Candida/crescimento & desenvolvimento , Candida/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/microbiologia , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/tratamento farmacológico , Doenças do Recém-Nascido/microbiologia , Kuweit/epidemiologia , Prevalência
7.
J Neuroimmunol ; 330: 31-34, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-30784773

RESUMO

Angiopoietin-like proteins (ANGPTLs) are a group of proteins with functions in lipid metabolism, angiogenesis, and inflammation. Here, we investigated their involvement in multiple sclerosis (MS) progression and response to treatment in 100 MS patients and 77 healthy controls. ANGPTLs significantly associated with MS progression and response to therapy. High ANGPTL6 levels associated with slow disease progression and good response to fingolimod treatment and low ANGPTL4 associated with poor response to natalizumab treatment. Therefore, we propose high ANGPTL4 and 6 levels as markers for positive response to MS treatments either natalizumab or fingolimod respectively. Further investigations into their role in MS is warranted.


Assuntos
Proteínas Semelhantes a Angiopoietina/sangue , Fatores Imunológicos/uso terapêutico , Esclerose Múltipla/sangue , Esclerose Múltipla/tratamento farmacológico , Natalizumab/uso terapêutico , Adulto , Biomarcadores/sangue , Estudos de Coortes , Feminino , Seguimentos , Humanos , Kuweit/epidemiologia , Estudos Longitudinais , Masculino , Esclerose Múltipla/epidemiologia , Adulto Jovem
8.
Exp Clin Transplant ; 17(Suppl 1): 83-91, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30777529

RESUMO

OBJECTIVES: The prevalence of BK-induced nephritis in renal transplant recipients is estimated to be 1% to 10%; the rate of graft loss within 1 year is 30% to 65%. We conducted this study to evaluate screening of BK virus in blood and/or urine among renal transplant recipients and to assess the effects of different therapeutic modalities in renal transplant recipients with BK nephropathy. MATERIALS AND METHODS: Kidney transplant recipients were screened at the time of transplant and then at 1, 2, 3, 6, 9, 12, 18, and 24 months posttransplant. Fiftynine patients were diagnosed with BK virus viremia. Patients were divided into 2 groups according to treatment: group 1 (n = 29) received an active treatment and group 2 (n = 30) received minimized immunosuppression. RESULTS: Most patients required graft biopsies to confirm diagnosis (86.2% in group 1 vs 50% in group 2; P = .03). Both groups were comparable regarding demographic data. Initial posttransplant graft function was significantly better in group 1 (P = .017); ultimately, there was no significant difference between both groups regarding graft survival (P= .51). Fifty percent of patients had biopsy-proven acute T-cell-mediated rejection before BK virus-associated nephropathy diagnosis (significantly higher in group 1). Serum creatinine levels were significantly better in group 2 at 3, 4, and 5 years after BK nephropathy (P = .001, .017, and .003, respectively). CONCLUSIONS: The prevalence of BK nephropathy in our renal transplant recipients was 5.9% with a rate of graft loss ranging from 43% to 51%. Regular screening, less intensive immunosuppressive therapy, and early intervention by reduction of immunosuppressive medications are advisable to obtain early diagnosis and to have better outcomes of BK virus-associated nephropathy with antiviral agents.


Assuntos
Antivirais/uso terapêutico , Vírus BK/efeitos dos fármacos , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Infecções Oportunistas/tratamento farmacológico , Infecções por Polyomavirus/tratamento farmacológico , Infecções Tumorais por Vírus/tratamento farmacológico , Antivirais/efeitos adversos , Vírus BK/imunologia , Vírus BK/patogenicidade , Sobrevivência de Enxerto/efeitos dos fármacos , Humanos , Transplante de Rim/mortalidade , Kuweit/epidemiologia , Infecções Oportunistas/imunologia , Infecções Oportunistas/mortalidade , Infecções Oportunistas/virologia , Infecções por Polyomavirus/imunologia , Infecções por Polyomavirus/mortalidade , Infecções por Polyomavirus/virologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Infecções Tumorais por Vírus/imunologia , Infecções Tumorais por Vírus/mortalidade , Infecções Tumorais por Vírus/virologia
9.
BMC Infect Dis ; 19(1): 3, 2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606116

RESUMO

BACKGROUND: Accurate drug susceptibility testing (DST) of Mycobacterium tuberculosis in clinical specimens and culture isolates to first-line drugs is crucial for diagnosis and management of multidrug-resistant tuberculosis (MDR-TB). Resistance of M. tuberculosis to rifampicin is mainly due to mutations in hot-spot region of rpoB gene (HSR-rpoB). The prevalence of disputed (generally missed by rapid phenotypic DST methods) rpoB mutations, which mainly include L511P, D516Y, H526N, H526L, H526S, and L533P in HSR-rpoB and I572F in cluster II region of rpoB gene, is largely unknown. This study determined the occurrence of all disputed mutations in HSR-rpoB and at rpoB codon 572 in M. tuberculosis strains phenotypically susceptible to rifampicin in Kuwait. METHODS: A total of 242 M. tuberculosis isolates phenotypically susceptible to rifampicin were used. The DST against first-line drugs was performed by Mycobacteria growth indicator tube (MGIT) 960 system. Mutations in HSR-rpoB (and katG codon 315 and inhA-regulatory region for isoniazid resistance) were detected by GenoType MDBDRplus assay. The I572F mutation in cluster II region of rpoB was detected by developing a multiplex allele-specific (MAS)-PCR assay. Results were confirmed by PCR-sequencing of respective loci. Molecular detection of resistance for ethambutol and pyrazinamide and fingerprinting by spoligotyping were also performed for isolates with an rpoB mutation. RESULTS: Among 242 rifampicin-susceptible isolates, 0 of 130 pansusceptible/monodrug-resistant isolates but 4 of 112 polydrug-resistant isolates contained a disputed rpoB mutation. All 4 isolates were also resistant to isoniazid and molecular screening identified additional resistance to pyrazinamide and ethambutol in one isolate each. In final analysis, 2 of 4 isolates were resistant to all 4 first-line drugs. Spoligotyping showed that the isolates belonged to different M. tuberculosis lineages. CONCLUSIONS: Four of 242 (1.7%) rifampicin-susceptible M. tuberculosis isolates contained a disputed rpoB mutation including 2 isolates resistant to all four first-line drugs. The occurrence of a disputed rpoB mutation in polydrug-resistant M. tuberculosis isolates resistant at least to isoniazid (MDR-TB) suggests that polydrug-resistant strains should be checked for genotypic rifampicin resistance for optimal patient management since the failure/relapse rates are nearly same in isolates with a canonical or disputed rpoB mutation.


Assuntos
Proteínas de Bactérias/genética , RNA Polimerases Dirigidas por DNA/genética , Mutação , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Antituberculosos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Etambutol/farmacologia , Genótipo , Humanos , Incidência , Isoniazida/farmacologia , Kuweit/epidemiologia , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase , Pirazinamida/farmacologia , Rifampina/farmacologia , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
10.
J Ultrasound Med ; 38(1): 165-172, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29732592

RESUMO

OBJECTIVES: Transcranial Doppler ultrasound is used to identify patients with sickle cell disease (SCD) at risk for stroke. We performed transcranial Doppler studies in patients from 4 countries in the Arabian Peninsula (Kuwait, Oman, Iraq, and United Arab Emirates) to document the prevalence of abnormal transcranial Doppler findings. METHODS: The patients were recruited from outpatient clinics and studied in a steady state. Transcranial Doppler examinations were performed with standard equipment by experienced operators. The time-averaged maximum mean velocity (TAMMV) was documented in the arteries of the circle of Willis. The hemoglobin (Hb) genotype was confirmed, and the fetal Hb level and complete blood counts were determined. RESULTS: There were 415 patients in the study, aged 2 to 18 years (mean ± SD, 8.6 ± 3.5 years). None of the patients had an abnormal TAMMV (ie, > 200 cm/s), whereas only 13 (3.1%), all from Iraq, had conditional values (170-200 cm/s) in the right middle cerebral artery and 7 (1.7%) in the left middle cerebral artery. There were no consistent TAMMV differences among male and female patients or in patients with different Hb genotypes (sickle cell anemia, sickle cell ß0- thalassemia, and sickle D). The use of hydroxyurea was associated with a lower TAMMV, whereas a blood transfusion history had no influence. Total hemoglobin, reticulocyte count, serum bilirubin, and fetal Hb values showed varying degrees of association with the TAMMV in the different vessels. CONCLUSIONS: This study has demonstrated the rarity of abnormal transcranial Doppler findings among Peninsular Arab patients with SCD. The guidelines for transcranial Doppler screening in this population need further studies and recommendations.


Assuntos
Anemia Falciforme/epidemiologia , Artérias Cerebrais/diagnóstico por imagem , Artérias Cerebrais/fisiopatologia , Acidente Vascular Cerebral/epidemiologia , Ultrassonografia Doppler Transcraniana/métodos , Adolescente , Anemia Falciforme/fisiopatologia , Árabes/estatística & dados numéricos , Circulação Cerebrovascular , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Iraque/epidemiologia , Kuweit/epidemiologia , Masculino , Omã/epidemiologia , Prevalência , Acidente Vascular Cerebral/fisiopatologia , Emirados Árabes Unidos/epidemiologia
11.
Mycoses ; 62(1): 51-61, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30184277

RESUMO

BACKGROUND: Cyberlindnera fabianii has rarely been reported as a human pathogen. Here, we describe an outbreak of C. fabianii fungaemia involving 10 preterm neonates during a seven-month period in Kuwait and review the published reports. METHODS: Blood cultures were processed, and yeast isolates were initially identified by ID 32 C and/or VITEK 2. Molecular identification was done by PCR sequencing of internally transcribed spacer (ITS) region and D1/D2 domains of rDNA. Fingerprinting was performed with microsatellite-based and minisatellite-based primers to examine genetic relatedness among the isolates. Antifungal susceptibility testing of the isolates was done by Etest. FINDINGS: All infected neonates were preterm, received prior antibiotics and had an intravascular catheter in place. All bloodstream isolates were initially identified as Candida utilis by ID 32 C and/or VITEK 2 and showed reduced susceptibility to triazoles. PCR sequencing of rDNA identified all isolates as Cyberlindnera fabianii. Fingerprinting studies yielded identical patterns indicating clonality. One neonate died before treatment, one died during treatment, and eight neonates survived treatment with amphotericin B with/without fluconazole or caspofungin. Source of infection remained unknown despite surveillance cultures. CONCLUSION: The outbreak highlights emergence of C. fabianii as a neonatal pathogen and reinforces importance of molecular methods in its accurate identification.


Assuntos
Surtos de Doenças , Fungemia/epidemiologia , Fungemia/microbiologia , Recém-Nascido Prematuro , Saccharomycetales/classificação , Saccharomycetales/isolamento & purificação , Antifúngicos/farmacologia , Sangue/microbiologia , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/microbiologia , Análise por Conglomerados , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , DNA Fúngico/química , DNA Fúngico/genética , DNA Intergênico/química , DNA Intergênico/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Feminino , Humanos , Recém-Nascido , Kuweit/epidemiologia , Masculino , Repetições Minissatélites , Epidemiologia Molecular , Tipagem Molecular , Técnicas de Tipagem Micológica , Filogenia , RNA Ribossômico/genética , Saccharomycetales/efeitos dos fármacos , Saccharomycetales/genética , Análise de Sequência de DNA
12.
J Steroid Biochem Mol Biol ; 187: 76-81, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30412765

RESUMO

The aim of this study was to determine the prevalence of vitamin D inadequacy in male athletes living in Kuwait, and to assess its relationship with possible risk factors including body composition, lifestyle and fasting Ramadan. A Cross- sectional study was conducted on a total of 250 male athletes registered in official sports clubs in Kuwait were included. Blood tests, anthropometric measurements and a lifestyle questionnaire were performed. Serum 25(OH)D level was used as a measure of vitamin D status. Vitamin D inadequacy was defined as serum 25(OH)D < 75 nmol/L, inadequate levels were further classified as vitamin D insufficiency (50-75 nmol/L), vitamin D deficiency (<50 nmol/L) and severe deficiency (<25 nmol/L). Thirty-six percent of the sample were football players, 13% were futsal players and the rest were players of 15 different outdoor and indoor sports. A prevalence of 83% of vitamin D inadequacy (< 75 nmol/L) was observed in male athletes in Kuwait, of which 23% had severe deficiency (< 25 nmol/L). The prevalence increased from 80% (n = 130) before Ramadan to 90% (n = 79) after Ramadan. There was a significant positive association between serum 25(OH)D concentrations and vitamin D intake (p < 0.001). Serum 25(OH)D concentrations were significantly inversely associated with risk of injuries (p = 0.008) and with the concentrations of parathyroid hormone (PTH) (p = 0.029). No statistically significant associations between 25(OH)D concentrations and sun exposure, physical activity or anthropometric levels were found. Similar to other studies in the Middle East, we found that healthy male athletes in Kuwait have a high prevalence of vitamin D inadequacy. The results of this study suggest the need for regular supplement intake and vitamin D awareness campaigns for athletes in Kuwait. More research is needed to assess the effect of Ramadan.


Assuntos
Hidroxicolecalciferóis/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Adulto , Atletas , Estudos Transversais , Humanos , Kuweit/epidemiologia , Masculino , Prevalência , Fatores de Risco , Adulto Jovem
14.
J Mycol Med ; 29(1): 35-38, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30578148

RESUMO

Candida blood steam infection is a life-threatening disease that seems to be under estimated. Understanding epidemiology of such disease is crucial for improved diagnosis, optimized treatment, and better outcome. Through this retrospective study, we aimed to determine the incidence of candidemia in a secondary care hospital, and to describe the epidemiology and outcome of candidemia among adult patients. The incidence of candidemia for all age groups was 0.24, 0.16 and 0.15 cases/1000 patient-days in 2014, 2015 and 2016 respectively. Among adult patients, 82 cases were identified. The patients had the following clinical characteristics with varying proportions: old age, diabetes, antibiotic exposure, use of vascular catheter, abdominal surgery, ICU hospitalization, haemodialysis, and total parenteral nutrition. All-cause 30-day mortality was 54% and ICU hospitalization was a recognized risk factor for death. The leading causative agents were Candida albicans (32%), and Candida parapsilosis (32%), followed by Candida tropicalis (20%), Candida glabrata (13%) and one each by Candida dubliniensis, Candida famata, and Candida auris. Almost all tested isolates were susceptible to caspofungin and amphotericin B. With regard to fluconazole, C. glabrata showed variable susceptibility. Other species were susceptible except one isolate, each of C. parapsilosis and C. auris. The study highlights the growing importance of non-C. albicans Candida species in the etiology of candidemia. Emergence of C. auris is a warning sign and needs to be closely monitored.


Assuntos
Candida/classificação , Candida/isolamento & purificação , Candidemia/epidemiologia , Adulto , Anfotericina B/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidemia/mortalidade , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Farmacorresistência Fúngica , Feminino , Humanos , Incidência , Kuweit/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Centros de Cuidados de Saúde Secundários
15.
Artigo em Inglês | MEDLINE | ID: mdl-30469450

RESUMO

Ambient air pollution in terms of fine and coarse particulate matter (PM2.5 and PM10) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014⁻2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days⁻1 year) associated with PM2.5 exposure and PM10 exposure, respectively. The annual average of PM2.5 and PM10 concentrations were recorded as 87.9 µg/m³ and 167.5 µg/m³, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 µg/m³ and 20 µg/m³, respectively. Results indicated a total of 252.18 (95% CI: 170.69⁻322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02⁻35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 µg/m³). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM10 interim targets were met (IT-1 = 70 µg/m³). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM2.5 and PM10 exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Mortalidade Infantil/tendências , Mortalidade Prematura/tendências , Material Particulado/análise , Anos de Vida Ajustados por Qualidade de Vida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Kuweit/epidemiologia , Expectativa de Vida , Tábuas de Vida , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
BMC Public Health ; 18(1): 1249, 2018 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-30419893

RESUMO

BACKGROUND: The increasing prevalence of type 2 diabetes and suboptimal glycaemic control in Kuwait requires novel, wide-reaching, low-cost interventions to motivate and mobilise individuals towards more effective self-management. More than 2 million people in Kuwait own mobile phones. We will test whether automated personalised health text messages based on principles of motivational interviewing and are responsive to biodata delivered remotely is potentially effective in improving glycaemic control compared to usual care. METHODS: This is a two-arm parallel single-blind randomised controlled trial of 572 individuals with type 2 diabetes in Kuwait. We will develop a culturally appropriate database of text messages supporting positive lifestyle changes in type 2 diabetes. A computer programme will deliver over 400 text messages over a 12-month period using algorithms which provide participants with information on diet and physical activity as well as personalised messages regarding motivators to change behaviours. Individuals aged 18-75 years with established type 2 diabetes who are fluent in Arabic or English and officially resident in Kuwait will be identified via screening of hospital diabetes clinic and primary care practices and invited to participate. A sample of 572 participants will be randomised to usual care or usual care plus the DATES text message intervention. Randomisation will be conducted by an independent Clinical Trials Unit and researchers collecting baseline and outcome data will be blinded to treatment allocation. The primary outcome is change in HbA1c and weight at 12 months in both study arms. Secondary outcomes will include changes in physical activity, fasting lipids and quality of life in both study arms. DISCUSSION: The potential of mobile phones in improving diabetes self-care in settings with a high prevalence of diabetes and widespread mobile phone usage has face validity. Mobile phones and text messaging are an understudied virtual communication media which can deliver discrete focused psychological support to motivate and enable diabetes self-care changes. TRIAL REGISTRATION: ISRCTN10342151 . 11/03/2015.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Promoção da Saúde/métodos , Autogestão/psicologia , Mensagem de Texto , Adolescente , Adulto , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Kuweit/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Motivação , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
17.
Arch Osteoporos ; 13(1): 129, 2018 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-30448960

RESUMO

A systematic review and meta-analysis was conducted on the prevalence of osteoporosis in the Eastern Mediterranean Region. The overall pooled prevalence of osteoporosis was 24.4%. The prevalence has increased significantly over the recent years. The highest pooled prevalence was in Saudi Arabia (32.7%), and the lowest was in Kuwait (15.1%). PURPOSE: To conduct a systematic review and meta-analysis on the prevalence of osteoporosis in the Eastern Mediterranean Region (EMR), as defined by the World Health Organization. METHODS: We included all observational studies reporting the prevalence of osteoporosis among general population. We searched literatures from the databases of PubMed, Scopus, Web of Science, and Index Medicus for the EMR published between January 2000 and December 2017 with no restriction of language. Two reviewers independently contributed in study selection and data extraction. STATA software was used for analyzing the collected data. RESULTS: A total of 1692 citations were retrieved. After excluding the irrelevant articles, 36 eligible studies were included. The overall pooled prevalence rate of osteoporosis in the EMR on 31,593 participants was 24.4% (95% confidence interval [CI], 20.4-28.4). Based on femoral densitometry, the prevalence of osteoporosis was 16.8% (95% CI, 9.5-24.2), and based on spinal densitometry, it was 24.3% (95% CI, 19.4-29.2). The pooled prevalence in males was 20.5% (95% CI, 10.5-30.5), compared with 24.4% (95% CI, 20.2-28.6) in females. The prevalence rate was significantly higher in 2007-2015 (32.7%; 95% CI, 25.1-40.3) than in 2000-2006 (19.8%; 95% CI, 12.5-27). CONCLUSIONS: Our findings indicate a considerable prevalence of osteoporosis among the people of the EMR. The prevalence has increased during recent years, showing that osteoporosis is becoming a critical health problem in this region. Prevention and control measures need to be implemented by health service authorities.


Assuntos
Osteoporose/epidemiologia , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Região do Mediterrâneo/epidemiologia , Estudos Observacionais como Assunto , Prevalência , Arábia Saudita/epidemiologia
18.
Dermatology ; 234(5-6): 186-191, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30286465

RESUMO

BACKGROUND: This study aimed to (i) assess the prevalence of exposure to environmental tobacco smoke (ETS) at homes, (ii) assess the prevalence of atopic dermatitis and (iii) evaluate the association between ETS exposure and atopic dermatitis status among adolescents. METHODS: During October 2015, a cross-sectional study design was implemented using a self-administered, modified version of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire among students enrolled in nine high schools of one of the six governorates of Kuwait. Prevalence of ETS exposure at home (1 or more smokers at home vs. none) and atopic dermatitis were computed. A multivariable log-binomial regression model was used to evaluate the adjusted association between ETS exposure and atopic dermatitis. RESULTS: Of 800 invited students, 746 (93.3%) participated, of whom 74.8% were Kuwaiti and 50.1% were female with a mean (SD) age of 16.8 (0.68) years. Prevalence of ETS exposure at home was 54%. Prevalence of atopic dermatitis was 14.9%. A final multivariable log-binomial regression model showed that compared with the adolescents free from atopic dermatitis, adolescents with atopic dermatitis were significantly more likely to have had ETS exposure at home (adjusted prevalence ratio = 1.49; 95% CI: 1.03-2.14; p = 0.034) or tended to be female (adjusted prevalence ratio = 1.42; 95% CI: 0.99-2.03; p = 0.054). CONCLUSIONS: A high prevalence of ETS exposure at home among adolescents was recorded. ETS exposure and female gender were significantly associated with atopic dermatitis status. Intervention fostering voluntary adoption of a smoke-free home rule may help protect the adolescents against ETS exposure and alleviate the menace of associated morbidity.


Assuntos
Dermatite Atópica/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Kuweit/epidemiologia , Masculino , Prevalência , Fatores de Risco , Fatores Sexuais
19.
Nutrients ; 10(10)2018 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-30336597

RESUMO

Few studies have investigated the association between Acne vulgaris (AV) and vitamin D level. In this study we aimed to investigate the association between 25-hydroxyvitamin D (25-OH-VitD) level and AV in a country with plenty of sunshine. A cross-sectional study was conducted on 714 adolescents who were randomly selected from public schools using multistage cluster random sampling with probability proportional to size. 25-OH-VitD levels were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The Global Acne Grading System (GAGS) was used to assess the severity of AV. Data on potential confounders were collected from the parents through a self-administered questionnaire, and from the adolescents using a face-to-face interview. Of 714 participants, 351 (41.16%) were males. The mean (standard deviation (SD)) age was 12.28 (0.81) years. AV was observed in 479 (67.1%) adolescents. There was no significant association between 25-OH-VitD level and clinically assessed AV before or after adjusting for potential confounders. This was consistent whether 25-OH-VitD was fitted as a continuous variable or categorized using acceptable cutoff points or tertiles. In this study vitamin D status was not associated with AV, therefore our data do not support vitamin D supplementation either to treat or to prevent AV.


Assuntos
Acne Vulgar/sangue , Vitamina D/análogos & derivados , Acne Vulgar/tratamento farmacológico , Acne Vulgar/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Kuweit/epidemiologia , Masculino , Vitamina D/sangue , Deficiência de Vitamina D/sangue
20.
BMC Psychiatry ; 18(1): 313, 2018 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-30261859

RESUMO

BACKGROUND: There are no published studies on the comorbidity of common mental conditions (anxiety, depression, and somatization) and physical illnesses in the Arab world. Our aim was to estimate the prevalence of common mental conditions comorbid with physical illnesses among primary care attenders in Kuwait, and the sociodemographic characteristics associated with this comorbidity. METHODS: The Patient Health Questionnaires for somatization, anxiety and depression (PHQ-SAD) were administered to a representative sample of 1046 attenders (M: F = 429: 617; mean age 37.6, SD 12.7) seen in primary care clinics in Kuwait. Based on well-established cut-off scores, the presence and severity of three mental conditions -depression, anxiety, and somatization-was ascertained; physical diagnoses were ascertained by the attending physicians. RESULTS: Of 1046 respondents, 442 (42.3%) had at least one mental condition and 670 (64.1%) had a physical illness diagnosis, viz.: diabetes mellitus (248/670 = 37.0%), hypertension (229/670 = 34.2%), asthma (82/670 = 12.2%), non-chronic physical illnesses (63/670 = 9.4%), or heart disease (48/670 = 7.2%), with 34.4% (360/1046) having mental-physical comorbidity. Male: female ratio for the 670 subjects was 287: 383. The unadjusted odds ratio (OR) for having a mental condition in those with a physical illness vs. those without a physical illness was 4.16 (95% C.I. = 3.12, 5.55). Comorbidity was associated with older age, being divorced or widowed, a lower level of education, and poorer living conditions. Regardless of the physical illness, the most frequent comorbid mental disorder was somatization. The prevalence and severity of mental conditions were associated with the number of physical illnesses. CONCLUSION: As has been reported in other parts of the world, somatization, anxiety, and depression are highly prevalent among primary care attenders in Kuwait and they are typically comorbid with physical illness. Strategies for their prevention and treatment need to take into consideration their association with physical illness and social disadvantage.


Assuntos
Ansiedade/epidemiologia , Árabes/psicologia , Depressão/epidemiologia , Doenças não Transmissíveis/epidemiologia , Transtornos Somatoformes/epidemiologia , Adulto , Idoso , Asma/epidemiologia , Comorbidade , Diabetes Mellitus/epidemiologia , Feminino , Cardiopatias/epidemiologia , Humanos , Hipertensão/epidemiologia , Kuweit/epidemiologia , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Prevalência , Atenção Primária à Saúde/estatística & dados numéricos
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