Adequate Prevention Research Articles

Epidemiology of Invasive Infections Caused by Streptococcus agalactiae in Argentina.

In recent years, an increase in the number of cases of invasive infections due to Streptococcus agalactiae (group B Streptococcus [GBS]) in adults has been reported. During 2014 and 2015, a multicentric, observational, and prospective study, including 40 health centers, was developed to describe the phenotypic and genotypic characteristics of GBS isolates circulating in Argentina and to analyze the clinical and demographic characteristics of patients with invasive infections. We recovered 162 invasive (GBSi) isolates from adult patients (n = 130, 80.2%), neonates (n = 24, 15%), and children below 18 years of age (n = 8, 4.8%), and colonizing (GBSc) isolates were recovered in prenatal GBS screening. GBS infection in adults was associated with underlying diseases, mainly diabetes mellitus. All isolates were penicillin susceptible. Resistance rates to erythromycin (25%) and clindamycin (26%) among the GBSc isolates were significantly higher than those from GBSi strains (17.3% and 16.1%, respectively); by contrast, levofloxacin resistance was significantly higher in GBSi isolates (14.8% vs. 7%). Serotype Ia was the most frequent in neonates and Ib was most frequent in adults. Serotypes Ia and III were prevalent in GBSc isolates. The increase of levofloxacin resistance was associated with the presence of a serotype Ib clone. This work emphasizes the need for GBS infection surveillance studies to implement correct treatments and adequate prevention strategies.

Modern approaches to screening diagnostics of the risk of metabolic syndrome based on integrated clinical and laboratory indicators (review)

The wide prevalence of metabolic syndrome (MS), its high comorbidity with diseases of the circulatory system and type 2 diabetes mellitus, as well as the possibility of reversibility of cardiometabolic risk with adequate prevention and a healthy lifestyle determine the high importance of early detection of MS during mass preventive examinations. Based on the generalization of modern domestic and foreign experience in the use of integrated clinical and laboratory indicators in the screening diagnosis of MS, the advantages, limitations, disadvantages and threshold values of the physiological norm of the most popular indirect anthropometric indices of central and abdominal obesity (body mass index, waist circumference, waist circumference to height ratio, body shape index), surrogate markers of adipose tissue dysfunction (lipid accumulation index and visceral obesity index) are considered, non-insulin methods for detecting disorders of carbohydrate metabolism (metabolic index), criteria for blood plasma atherogenicity (non-high-density lipoprotein cholesterol, Castelli II risk index, cholesterol coefficient of atherogenicity, plasma atherogenic risk index). It is shown that the use of calculated ratios of routine anthropometric data (weight, height, waist circumference) and biochemical parameters (glucose level, total cholesterol, high-density lipoprotein cholesterol, triglycerides), allows to increase the sensitivity and prognostic significance of generally recognized criteria for cardiometabolic risk in mass screening examinations of the population.

Epidemiologia de acidentes ofídicos no estado do Amazonas entre 2010-2020

Epidemiological studies can improve knowledge of the profile of snakebites in a given region and help identify opportunities for improving health care and preventing this type of disease. Thus, the objective of this work was to carry out a survey of data regarding the epidemiological aspects of snakebites in municipalities belonging to the State of Amazonas. The study was carried out through a documentary survey through the electronic search of articles, thesis, dissertation and monographs, in academic Google databases and database of the Information System of Notifiable Diseases (SINAN). The final work included a total of 09 scientific articles. Regarding the data obtained through the consultation of data in the Information System of Notifiable Diseases (SINAN), 16,868 cases of snakebite accidents were reported for the state of Amazonas in the period corresponding to the years 2010-2020, where the cases with the highest number of cases were contacted. records of accidents affected by species belonging to the genus Bothrops, followed by the genus Lacheses. In view of the results, it is important to promote educational campaigns, being necessary the implementation of programs that can increase the knowledge of the residents about the forms of adequate treatment and prevention of these accidents, mainly by rural workers, in order to reduce the accident cases.

Simulation Analysis of Ammonia Leakage and Dispersion in a Large-Scale Refrigeration System

The use of ammonia in large-scale refrigeration systems (such as those used for a stadium) requires adequate ammonia leakage prevention mechanisms are put in place. In the present study, numerical simulations have been conducted to study the dispersion law in the ammonia machinery room of the refrigeration system for the 2022 Beijing Winter Olympics. The wind speed, and release location have been varied to investigate their effects on the dispersion profile. Different positions of the leakage points in the ammonia storage tank have been found to lead to different areas affected accordingly. In general, the dangerous region area decreases with an increase in the wind speed. However, when the wind is aligned with the leakage direction, this trend is reverted. The study may offer an effective method to predict the impact of ammonia dispersion and implement the safe operation of such large-scale systems.

Role of Socioeconomic Status (SES) in Globe Injuries: A Review.

Globe injury is a serious worldwide public health issue frequently leading to permanent vision impairment. The plethora of different types of globe injuries is classified into categories, including open and closed globe injuries. Globe injury occurs mainly in the workplace and at home, affecting predominantly middle-aged working men. Socioeconomic status (SES) is defined by income level, educational attainment, and employment status. Low socioeconomic status has been associated with a higher incidence of globe injury and can be utilized to identify at-risk populations. For managing open and closed globe injuries, different strategies are applied and the implementation of adequate globe injury prevention measures is needed for reducing the occurrence of globe injury. The following article aims to provide an overview of globe injury characteristics and their correlation with socioeconomic status and to highlight the significance of considering SES as a variable in globe injury prevention.

Response of Antipsychotic Drugs in Health Section Late-onset and Early-onset Schizophrenia in the Vindhya Region, Central India: A Prospective Cohort Study

Introduction: Previous studies were predominantly on earlyonset schizophrenia with little emphasis on clinical profile, therapeutic responsiveness and various investigational, biochemical and neuroimaging variables in Late-onset Schizophrenia (LOS), which is an emerging concern in elderly morbidity, and differs significantly from Early-onset Schizophrenia (EOS). Aim: To study the clinical profile, and response to various antipsychotic drugs in LOS and compare it with EOS. Materials and Methods: A clinical prospective cohort study was conducted in Shyam Shah Medical College, Rewa Madhya Pradesh, India, from January 2020 to June 2021, with baseline and follow-up assessment of psychotic and cognitive symptoms after four weeks using PANSS (Positive and Negative Syndrome Scale), MoCA (Montreal Cognitive Assessment) and BPRS (Brief Psychiatric Rating Scale) scales. A total of 51 patients were included in the study, divided into two groups of early and late onset, attending the out-patient and in-patient services during the period at the center and concomitant treatment with antipsychotics for four weeks. Statistical analysis was done in Statistical Package for Social Sciences (SPSS) version 21.0 with p-value of 0.05. Results: A total of 51 patients, 27 in EOS group and 24 in LOS were included and analysed in the present study. The demographic profile of late and EOS varied in mean age with EOS at 30.11 years and LOS at 57.66 years), gender distribution predominantly males (n=19) in EOS and predominantly females (n=20) in LOS) and the average age of onset of EOS was 22.05 years and LOS was 55.54 years. The duration of illness in EOS 7.98 years and LOS was 2.12 years. The mean Positive and Negative Syndrome Scale score at baseline for EOS was 1.92±1.07 and LOS was 2.83±0.56 and four weeks for EOS was 1.70±0.91 and LOS was 2.83±0.56. The response in Positive and Negative Syndrome Scale at 4 weeks as well as individual domain scale score such as hallucinations, suspiciousness, blunted effect, emotional withdrawal, active social avoidance showed significant results in both EOS and LOS. Conclusion: Schizophrenia can manifest for the first time in late life and manifestations of stringently defined schizophrenia is by no means confined to onset at younger ages. Although there are undoubted similarities between the symptoms of EOS and LOS, there are also clear differences, especially demographic and clinical characteristics, early identification of which will help in adequate intervention and prevention of further morbidity in the elderly.

Correlates of help-seeking by parents for the socioemotional development of their 3-year-old children: a longitudinal study

ObjectivesTimely parental help-seeking regarding their child’s socioemotional development is associated with a lower rate and lower severity of psychosocial problems in later life. This study aimed to examine the correlates...

Understanding rural local government response during COVID-19-induced lockdown: perspective from Bangladesh.

This study intends to explore the responses of local government during the COVID-19-induced lockdown in the rural areas, with particular emphasis on Bangladesh. By adopting a qualitative phenomenological research approach and employing multi-method data collection techniques (for instance, Key Informant Interview (KII), Focus Group Discussion (FGD), participant observation, and content analysis), this study found that the local governments managed the crisis of the pandemic relatively well with its limited manpower and funding through adequate preparedness and prevention strategies; effective emergency responses; and consolidated post-lockdown measures. The study revealed that the Bangladesh local government promptly took some essential actions, such as preparedness and prevention, arrangement of home quarantine and isolation, the training program for readiness, and disseminated crucial information to the local people during the pandemic, such as using masks, hand washing and sanitizing, and social distancing. Besides, the local government delivered relief, such as food and non-food items and financial support. Furthermore, the rural local government took post-lockdown responses to tackle pandemic in rural Bangladesh. Nevertheless, the service delivery individuals from local governance encountered numerous challenges, like scarcity of manpower, less support, and superstition, while providing services during the pandemic.

Factores que influenciam a discriminação social em idosos

The aim was to evaluate the perception of the elderly about the occurrence of episodes of social discrimination and to identify factors that influence social discrimination. Descriptive-correlational study, with 333 elderly people. The Social Discrimination Against the Elderly scale was used. Most were female (59.5%), mean age 76.13 years; 83.1% perceive themselves to have been victims of episodes of social discrimination. Activities of daily living (p = 0.000), depression (p = 0.000), total functional social support (p = 0.001), visiting or receiving visits from family or friends (p = 0.005) influence the social discrimination of the elderly . It was found that elderly people who are less independent in activities of daily living, more depressed, with less functional social support and who do not visit or are visited by family or friends tend to be victims of greater social discrimination. The results point to the need for greater attention from the community in general and from health professionals in particular, in order to devise adequate prevention and resolution strategies for this phenomenon.

Vaccination and Laboratory Diagnosis of Equine Influenza in Portugal in Comparison with Other European Countries

Equine Influenza (EI) is a disease caused by the genus A influenza virus, with a global distribution and under constant review. Equine Influenza is highly contagious and affects the respiratory tract. Vaccination in horses is an adequate prevention method, however some strains have the capacity to infect immunized horses, due to the mutagenic changes that the virus undergoes. This work aimed to study the Veterinary Medicine performance regarding Equine Influenza in Portugal in the years 2018 and 2019, and to compare the clinical practice in Portugal with that of other European countries. The study was based on the responses to a questionnaire consisting of nine questions on: 1) Geographical area of clinical practice; 2) Activity of equines assessed; 3) Number of suspected cases of Equine Influenza in the last two years; 4) Number of cases of Equine Influenza diagnosed with the support of laboratory tests in the last two years; 5) Number of vaccinations against Equine Influenza in the year 2018; 6) Number of vaccinations against Equine Influenza in the year 2019; 7) Whether the vaccination protocol used follows FEI/FEP standards; 8) Whether the vaccination protocol is annual or biannual; and 9) Use of laboratory tests for Equine Influenza in the last two years. The surveys were circulated online in Portugal and in Germany, France, Ireland, Italy, the Netherlands, the United Kingdom and Sweden for anonymous reply. In Portugal, 50 responses to the survey were obtained. Veterinarians reported suspected cases. Only four cases were confirmed using laboratory tests. 22 professionals applied more than 100 vaccines against Equine Influenza in the year 2018, and a decrease was observed in the year 2019. The Veterinarians did not reveal a preference for biannual or annual vaccination. Most professionals (94%) did not use laboratory tests to confirm the suspected infection. In Portugal it was possible to identify an opportunity to improve the clinical practice of Veterinarians in the use of laboratory tests for disease diagnosis and vaccination. The decree law that establishes the compulsorily notifiable diseases does not match the list of the World Organisation for Animal Health (OIE) and therefore the General Directorate of Food and Veterinary (DGAV) does not have the data needed to properly notify the disease. Equine Influenza needs greater attention in Portugal and there are a number of measures that can be adopted to improve disease management in the country.

Placement and management of Peripherally Inserted Central Catheters (PICC): Which complications? A retrospective 2-year single-centre experience

Introduction: Peripherally inserted central catheters (PICCs) are catheters placed in the central venous system, through a peripheral vein. PICCs’ are devices designed for intermediate to long-term use, which are usually implanted for long periods and may be subjected to mechanical and infectious complications as well as thrombosis and acute bleeding during insertion or maintenance procedures. The aim of this study is to investigate and describe the various types of complications resulting from placement and management of PICC catheters in patients admitted to the SS Antonio e Biagio e Cesare Arrigo Hospital wards. Methods: Data was collected from the medical records of patients undergoing PICC implantation from June 2018 to December 2019.Results: Data from 320 patients were included in the study. 55% of patients did not develop complications. 34% of all patients with complications had minor complications and 86% of devices were not removed before the end of treatment.Conclusions: PICCs’ appear to be safe devices for use, with acceptably low rates of infectious or thrombotic complications. The most common complications have been minor causes, potentially avoidable with adequate prevention measures.

DRESS/DIHS syndrome induced by sulfasalazine

Among the manifestations of drug hypersensitivity, DRESS/DIHS syndrome is of particular importance. The clinical manifestations include rash, enlarged lymph nodes, fever, hepatitis, leukocytosis with eosinophilia, as well as the involvement of other organs and systems. The most common causative agents include anticonvulsants, antidepressants, sulfanilamides, non-steroidal anti-inflammatory drugs, and allopurinol, but the list is constantly expanding. The exact pathogenesis of DRESS/DIHS syndrome is currently unclear. Timely diagnosis and adequate therapy can improve prognosis of this disease. In our clinical case, DRESS syndrome developed after the patient was administered sulfasalazine for erosive proctosigmoiditis. In order to ensure adequate prevention, early diagnosis, and proper management of DRESS syndrome, it is necessary to raise awareness of practitioners of different specialties about the possibility of developing this undesirable reaction to pharmacotherapy.

Blastocystosis And Iron Deficiency Anemia in Pregnant Women. A Call to Deep in A Little-Known Association

During the last twenty-five years, in parallel with the demonstration of a rapid increase of the global prevalence of blastocystosis, it has been documented the association between this parasitic infection and iron deficiency anemia in general population. More recently, it has been evidenced the high prevalence of blastocystosis in pregnant women and its association with iron deficiency anemia. Herein, we revise the most recent progress in the understanding of this association, the possible mechanisms that support it, including the Blastocystis subtypes involved, and its clinical consequences and public health significance. Taken in consideration the adverse impacts of anemia on the health of mothers and progeny, an adequate prevention and control of this parasitism during pregnancy may be mandatory. At the same time, and looking the problem from a more holistic multi-diseasebased perspective, the current initiatives to improve the prevention and control of intestinal parasitism in endemic areas may include in their communication strategies actions to inform, both at academic and community levels, about the possible adverse effects of blastocystosis on pregnancy evolution.

Edge security for SIP-enabled IoT devices with P4

The exponential growth of IoT devices poses security concerns, in part because they provide a fertile breeding ground for botnets. For example, the Mirai botnet infected almost 65,000 devices in its first 20 h. With the prevalence of Session Initiation Protocol (SIP) phones and devices on the networks today, the attacker could easily target and recruit these IoT devices as bots. Conventional network security measures do not provide adequate attack prevention, detection, and mitigation for these widely distributed IoT devices. This paper presents microVNF, a Virtualized Network Function (VNF) that leverages the programmable data plane feature on the edge switch. Based on knowledge gained from the Mirai botnet incident and following the defense-in-depth principle, microVNF protects IoT devices against SIP DDoS attacks in two stages: before and after infection. Prior to infection, it protects against SIP scanning, enumeration, and dictionary attacks. After infection, microVNF blocks botnet registration attempts to the command-and-control (CNC) server, thereby preventing the botnet from receiving commands sent from the CNC server, and detects and mitigates botnet SIP DDoS attacks. We conducted six experiments that involved using popular attack tools against microVNF, and it successfully performed deep-packet inspection of unencrypted SIP packets so as to track anomalies from a typical SIP state-machine. In this use case, besides providing physical connectivity to the IoT devices, the edge switch containing microVNF also provides the first line of defense in stopping malicious packets from propagating upstream to the core network. In addition to securing SIP, the microVNF approach can be adapted to other text-based, application-layer protocols such as HTTP and SMTP. MicroVNF leverages the native capability of programmable data planes without depending on external devices, thereby making this approach practical for securing edge-computing environments against application-layer attacks.

Microvascular Inflammation and Cardiovascular Prevention: The Role of Microcirculation as Earlier Determinant of Cardiovascular Risk.

Healthcare systems encumbered by cardiovascular diseases demand adequate cardiovascular prevention. Indeed, even with the most novel therapies, the residual cardiovascular risk still fuels morbidity and mortality. Addressing inflammation as a putative mediator of this risk has brought along promising in vitro results, though large clinical trials have only in part confirmed them. To fully exploit the therapeutic potential between the inflammatory hypothesis, a change of viewpoint is required. Focus on microcirculation, whose dysfunction is the primary driver of cardiometabolic disease, is mandatory. Several factors play a pivotal role in the capacity of microvascular inflammation to promote a health-to-disease transition: the adipose tissue (in particular, perivascular and epicardial), the mitochondria function, the hyperglycemic damage and their epigenetic signature. Indeed, the low-grade inflammatory response, which is now an acknowledged hallmark of cardiometabolic disease, is promoted by these mediators and leaves a permanent epigenetic scar on the microvasculature. Even if a more profound knowledge about the mechanisms of metabolic memory has been brought to light by recent evidence, we still have to fully understand its mechanisms and clinical potential. Addressing the detrimental role of inflammation by targeting the microvascular phenotype and leveraging epigenetics is the road down which we must go to achieve satisfactory cardiovascular prevention, ultimately leading to disease-free ageing.

Prevention of venous thromboembolism in hematologic neoplasms: an expert consensus from SEHH-SETH.

Venous thromboembolism (VTE) is a serious complication in hematologic neoplasms, so finding adequate prevention strategies is an urgent requirement. However, prospective studies with large enough cohorts are scarce, limiting the development of evidence-based thromboprophylaxis guidelines. The present position paper is addressed to all hematologists treating patients affected by hematologic neoplasms with the aim to provide clinicians with a useful tool for the prevention of VTE.

Seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a tertiary care hospital in Riyadh, Saudi Arabia

BackgroundThe SARS-CoV-2 pandemic has led to a strain on medical resources. The development of countermeasures to prevent its spread is evolving. Healthcare workers (HCWs) are at high risk for contracting and transmitting the disease. MethodsSerology testing of volunteer HCWs was performed at King Faisal Specialist Hospital and Research Center in Riyadh (the Center) in order to determine the prevalence of SARS-CoV-2 antibodies, as well as the associated risk factors, in the hope of implementing adequate prevention and control measures. Results1076 subjects participated in this study, of whom 24.3% were seropositive. The majority were nurses (379, 35%) or physicians (245, 22.2%). 392 (36.4%) of the 1076 subjects were caregivers for COVID-19 patients, and 463 (43.0%) reported contact with infected employees. There was a statistically significant association between taking care of COVID-19 patients and being diagnosed with COVID-19 (chi-square test, p = 0.046). There was a significant association between being in contact with infected employees and having a positive IgG result (chi-square test, p < 0.001). ConclusionsA baseline analysis of SARS-CoV-2 seropositivity in HCWs at a large tertiary care hospital in Riyadh was performed as the first part of a prospective study of HCWs. The reported seropositivity was 24.3% — higher than that of other hospitals in Riyadh. IgG testing was very useful in the detection of previous SARS-CoV-2 infection, as it has high negative predictive value.

Selección de lo mejor del año 2021 en cardiología geriátrica

In this text we review some of the main studies related to the diagnosis and treatment of the most prevalent cardiovascular diseases in older patients published during the last year, also highlighting the importance of adequate prevention, both primary and secondary. Similarly, prevalent entities such as ischemic heart disease, atrial fibrillation or heart failure, among others, deserve special attention, as well as the role of cardiac rehabilitation in older patients, given its benefits and prognostic impact regarding it addresses to a large extent some of the common geriatric syndromes in this population. Finally, we review some important aspects in the current COVID-19 pandemic and some of the works led by the Geriatric Cardiology Section of the Spanish Society of Cardiology.

Impact of Literacy on Hypertension Knowledge and Control of Blood Pressure in a Southern Indian Tertiary Hospital

Background : Hypertension is a global public health concern. Awareness and knowledge about the disease in a community collectively would allow adequate prevention, promote self-care practices, adherence to medication and ultimately effective management of hypertension. Aims: To ascertain the level of education associated with the knowledge of hypertension and control of blood pressure. Methods: A cross-sectional questionnaire survey consisting of item questions about awareness and knowledge of hypertension. Hypertensive patients (n = 424) of both genders and more than 20 years of age were included in the study. Hypertensive patients were divided into two groups (school group and school pass-out group) to assess the level of knowledge. Chi-square test was performed to determine the assessment, and p-value &lt; 0.05 was considered significant. Results: Out of 424 participants, 71.2% were school group and 28.7% school pass-out group. School pass-out group had significant knowledge about dangerous natural course of hypertension (p = 0.00069), hypertension can lead to death if untreated (p = 0.015), benefits of cessation of smoking (p = 0.03), advantage of limiting alcohol (p = 0.019) and performing regular exercise (p = 0.013) reduces blood pressure. School pass-out group had significant (p = 0.04) hypertension control compared to the school group. Conclusion: Educational status plays a vital role in increasing knowledge and improving the management of hypertension through better self-care practices and strict adherence to medication. Community- based health education interventional programs targeting the lower socioeconomic group of a population would help to reduce the gap in awareness and effective control of hypertension.

Side-overlap esophagogastric tube (SO-EG) reconstruction after minimally invasive Ivor Lewis esophagectomy or laparoscopic proximal gastrectomy for cancer of the esophagogastric junction.

Both laparoscopic proximal gastrectomy with lower esophagectomy (extended LPG) and minimally invasive Ivor Lewis esophagectomy (MIILE) are acceptable treatments for adenocarcinoma of the esophagogastric junction (AEG), but the optimal reconstruction technique for mediastinal esophagogastrostomy (one that provides adequate reflux prevention) has not been established. We devised a novel side-overlap esophagogastric-tube (SO-EG) reconstruction. We performed a retrospective review of patient records after LPG or MIILE. In each patient, we created a 3-cm wide gastric tube, overlapping the esophagus by 5 cm. A linear stapler was inserted into the left side of the esophageal stump and the anterior gastric wall along the greater curvature. The entry hole was closed to make a slit-like anastomosis, and the right side of the esophageal wall was fixed to the anterior gastric wall. Ten consecutive patients underwent this procedure between June 2020 and July 2021. Five patients had Siewert type II AEG: 4 with lower thoracic esophageal cancer and 1 with benign lower esophageal stenosis. A total of 3 patients underwent extended LPG, and 7 underwent MIILE. The median operative time was 352 min (range, 221-556 min). The postoperative course was uneventful in 9 patients; a single patient developed pneumonia. Seven patients underwent follow-up endoscopy at 6 months. One patient with anastomotic stenosis and 2 with mild reflux esophagitis were treated conservatively. Our novel SO-EG reconstruction is simple and feasible, with acceptable results for preventing reflux esophagitis. This technique can be performed with either extended LPG or MIILE.