Awareness Of Symptoms Research Articles

Effect of a National Stroke Awareness Campaign on Ambulance call-outs and Paramedic Diagnosis of Suspected Stroke

Abstract Background The Irish Heart Foundation and National Clinical Programme for Stroke ran the Face, Arm, Speech, Time (FAST) public awareness campaign in January and July 2023, to raise awareness of stroke symptoms and the need for rapid response. We aim to evaluate the impact of this campaign. Methods Interrupted time series (January 2021 to December 2023) assessed the impact of the campaign on: calls received by ambulance control triaged as suspected stroke and provisional stroke diagnosis made by paramedics at time of leaving scene. Means were compared using Kruskal-Wallis test. Results Pre-campaign, the mean calls per month triaged as suspected stroke was 1060, which rose to 1130 and 1165 following the January and July bursts of the campaign respectively (p<0.0017). There was a baseline trend for increasing ambulance calls for suspected stroke (β= 0.01, 95% CI 0.008 to 0.0121; p < 0.001) and paramedic provisional stroke diagnoses (β=0.0083, 95% CI 0.006 to 0.0110; p<0.001). The January burst of the campaign was associated with a reduction in ambulance calls (β= -0.014, 95% CI -0.022 to -0.007; p <0.001), whereas the July burst of the campaign showed a slight increase in calls compared to no campaign (β=0.031, 95% CI 0.016 to 0.047; p <0.001). Conversely, there was a trend towards an increase in paramedic-suspected strokes following the January burst of the campaign and a trend towards a decrease after the July component. Conclusion The mean number of callouts and paramedic provisional diagnosis of suspected stroke increased following the 2023 FAST campaign (9.91 percent and 12.18 percent). Overall, the study suggests the campaign led to more suspected stroke calls, but the immediate impact on call volume during the campaign periods themself was complex. These results prompt the need for further analysis.

Abstract B075: The "let's talk about Black people and cancer" conference

Abstract In the United Kingdom, despite having a healthcare service that is free at the point of access, inequalities in cancer care persist. Recent data shows that for certain cancer groups (e.g. breast cancer), Black patients present with worse grade and stage leading to poorer outcomes. Reasons for the disparities are multifactorial but include lack of awareness in the community, structural barriers to accessing healthcare, limited research into genetic variability and/or biological differences, and hesitancy to engage with health care professionals due to historic wrongs. Often different stakeholders work in different silos to try and remediate these barriers however they are not often in one space and have the opportunity to learn from patient experiences and how they can all dovetail together to improve patient outcomes. In an attempt to bring different sectors together the senior author established the “Let’s talk about Black people and cancer” conference 2024. The aim of this event was to increase awareness and understanding of cancer in the UK Black population. Methods This event covered the major cancer groups (breast, prostate, haematological, bowel and gynaecological) focusing on genomics, symptom awareness, screening programs, and how and when to access secondary care. We sought patient feedback from this conference style intervention to see the effect on attendees in terms of increase in knowledge specifically around Black people and cancer. This study utilized a two-part survey to evaluate the effectiveness of the conference, assessing knowledge held by registered attendees pre- and post-conference. A 5-point Likert scale was used to extract degrees of opinion, providing accurate and representative feedback. There was a total of 46 questions in the survey targeting the demographics of the attendees, their connection to cancer, and knowledge about cancer including the risks/outcomes regarding Black people specifically. Results The world cancer day conference had 190 registrants. 83 responses to the questionnaire (43.7% response rate). Pre-conference questionnaires highlighted around two thirds had knowledge of the 3 major screening programs, but after the conference this increased to more than 90%. A similar trend was noticed when looking at change in knowledge regarding the five cancer groups covered. Conclusion We have demonstrated that this targeted conference style intervention was effective in raising awareness not just for the public but for those professionals involved in the delivery of cancer care for Black people. While these are snap shots in time it would be useful to see how that information translates in a longitudinal fashion in terms of positive modifications in health behaviors and delivery of services. Citation Format: Teniola Adeboye, Georgette Oni. The "let's talk about Black people and cancer" conference [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B075.

Abstract B166: Impact of rurality on early-onset colorectal cancer outcomes: Age, geographic disparities, and the need for improved access and awareness in the United States

Abstract BACKGROUND: While overall colorectal cancer (CRC) rates have stabilized or declined in the United States (U.S.), early-onset CRC (EO-CRC), diagnoses before age 50, has increased. Rural U.S. residents face a higher CRC incidence (43.9 vs. 40.1 per 100,000) than urban residents. CRC mortality, once highest in the Northeast, is now most prevalent in the South and Midwest, particularly among Non-Hispanic Black populations. This geographic shift is also evident in EO-CRC. Existing literature lacks comprehensive analysis on the influence of rurality and age at CRC diagnosis. In this study, we sought to elucidate the relationships between age at diagnosis with CRC outcomes, while examining the moderating role of rurality. Methods: We used data from the 2006-2020 Surveillance, Epidemiology, and End Results (SEER) Program. Rurality was defined using census tract level U.S. Department of Agriculture (USDA)’s 2010 Rural Urban Commuting Area (RUCA) codes: rural (codes 8, 9, 10) and urban (all other listed codes). We conducted multilevel regression modeling (logistic and Cox proportional hazards) to examine the associations between age at diagnosis, rurality, and CRC outcomes (late-stage diagnosis and survival), adjusting for race, marital status, sex, and year of diagnosis. Results: We identified 835,907 patients aged 20-79 from the 2006-2020 SEER program. Most patients lived in urban areas (86%), were non-Hispanic white (66%), and married (41%). After adjusting for marital status, race, sex, and diagnosis year, we found that patients aged 30-39 (aOR: 1.49, 95% CI: 1.44–1.55) and 40-49 (aOR: 1.43, 95% CI: 1.39–1.46) had over a 40% increased likelihood of late-stage CRC compared to patients aged 50-59. Urban patients aged 30-39 had a 52% higher likelihood of late-stage CRC (aOR: 1.52, 95% CI: 1.46–1.58). Patients aged 20-29 (aOR: 0.81, 95% CI: 0.77–0.86) had a reduced risk of CRC death compared to those aged 50-59. Conversely, patients aged 40-49 (aOR: 1.09, 95% CI: 1.07–1.11), 60-69 (aOR: 1.16, 95% CI: 1.14–1.17), and 70-79 (aOR: 1.39, 95% CI: 1.28–1.36) had increased risks of CRC death compared to patients aged 50-59. Rural patients aged 20-29 (aOR: 0.79, 95% CI: 0.68–0.94) and 30-39 (aOR: 0.95, 95% CI: 0.87–1.03) had a reduced risk of CRC death compared to rural patients aged 50-59. Conclusion: We observed that patients aged 30-49 were more likely to be diagnosed with late- stage CRC compared to those aged 50-59, particularly in urban areas. To reduce the burden of EO-CRC and prevent advanced-stage diagnoses in young adults, it is essential to enhance access to care and raise awareness of CRC symptoms among younger Americans. Future research should explore urban -rural barriers to healthcare access, including the role of healthcare infrastructure, transportation, and provider availability, to develop strategies for improving EO-CRC early detection and treatment outcomes. Citation Format: Meng-Han Tsai, Justin X. Moore, Caitlyn Grunert. Impact of rurality on early-onset colorectal cancer outcomes: Age, geographic disparities, and the need for improved access and awareness in the United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B166.

Abstract C025: Enhanced efficacy of gemcitabine analogs and AZD 1775 combination therapy in patient-derived organoids

Abstract Pancreatic cancer (PCa), specifically Pancreatic Adenocarcinoma (PDAC), is projected to become the second leading cause of cancer related death by 2040. Currently, the 5-year survival rate for pancreatic cancer is between 7% - 12%. The standard treatment options for PDAC are chemotherapy and surgical resection. However, pancreatic cancer presents multiple challenges to successful treatment. First, PDAC is usually diagnosed in the advanced stages of the disease, even if diagnosed early only a small fraction of patients are eligible for surgical resection, about 13% - 15%. Second, PDAC is characterized by a stiff extracellular matrix. This stiffness can lead to poor vascularization, diminished immune responses and cell migration/metastasis. Finally, PDAC is notorious for being extremely resistant to chemotherapy regiments. In addition to these challenges, health disparities add to the dismal prognosis of pancreatic cancer. Examples of these disparities include unequal access to healthcare facilities and screenings, awareness of disease risk factors and symptoms and socioeconomic factors. Differences in genetics can influence the various outcomes seen in PDAC in terms of health disparities. Certain genetic mutations, some more prevalent in certain ethnic groups, can increase the risk for PDAC. Variation in tumor heterogeneity and genetic factors impacting drug metabolism can influence patient outcomes. To overcome some of these challenges, we have developed and tested novel gemcitabine analogs, conjugated with various fatty acid chains in collagen-based 3D gel, Patient Derived Organoid (PDO) models. The collagen-based gel allows tuning of the physical stiffness by varying the gelatin percentage, creating a more realistic tumor microenvironment with the intratumoral pressure can be upwards of 10 kPa. We have tested the gemcitabine analogs on patient derived cells, G43 and G46, from black and white patients respectively, in both soft and stiff matrices. Our results indicated that medium to long fatty acid chains (8, 10 and 18 carbon chains) have increased effectiveness, especially in softer matrices. Comparatively, G46 cells exhibited higher drug resistance across all environments than G43 cells. Recent studies have shown that combining Gemcitabine with AZD 1775, a WEE1 inhibitor may have synergistic effects. We tested the combinations of Gemcitabine analogs and AZD-1775 on both G43 and G46 patient derived cells in 2D and 3D environments. Our data suggests that short to medium length fatty acid chains (2-8 carbons) provide optimal combinational effectiveness. The combined treatment also demonstrated promising results in increasing treatment effectiveness in G46, which are typically chemoresistant. Further studies will examine the influence that tumor microenvironment may have on PDAC response to the combination therapy, as well as intrinsic difference between black patient-derived cells and white patient-derived cells and their sensitivity or resistance to treatment. Citation Format: Jonathan Barajas, Edward Agyare, Xueyou Zhu, Sherise Rogers, Ba Xuan Hoang, Bo Han. Enhanced efficacy of gemcitabine analogs and AZD 1775 combination therapy in patient-derived organoids [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C025.

Investigation of Malaria Outbreak in Sagambe Area, Mutasa District, Zimbabwe

The burden of Malaria remains a global concern, killing millions of people annually, yet it is a preventable and curable disease.. Malaria, a mosquito-borne disease caused by a parasite, leads to fever, chills, and flu-like symptoms, and can be fatal if untreated. In Zimbabwe, the malaria incidence rate decreased from 39 cases per 1,000 people in 2014 to 25 per 1,000 in 2015, a 36% reduction. A study in Sagambe, Mutasa District aimed to identify risk factors for contracting malaria. Using a 1:1 unmatched case-control study, 88 cases and 88 controls were examined. Data were collected via interviewer-administered questionnaires for cases and controls, and self-administered questionnaires for key informants. Evening outdoor activity significantly increased the risk of malaria (AOR = 9.71, 95% CI 1.97-47.85). Other risk factors included sex (p = 0.023), not owning a mosquito net (OR = 0.26, 95% CI 0.14-0.49), not sleeping under a net the previous night (OR = 0.14, 95% CI 0.07-0.35), not closing windows after sunset (OR = 4.39, 95% CI 1.79-11.11), and not wearing long sleeves outdoors (OR = 0.08, 95% CI 0.01-0.56). The outbreak was linked to evening outdoor activities. Participants had high knowledge of malaria transmission but limited awareness of symptoms beyond headache and general body weakness. The study suggests enhancing health education campaigns in Sagambe.

Study on the public awareness of stroke risk factors, symptoms, treatment and rehabilitation: A community based cross sectional survey from a tertiary referral centre in South India

Background: The incidence of Non communicable diseases (NCDs) including stroke is increasing in India over the past few years. Thrombolysis therapy has revolutionized management of acute ischemic stroke. In spite of such recent advances in stroke therapy, the public remains uninformed about stroke symptoms and management. Objective: To assess the public awareness of stroke risk factors, symptoms, treatment and rehabilitation measures. Methods: The study was a community-based cross-sectional study, designed as an online survey. The tool used for the survey was a semi-structured online questionnaire. Results: Regarding the risk factors of stroke, of the participants, 41 (14.8%) were aware of valvular heart diseases, 18 (6.5%) of lack of exercise, 238 (85.9%) of dyslipedemia, 236 (85.2%) of hypertension, 222 (80.1%) of smoking, and 154 (55.6%) of diabetes. Regarding symptoms of stroke, of the participants, 209 (75.5%) were aware of loss of balance, 240 (86.6%) of speech abnormalities, 261 (94.2%) of facial weakness, and 234 (84.5%) of weakness. Conclusion: Efforts should be made to educate the public regarding uncommon symptoms of stroke, thrombolysis treatment and rehabilitation measures, so that people make beneficial health care decisions in stroke management.

Toward Malaria Elimination: Understanding Awareness, Prevention, and Health-Seeking Patterns in Odisha, India.

Given India's goal of eliminating malaria by 2030, this study aimed to investigate community perspectives on malaria in highly endemic areas of Odisha, a region historically prone to malaria. The research explores self-reported malaria events, community knowledge, attitudes, practices, health-seeking behaviors, and access to healthcare services. A community-based cross-sectional survey conducted among 387 households between November 2022 and May 2023 served as an extension of our recent project, monitoring malaria elimination efforts in remote and challenging-to-reach communities in Odisha. The participants, who had a mean (SD) age of 41.7 (13.17) years, were predominantly male (88.4%). Self-reported malaria in the last 12 months prior to the survey was 6.2%, with half of the patients opting for primary health centers for treatment, averaging a 5-day recovery per episode. The median cost per malaria treatment episode was U.S. dollars 20.17. A significant majority (79.8%) demonstrated a strong awareness of malaria symptoms and transmission, with 83.3% expressing a favorable attitude toward disease prevention. Notably, 65.1% reported consistent use of long-lasting insecticidal nets. However, nearly half of the participants reported inadequate larval source management and indoor residual spraying services. Although there were slight variations in knowledge, attitude, and practice scores among demographic groups, the overall understanding of and approach to malaria were consistent in the study population, with no statistically significant differences (P >0.05). The study findings offer hope, suggesting that with sustained dedication and focused surveillance, malaria could become a thing of the past.

“But who do you say that I am?” Affectus Fidei and Bonds of Trust in Psychoanalytic Practice

Affective bonds that span our lives rest on a foundation of credibility and truth. This study proposes an introductory description of theological and psychoanalytic elements that build a conceptual model resting on the fundamental truths of Christian faith. Theological elements are used to form a floor whereon psychotherapeutic work can rest and build the path that runs from the awareness of symptoms and asking for help to the attainment of enduring and authentic happiness. Affectus fidei (the affection of faith) emerges as the central theological concept that ties together the existential-relational elements of human life as observed in the here-and-now of therapeutic work, toward the development of confidence and self-understanding that leads toward growth and health. The here-and-now of therapeutic attainments depends on the symbolic space that opens between past and future, the real and the imaginary, the desired and the unhoped for. Without a foundation of credibility and truth, the symbolic activity of therapy that aims at a more mature look at one's life cannot emerge. When the affective space of therapy is recognized as credible, the symbolic dimension emerges and the work of therapy flourishes. Only then do the members of the therapeutic couple surrender confidently to the persuasive affective bond that rests on the credibility of the good.

Characteristics, management, and major adverse cardiac events of ST-elevation myocardial infarction (STEMI) patients in rural area: a Jember acute coronary syndrome medical records study

The mortality and morbidity of ST-elevation myocardial infarction (STEMI) remain high, and it is still the leading cause of death worldwide. Timely reperfusion lowers the risk of MACE and improves survival. However, reperfusion delay is still a significant issue in developing countries, particularly rural area. This study aimed to determine the characteristics, management, and major adverse cardiac events of STEMI patients in Jember Distric to enhance reperfusion therapy in rural areas. It was an analytical observational cross-sectional study with a quantitative method. A total of 108 medical records of STEMI patients of the Dr. Soebandi District Hospital, Jember in period of 2019 to 2020 were included using the consecutive sampling technique. As much as 78 (62%) of the patients did not receive reperfusion therapy while the remaining patients (41 or 38%) received the therapy, namely percutaneous coronary intervention (20 or 18.5%), fibrinolytic therapy (19 or 17.6%), and both (2 or 1.9%). Multivariate analysis for reperfusion was statistically significant (p=0.016; OR 3.688 95% CI: 1.274-10.679). The level of education, health funding, and distance to the hospital did not affect the delay of the reperfusion therapy. Reperfusion was highly associated with the incidence of MACE and this study discovered a threefold benefit of reperfusion in lowering the occurrence of MACE (p=0.016). In conclusion, the majority of STEMI patients does not get reperfusion therapy. Delays in reperfusion treatment are not related to the patient's level of education, health funding, or distance to the hospital. Nonetheless, the delay my be attributed to the Jember community's lack of awareness of STEMI symptoms.

Analyzing spatial delays of tuberculosis from surveillance and awareness surveys in Eastern China

The spatial delays of pulmonary tuberculosis (PTB) have been less explored. In this study, a total of 151,799 notified PTB cases were included, with median patient and diagnostic delays of 15 [interquartile range (IOR), 4–35] and 2 (IOR, 0–8) days, respectively. The spatial autocorrelation analysis and spatial–temporal scan statistics were used to determine the clusters, indicating that the regions in the southwestern and northeastern parts of Zhejiang Province exhibited high rates of long-term patient delay (LPD, delay ≥ 15 days) and long-term diagnostic delay (LDD, delay ≥ 2 days). Besides, the Mantel test indicated a moderately positive correlation between public awareness of suspicious symptoms and the LPD rate in 2018 (Mantel's r = 0.4, P < 0.05). These findings suggest that PTB delays can reveal deficiencies in public health education and the healthcare system. Also, it is essential to explore methods to shift PTB knowledge towards real changes in attitude and behavior to minimize patient delay. Addressing these issues will be crucial for improving public health outcomes related to PTB in Zhejiang Province.

Subjective Health Impairment And Associated Factors In The Heatwave Of Summer 2022: An Online Survey

Heatwaves might diminish the sense of well-being and are associated with increased mortality. Individual measures to protect against heat are often insufficient, with the perception of one's own risk playing a crucial role. Due to varying levels of vulnerability, it is expected that the perception differs among populations. Presumably, symptom awareness is higher when people are concerned with and inform themselves about the topic of heat. Our study examined subjective health impairment during the heatwave in 2022, its association with socio-demographic and economic factors, as well as perceived heat stress and individual engagement with the issue. An online survey of a population-based sample from five federal states of Germany was carried out. Multivariable regression analyses were conducted to explore the relationship between subjective health impairment due to heat and potential risk indicators. Out of 3,111 people contacted, 1,522 responded, with 649 (20.9%) included in the analysis as they were affected by heat in their region of residence during the summer of 2022. The average subjective health impairment was 9.29 (SD: 5.25) out of 29 possible points. Higher age was associated with lower impairment; -1.36 points (95%-CI: -4.10; 1.38) in the group of those aged 80 and compared with the reference group of 60 to 69-year-old people. Furthermore, higher impairment was reported more by women and individuals with lower educational levels. Low impairment was associated with a high perceived level of information. Interventions aimed at reducing heat-related health problems should target a broader audience, particularly young people, women, individuals with lower education, and working people.

Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC.

Background/Objectives: Self-recognition of recurrent myocardial infarction (re-MI) may be essential for reducing prehospital time contrast to awareness of re-MI symptoms. However, data on the current status and clinical impact of self-recognition of re-MI are limited in the contemporary period. Thus, this study aimed to increase this body of knowledge. Methods: We enrolled 1018 patients with re-MI using data from the Korean Registry of Acute Myocardial Infarction for Regional Cardiocerebrovascular Centres. The patients were classified into self-recognised MI and unrecognised MI groups, and the differences between them were compared. Results: The rate of self-recognition among the patients with previous experience of MI was only 52.4%. Among the patients with re-MI, factors associated with self-recognition included recent first MI within 3 years, prior dyslipidaemia, two or more MI symptoms, and the male gender (p < 0.05). Factors associated with a lack of recognition were older age (≥70 years), prior stroke, and cancer history (p < 0.05). The proportion of symptoms-to-emergency room arrival time within 90 min among the patients with ST-elevation MI was significantly higher in the self-recognised group than in the unrecognised group (52.6% vs. 31.6%, p < 0.001). The self-recognised group showed a lower in-hospital mortality rate (1.5% vs. 6.2%, p < 0.001), and this benefit was maintained even after 1 year (hazard ratio: 0.53; p < 0.001). Conclusions: Only half of the patients who previously experienced a MI recognised a re-MI when it occurred. This recognition reduced prehospital delay and led to higher survival rates, which highlights the importance of patient education as well as objective monitoring devices, irrespective of individual recognition ability for immediate response.

XRCC1 and XPD polymorphisms: clinical outcomes and risk of prostate cancer in Bangladeshi population.

In Bangladesh, only a fraction of prostate cancer patients are diagnosed annually due to lack of symptom awareness and screening challenges, resulting in high mortality. Aiming to improve screening methods, we evaluated X-ray cross-complementing gene 1 (XRCC1) Arg194Gln and Xeroderma pigmentosum group D (XPD) Lys751Gln polymorphisms to determine their relevance as potential markers for predicting prostate cancer risk, severity and clinical parameters in Bangladeshi population. This study included 132 prostate cancer patients and 135 healthy controls. Genotype analysis was done from blood samples by the PCR-RFLP method. The XRCC1 Trp/Trp genotype was associated with prostate cancer (ORadj = 5.51; 95% CI = 1.13-26.78; p-value = 0.03) compared to Arg/Arg genotype. No significant association was found between the XPD variants and prostate cancer risk. The XRCC1 Trp/Trp genotype increased prostate cancer risk in smokers and non-smokers but was statistically non-significant. In individuals without a family history of cancer, the XRCC1 Trp/Trp genotype had a non-significant 4.64-fold higher risk (ORadj=4.64; 95% CI = 0.88-24.36; p-value = 0.07), while the XPD Gln/Gln had a 2.66-fold non-significant higher risk (ORadj=2.66; 95% CI = 0.88-8.10; p-value = 0.09). The XRCC1 Trp/Trp variant was associated with hematuria risk, higher mean serum creatinine, and mean prostate-specific antigen (PSA) levels in prostate cancer patients. The XPD Gln/Gln variant was only associated with higher mean serum creatinine levels. Our findings suggest that XRCC1 screening may be used as a biomarker for prostate cancer to improve early diagnosis in Bangladesh.

Causalidade e Gravidade das Reações Adversas e Alterações Laboratoriais ao Tratamento com Benznidazol em Pacientes com Doença de Chagas Crônica

Abstract Background Chagas disease (CD) is a serious public health problem in Latin America. Benznidazole (BNZ) is used for the treatment of CD and, despite its wide use, little information is available about its toxicity and mechanisms of adverse drug reactions (ADR). Objectives To identify and classify clinical and laboratory adverse reactions caused by BNZ in terms of causality and severity. Methods Prospective cohort study from January 2018 to December 2021. Treatment follow-up included visits and biochemical tests (complete blood count, liver and kidney function tests) before, during and after treatment. ADR were classified according to causality and severity. In the statistical analysis, the significance level was set at p&lt;0.05. Results Forty patients with chronic CD were included. A high prevalence of ADR was observed 161 ADR in 30 patients [90%]; of these, 104 (64.6%) were classified as possible and 57 (35.4%) as probable. The ADR were classified as moderate and mild. Of the 40 patients, nine (22.5%) discontinued treatment. ADR associated with treatment discontinuation and interventions were those that affected the dermatological system, central and peripheral nervous system and sense organs such as ageusia. Mild hematological and biochemical changes such as lymphopenia were observed after 30 days of treatment. Conclusion Many patients were able to complete the treatment even with ADR, which can be attributed to the successful follow-up strategy with symptomatic treatment and counseling, leading to patient’s awareness of symptoms and treatment adherence.

Causality and Severity of Adverse Reactions and Biochemical Changes to Benznidazole Treatment in Patients with Chronic Chagas Disease.

Chagas disease (CD) is a serious public health problem in Latin America. Benznidazole (BNZ) is used for the treatment of CD and, despite its wide use, little information is available about its toxicity and mechanisms of adverse drug reactions (ADR). To identify and classify clinical and laboratory adverse reactions caused by BNZ in terms of causality and severity. Prospective cohort study from January 2018 to December 2021. Treatment follow-up included visits and biochemical tests (complete blood count, liver and kidney function tests) before, during and after treatment. ADR were classified according to causality and severity. In the statistical analysis, the significance level was set at p<0.05. Forty patients with chronic CD were included. A high prevalence of ADR was observed 161 ADR in 30 patients [90%]; of these, 104 (64.6%) were classified as possible and 57 (35.4%) as probable. The ADR were classified as moderate and mild. Of the 40 patients, nine (22.5%) discontinued treatment. ADR associated with treatment discontinuation and interventions were those that affected the dermatological system, central and peripheral nervous system and sense organs such as ageusia. Mild hematological and biochemical changes such as lymphopenia were observed after 30 days of treatment. Many patients were able to complete the treatment even with ADR, which can be attributed to the successful follow-up strategy with symptomatic treatment and counseling, leading to patient's awareness of symptoms and treatment adherence.

Public awareness and provider counseling regarding postmenopausal bleeding as a symptom of endometrial cancer.

Our study aims to understand public knowledge of postmenopausal bleeding as an endometrial cancer symptom and how past provider counseling on postmenopausal bleeding affects knowledge and care-seeking behaviors related to postmenopausal bleeding. This was a cross-sectional survey study of people assigned female at birth. Study participants were recruited at a university research facility located at the Minnesota State Fair in September 2021. Participants answered questions about demographics, endometrial cancer knowledge, whether they had received counseling about postmenopausal bleeding, and whether and when they would present for care after experiencing postmenopausal bleeding. Six hundred forty-eight surveys were completed and included in analyses. Sixty-three percent of participants identified postmenopausal bleeding as a symptom of endometrial cancer. Those who correctly selected this symptom were more likely to be born in the United States, have a college education or higher, and have private insurance. Of the 145 postmenopausal participants, 46.5% reported that their provider counseled them on postmenopausal bleeding. Fifty-nine percent of the postmenopausal participants reported that they would tell their provider if they had postmenopausal bleeding after only one episode. There is a need for increased recognition of postmenopausal bleeding and provider counseling on postmenopausal bleeding, and educational interventions should focus on public and provider awareness of endometrial cancer risks and symptoms.

Stroke Knowledge and Response Among the General Population in Saudi Arabia: A Population-Based Survey.

Stroke, a condition that disrupts brain function and can result in long-lasting clinical symptoms or death, remains a substantial global health concern. General awareness of stroke leads to a proper response to stroke, pursuit of medical treatment, and a better outcome. Our study aims to explore how the general Saudi Arabian population responds to stroke, investigate the relationship between stroke knowledge and appropriate actions, and identify the most relied upon medical information source about stroke among the public. By highlighting these aspects, we aspire to contribute to the development of effective stroke prevention and management strategies in Saudi Arabia. This descriptive, cross-sectional, web-based study was carried out across multiple regions in Saudi Arabia. Data collection involved a validated online questionnaire (STAT) in Arabic,targeting adults aged 18 and older. Data analysis was performed using SPSS software. The study included 390 participants. Notable findings emerged regarding the recognition of stroke symptoms and the factors influencing this recognition. A substantial proportion of respondents correctly identified visual disturbances (55.9%), motor impairment (39.5%), cardiac symptoms (56.2%), sensory symptoms (32.8%), chest pain (62.6%), and arm weakness (36.7%) as indicators requiring immediate medical attention. However, there were lower correct response rates for symptoms such as sudden dizziness (22.8%), confusion (16.9%), difficulty understanding (27.9%), and urinary symptoms (26.9%). Older individuals and retirees generally scored higher in correctly identifying these symptoms. Our study highlights a commendable level of awareness of certain stroke symptoms, such as visual disturbances and chest pain, among the general population of Saudi Arabia. Nonetheless, notable gaps remain in recognizing other symptoms, such as sudden dizziness and confusion. This identification gap presents a clear opportunity for targeted educational initiatives that are essential to improving public recognition of these symptoms. By addressing these gaps, we aim to enhance the response to stroke incidents, potentially improving outcomes and reducing morbidity rates.

Prevalence of obsessive-compulsive symptoms among adult population in primary care centers in Bahrain - A cross-sectional study.

The global increasing prevalence of obsessive-compulsive disorders and symptoms among various age groups and nationalities is considered a great clinical challenge. However, limited data are available on this topic in the Middle East and Gulf Council Countries. This study aimed to raise awareness of obsessive-compulsive symptoms among adults in Bahrain by determining its prevalence and risk factors among patients attending primary healthcare centers. A cross-sectional study was conducted among adult patients attending primary healthcare centers in Bahrain. A self-administered online questionnaire using Google form, a free online survey-creating website, was distributed through WhatsApp messages. A snowball sampling technique was used. The questionnaire consisted of three parts: the socio-demographic data of participants, the Maudsley Obsessional-Compulsive Inventory, and the Yale-Brown Obsessive-Compulsive Scale. Descriptive and inferential analyses were conducted. A total of 614 participants were included with a mean age of 30.04 ± 13.04 years. Most participants were females (82.5%) and single (n = 347, 56.5%). The estimated prevalence of obsessive-compulsive symptoms among the participants was 15%; most of them reported mild symptoms (85%). Significantly higher obsession and compulsion symptoms were found among non-Bahraini (P < 0.001 and P < 0.002), single (P < 0.001 and P < 0.033), and student participants (P < 0.001 and P = 0.002) compared to their counterparts, respectively. In addition, undergraduates reported higher obsessions compared to other participants (P = 0.005). Approximately, one in every eight people in Bahrain were found to suffer from obsessive-compulsive symptoms, especially single, students, and non-Bahraini participants. These findings highlight the need for raising awareness of obsessive-compulsive disorder and its symptoms as well as the importance of early detection and management of obsessive-compulsive disorder.

Identifying barriers and facilitators for the effective diagnosis and provision of primary health care for otitis media from the perspective of carers of Aboriginal children.

To identify the barriers and facilitators for timely detection and optimal management of otitis media (OM) in Aboriginal children in a primary care setting from the perspective of carers of Aboriginal children. A qualitative, Aboriginal co-designed, participatory action research study with interviews and focus groups in a large town in the Kimberley, Western Australia. The Consolidated Framework for Implementation Research informed stakeholder group identification and interview framework development. Data underwent thematic analysis using NVivo software. Thirty-two carers of Aboriginal children participated. Key barriers identified for the detection of OM were limited information about OM provided to carers and carers feeling disempowered to express their concerns. Key facilitators identified were the provision of health information through health promotion and the use of culturally secure resources. Having a culturally secure clinical environment was identified as essential, with Aboriginal Health Workers playing a vital role in clinical care. No barriers to management of OM in primary care were reported. Facilitators included health care practitioners (HCPs) emphasising the importance of completing antibiotic course and the clinic providing necessary medications. A culturally secure health promotion strategy with health promotion teams, campaigns and resources is needed to increase community awareness of OM signs and symptoms and facilitate appropriate health seeking. It is essential that the local Aboriginal community co-lead and co-develop these initiatives to ensure the unique wisdom and knowledge of Aboriginal people are captured. HCPs and the clinic effectively facilitate management of OM by providing medications and emphasising completion of antibiotics.

Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students.

Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted on 80 high schools in Gunma Prefecture, Japan. The survey incorporated the Quick Environmental Exposure and Sensitivity Inventory, as well as items related to allergies, the living environment, and lifestyle. Of the 4630 students analyzed, according to Hojo's cut-off value, 9.0% were classified as high-risk for MCS and 77.9% reported some allergy-like symptoms. Significant factors associated with elevated MCS risk included female sex, having various allergic conditions, having experienced living in a new home or home renovations or extensions, proximity to environmental stressors (freeways, national highway, factories, rubbish dumps, or sources of offensive odors), insufficient physical activity (exercising less than once a week outside of physical education classes), having cold hands and feet, being fatigued, having a bedtime earlier than 11 p.m., and having moderate-frequent subjective stress. Overall, 9.0% of high school students in Japan are at high risk for MCS. Enhancing awareness of MCS-like symptoms and addressing allergies, living environments, and lifestyle habits may mitigate these symptoms.