Elimination Of Risk Factors Research Articles

Risk factors for omphalitis in neonatal dairy calves

Knowledge about potential risk factors for animal health is crucial to achieve animal welfare. The aim of this study was to provide practical guidance for farmers to improve the health status of their youngstock by identifying and eliminating risk factors for omphalitis in neonatal calves. A cross-sectional study including 3,445 dairy calves from 567 farms located in three structurally different regions of Germany was performed from December 2016 to July 2019. On each farm calves aged five to 21 days underwent clinical examinations with special consideration of the umbilicus for signs of inflammation. Information regarding animal health, hygiene, and management was obtained via interviews with the farmers. Rearing conditions were recorded following visual inspection using written standard operating procedures. Multifactorial statistical analyses were performed to identify potential risk factors for omphalitis on animal and farm level. The overall omphalitis prevalence in calves aged five to 21 days was 30.9%. Across all regions and farms, every fourth calf per farm exhibited signs of omphalitis (median farm prevalence: 25.0%, interquartile range: 0.0–50.0%). According to the farmers, however, only 4.5% of the calves had been treated for omphalitis in the preceding 12 months. Risk factors for omphalitis identified included the dampness of the lying area in the first 2 weeks of life, a body condition score of the dam after calving outside the optimal range, and the time that calves spent with their dam after birth. Calves on farms providing dry lying areas in the first 2 weeks of life had 0.77 times the risk of omphalitis compared to calves on farms with predominantly damp bedding. When the dams were judged under- or over-conditioned after calving, their offspring had a 1.4 times higher omphalitis risk, respectively, compared to calves from dams optimal conditioned. Calves from farms separating calf and dam beyond 12 h after birth were 0.75 times as likely to develop omphalitis than calves from farms performing immediate separation. These results highlight the complexity of multifactorial diseases such as umbilical infection. The evidence presented can help to establish guidelines for dairy farmers to improve the umbilical health of their calves.

TEMPO ENTRE SUSPEITA CLÍNICA E DIAGNÓSTICO E PRESENÇA DE METÁSTASES EM CÂNCER DE MAMA EM HOSPITAL DE REFERÊNCIA DA REGIÃO NORTE

The word cancer comes from the term karkínos, from the Greek language, which refers to the term crab. Hippocrates, the father of medicine who lived between 460 and 377 BC was the author of this term. There are reports of this disease more than 3 thousand years before Christ, in ancient Egypt, where mummies were found that already showed the impairment of the human body caused by this pathology. Currently, breast cancer is a global public health problem. Eliminating risk factors or diagnosing and treating cancer precursor lesions are an example of the practical difficulties encountered in primary prevention. The study is cross-sectional and descriptive, carried out through interviews and analysis of clinical records of 114 patients treated at the Hospital Ophir Loyola, between the years 2016 and 2017, in the city of Belém, in the state of Pará. The data were presented in the form absolute and relative frequency. Thus, the importance of early detection actions and treatments carried out at the beginning of the development of the disease is evident, leading to an increase in survival and consequently a reduction in morbidity and mortality, improving the prognosis of women affected by this pathology by determining the variables of clinical and epidemiological interest capable of changing negative outcomes.

Understanding Mucocele of Tongue in Children: A Case Report

Introduction: Mucocele is cystic lesion that occur in oral cavity. Commonly it happens due to trauma or obstruction of minor salivary gland ducts. Certain mucoceles may heal spontaneously, while others might surgical intervention due to frequent recurrence. Mucoceles on the tongue are rare and typically occur on the underside, where the glands of Blandin and Nuhn are located. Appropriate diagnose and treatment must be chosen correctly. Case History: A 12-years old-girl presented of enlarged gum and recurrent swelling firstly noticed a month ago. Excision was done under local anesthesia using electrocautery. A clinical diagnose of mucocele was confirmed by histopathological examination. Discussion: Mucoceles on the tongue are uncommon and primarily occur on the ventral surface where the glands of Blandin and Nuhn are situated. Complete excision was done once the diagnosis was confirmed using electrocautery which have indicated that this method is faster, simpler, and causes minimal postoperative discomfort compared to conventional excision. To minimize recurrence, strategies such as removing surrounding glandular acini, excising or dissecting the lesion down to the muscle layer, and avoiding damage to adjacent glands and ducts are recommended. Conclusion: Mucoceles on the tongue are uncommon and primarily occur on the ventral. Since mucocele are asymptomatic, complete surgical excision of mucocele of tongue must followed by eliminate risk factors to prevent recurrency.

Current view of the management of patients with endometrial hyperplasia: A review

Endometrial hyperplasia (EH) is a spectrum of morphological changes in the endometrium characterized by the proliferation of glands and an increase in the gland-stromal ratio. The relevance of this disease is due to its high prevalence (10–55%). The clinical significance of EH is related to the increased risk of endometrioid cancer. One of the leading causes of EH is absolute or relative hyperestrogenism and progesterone deficiency that does not eliminate the proliferative effect of estrogens. The risk group for EH includes women with early menarche, late menopause, infertility, anovulation, polycystic ovary syndrome, obesity, type 2 diabetes mellitus, hypertension, Lynch syndrome, estrogen-producing ovarian tumors, as well as those receiving estrogen monotherapy or tamoxifen. Most leading experts believe that therapy should include surgery followed by drug therapy aimed at eliminating risk factors to reduce the risk of EH recurrence. Despite numerous research findings demonstrating the benefits of a particular treatment modality and the consequent presence of these modalities in clinical guidelines, the potential benefits of alternative therapies are still being discussed. This issue requires further study and the selection of optimal treatment regimens for patients with EH.

Awareness of Domestic Accidents Among Mothers of Children Aged Less than 10 Years in an Urban Locality of South Karnataka: A Cross-Sectional Study

Introduction: Domestic accidents are one of the five leading causes of death due to injuries in industrialised and developed countries. Awareness about domestic accidents and their prevention can help in eliminating risk factors of accidents. Since children are vulnerable to accidents, the immediate caregivers must have adequate knowledge regarding the causes and prevention to reduce the morbidity and mortality due to accidents. Objective: To study the socio-demographic profile of the study subjects; To assess the knowledge on prevention of domestic accidents among mothers of children aged less than 10 years. Methods: A cross-sectional study was undertaken in the urban field practice area of a medical college in Southern Karnataka among mothers of children aged less than 10 years using a pre-structured proforma. Data was analysed using descriptive and inferential statistics. Results: A total of 385 mothers were part of the study. 51.4% had good knowledge regarding domestic accidents and their prevention. There was a statistically significant association between the level of awareness of domestic accidents with maternal age, educational status, occupation, religion, type of family and standard of living. Conclusion: The knowledge of domestic accidents and their prevention was 51.4%.

Improving surgical treatment of patients with patellar instability

BACKGROUND: The high frequency and recurrence of chronic patellar instability and the lack of unified treatment techniques indicate the need for a comprehensive individualized approach in the diagnosis and surgical treatment of patellar instability.
 AIM: To develop an algorithm and compare the anatomical and functional results of its use with those of traditional surgical treatment of patients with patellar instability.
 MATERIALS AND METHODS: The functional results of the treatment of 194 patients with patellar instability were compared. Two groups of patients were formed. The surgical treatment techniques of the main group (n = 93) were based on the results of the preoperative examination, considering risk factors of instability development, established as a result of retrospective analysis of the control group (n = 101). The effectiveness of the algorithm was compared with the techniques of patellar stabilization used from 2010 to 2015. The Kujala, IKDC 2000, and Lysholm scales were used to assess the functional results of treatment.
 RESULTS: Surgical treatment of instability aims to eliminate risk factors such as anomalies of the extensor apparatus of the knee joint and to repair or reconstruct damaged structures. Plasty of the medial patellofemoral ligament is the method of choice for patellar stabilization. In the case of dysplastic changes in the patellofemoral joint, combinations of proximal and distal knee joint surgeries were performed. Rotational lower-limb deformities were treated by corrective derotational osteotomy of the femur. Trochleoplasty was performed in cases of type B or D femoral block dysplasia. Patients with stiff lateral patellar retention underwent lateral release or extension tenotomy. In both groups, the functional status of the patients significantly (p 0.05) improved 12 months postoperatively. The mean values of the functional scales increased because of the increased number of patients with excellent and good scores in the group. Higher values were recorded in the main group (Kujala, p = 0.038; IKDC 2000, p = 0.021; Lysholm, p = 0.032). Patellar dislocation recurred in 2 (1.9%) patients in the control group (p = 0.172).
 CONCLUSIONS: The proposed algorithm helped verify the degree, type, and etiology of patellar instability and helped obtain better anatomofunctional treatment results in patients.

A Critical Appraisal of Gilgit-Baltistan Education Strategy 2015-2030

This study aims to analyze Gilgit-Baltistan Education Strategy 2015-2030 and its revised strategy and implementation plan issued on September 2023 by the Directorate of Education Gilgit-Baltistan. An objective analysis reveals that none of the promised goals outlined in Education Strategy w.e.f 2015 to 2023 have been achieved at any satisfactory level. Revised Strategy and Implementation Plan w.e.f 2023 to 2030 do not reflect on major causes of failure to achieve previously set targets/goals. The strategy paper entails abstract assumptions, encouraging intervention from private sectors and an idealistic call for financial commitments from provincial and federal government. The findings of the study reveals that the subject strategy fails to chart out clear guidance to acclimatize the available resources and it does not incorporate any pragmatic mechanism to eliminate risk factors indicated against each set of goal and objective. The study underscores the importance of considering judicious utilization of available financial and human resources and revision of departmental regulations and statutory laws to curb undue favours and prevent political interferences in Education department Gilgit-Baltistan.

Application of the risk-oriented approach in the practical activities of detectives of the bureau of economic security

The paper examines the essence and features of the application of a risk-oriented approach in the activities of detectives of the Bureau of Economic Security, the importance of introducing a risk-oriented approach in order to identify potential risks of committing criminal offenses in the spheres of budgetary, tax, customs, monetary and investment activities. General methods of conducting inspections of the Bureau of Economic Security and their features are considered. In particular, such methods are characterized as: documentary scheduled and unscheduled inspections; actual on-site and off-site inspections; monitoring checks of compliance with legal requirements. Control purchases of goods, works or services; examinations and interviews of company officials and employees; inventories of goods and material values, calculations and obligations of the enterprise. It has been investigated that the implementation of a risk-oriented approach consists in the analysis and comparison of information contained in the databases of the Bureau of Economic Security (BEB) with data obtained from automated information and reference systems, registers, data banks of state authorities, local self-government bodies , to which access is provided in accordance with the provisions of Article 7 of the Law of Ukraine "On the Bureau of Economic Security of Ukraine", as well as structured and unstructured data from other sources. It is argued that based on the results of identifying, assessing and defining risks, risk management measures are taken, which consist in timely response to them by minimizing or eliminating risk factors that have led or may lead to their occurrence, as well as the consequences of the manifestation of such risks. It was determined that the tools and methodology of the risk-oriented approach for the activities of the Bureau of Economic Security can become useful only under the conditions of quality implementation, taking into account foreign experience and careful implementation of each of the described stages.

The Analysis and AI Simulation of Passenger Flows in an Airport Terminal: A Decision-Making Tool

In this paper, a decision-making tool is proposed that can utilize different strategies to deal with passenger flows in airport terminals. A simulation model has been developed to investigate these strategies, which can be updated and modified based on the current requirements of an airport terminal. The proposed tool could help airport managers and relevant decision makers proactively mitigate potential risks and evaluate crowd management strategies. The aim is to eliminate risk factors due to overcrowding and minimize passenger waiting times within the terminal to provide a seamless, safe and satisfying travel experience. Overcrowding in certain areas of the terminal makes it difficult for passengers to move freely and increases the risk of accidents (especially in the event of an emergency), security problems and service interruptions. In addition, long queues can lead to frustration among passengers and increase potential conflicts or stress-related incidents. Based on the derived results, the optimized routing of passengers using modern technological solutions is the most promising crowd management strategy for a sample airport that can handle 800 passengers per hour.

Using a Mixed-Method Approach to Explore the Factors Influencing the Family Resilience of Stroke Survivors in China.

Stroke is a critical public health issue in China that necessitates a closer examination of family resilience (defined here as the collective capacity of individuals, families and communities to effectively navigate challenges, recover from adverse events and foster positive adaptation). Amid rising stroke incidence, this study addresses the dearth of research on family resilience among stroke survivors in China, aiming to assess its level, identify influencing factors and establish coping strategies for family caregivers. This mixed-methods research employed a sequential explanatory design. Questionnaires were distributed to 258 stroke survivors and their family members at outpatient follow-up visits. In the first stage (ie the quantitative research stage), the research tools for data collection included a general demographic sociological data questionnaire, the Family Resilience Assessment Scale (FRAS), the Self-Efficacy for Managing Chronic Disease 6-Item Scale, the Caregiver Burden Scale, the Family Functioning Scale and the Social Support Rating Scale. Quantitative data were analysed using IBM SPSS 26.0 software, utilising descriptive statistics for summarising sociodemographic characteristics and conducting analyses, such as independent-sample t-tests, one-way analysis of variance and Spearman correlation analysis. The second stage (ie the qualitative research stage) involved complementing and validating the data, developing a quantitative-qualitative interview framework and selecting participants for interviews. Colaizzi's seven-step analysis was applied to analyse interview data. In the third stage, the quantitative and qualitative research results were integrated, and a comprehensive analysis was performed to obtain an accurate conclusion. A total of 242 families responded to the questionnaire (response rate: 93.8%). In total, the mean age of stroke survivors was 61.86 ± 8.76 years old, and 69.8% were male. The quantitative results showed that the FRAS mean score was (185.33 ± 24.78), which was above the medium level. The multiple linear regression analysis confirmed that family function was the strongest influencing factor on family resilience (β = 0.948, p < 0.01). The qualitative analysis revealed four themes of family adaptation experience: loss of independence and certainty, facing threats and challenges, seeking family advantage resources and adopting coping strategies. This hybrid study sheds light on the adaptation process of the families of stroke survivors, revealing family function as the primary influencer of resilience. Recognising that eliminating risk factors is challenging, our suggestion is for clinical practitioners to emphasise family strengths and implement resilience-oriented interventions. Focusing on enhancing coping abilities and fostering adaptation within families can aid in the rehabilitation process, promoting the well-being and growth of both the family unit and individual members, while alleviating caregiver burden.

EVALUATING THE RISK OF DELIRIUM IN ELDERLY INPATIENTS IN COVID-19 INTENSIVE CARE: A PROSPECTIVE AND OBSERVATIONAL STUDY

Introduction: Delirium is dangerous, often preventable, and associated with a high financial burden and increased morbidity and mortality. This study aimed to evaluate the risk of delirium in elderly inpatients in COVID-19 intensive care units. Materials and Method: This study used a prospective and observational design. Between July and November 2022, 49 intensive care patients were admitted to a training and research hospital in northeast Turkey. The data were collected using the Patient Information Form, Critical-Care Pain Observation Tool, Ramsay Sedation Scale, and Nursing-Delirium Screening Scale. Results: The patients’ mean age was 76.90±8.29 years. The longer the length of stay in the intensive care unit, the incidence of delirium increased. The incidence of delirium increased in patients aged 70–95 years (p=0.007). Patients with delirium experienced insomnia and agitation and used more sedative drugs (p&lt;0.05). The predictors of early delirium were sedation (β=0.869), agitation (β=-0.582), and diastolic blood pressure (β=0.258). The predictors of delirium were pain (β=-0.599) and sedation (β=0.267). Conclusion: The study demonstrated that older age, agitation, sedation, pain, and diastolic blood pressure predicted delirium in elderly COVID-19 inpatients. It is necessary to identify and eliminate risk factors to reduce the risk of delirium in elderly patients. Nurses should play an active role in identifying and managing delirium in elderly COVID-19 patients. Keywords: COVID-19; Delirium; Aged; Intensive Care.

ORGANIZATION OF INDIVIDUAL PREVENTION OF CRIMES COMMITTED BY WOMEN

Prevention of crime among women, as well as crime in general, is carried out through various measures (general, special criminological prevention andindividual prevention). To reduce the number of offenses committed by women, it is necessary to promptly identify women prone to committing socially dangerous acts, apply educational measures to them, eliminate risk factors in the main areas of women’s life (family, educational institutions), provide effective assistance to women in realizing their basic social functions.

Selection of Tools for Comprehensive Assessment of Patients with Obesity for Patient-oriented Treatment in Primary Care

In the modern world, obesity has become a large problem and now is one of the most complex medical and social problems. That is why the assessment of the health status of an obese patient is of the great importance for maintaining health, eliminating risk factors, patient-oriented treatment and improving the quality of their life. The article analyzes literature data regarding tools for complex assessment of obese patients at the level of primary health care (PHC) for the implementation of patient-oriented treatment. The bibliosemantic method and the system analysis method were used for the analysis. A systematic review of literature sources identified the most practical tools for assessing obesity at PHC level. It is noted that for clinical and instrumental assessment of the patient’s condition, anthropometric, instrumental indicators should be used: height, body weight, waist circumference, hip circumference, blood pressure; calculated indexes: Quetelet index (BMI), body surface area (BSA), waist/hip ratio (WHR), Conicity Index (ConI), A body shape index (ABSI), Abdominal Volume Index (AVI). These indicators better describe abdominal obesity and make possible to assess the risks of non-communicable diseases. Laboratory indicators include determination of fasting glucose, insulin, HOMA index, lipidogram (with determination of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein, very low-density lipoprotein, atherogenicity index). The best tools for assessing psychosocial status and sleep were: the Dutch Eating Behavior Questionnaire (DEBQ), the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Scale, the Hamilton Anxiety Scale (HAM-A), the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS). The SF-36 (36-Item Short Form Health Survey), IPAQ, FINDRISK scale should be used to assess the quality of life and risks. For a complex assessment of obese patients at the primary care level, in addition to generally accepted clinical and laboratory examinations, it is necessary to study eating behavior, anxiety and depression levels, sleep quality, quality of life, physical activity level, and the risk of diabetes in patients. This allows family doctors to improve their patient-centered approach. Due to their compactness, availability and high sensitivity, they can be widely used by general practitioners.

Prevalence and Pattern of Musculoskeletal Disorder in Panteka Mechanic Village, Kaduna

Musculoskeletal disorders (MSDs) are illnesses that make working people disabled and generate significant economic loss worldwide. Automobile mechanics are at risk of injury at the onset of MSDs due to repetitive tasks, uncomfortable posture, and heavy lifting of objects. The frequency and pattern of work-related musculoskeletal disorders among auto mechanics in Panteka Village, Kaduna State, are investigated in this study. Using a version of the standard Nordic Musculoskeletal questionnaire, a quatitative method was used to gather data on the prevalence pattern of musculoskeletal illnesses at Panteka Village. To analyze the data obtained, purposive sampling method was employed. The study found that there was a high prevalence of MSDs among auto mechanics in Panteka village, with rates of 90% (Neck), 92.3% (shoulder), 56.4% (knee) and over 70% prevalence of MSD for lower and upper back. The results of relationship between age of respondents, years spent as a mechanic and prevalence of the musculoskeletal disorders showed no significant relationship. However, there was a significant relationship between the respondent's section of mechanic activities ie the nature of their job and MSD. These are primarily the result of poor ergonomics and insufficient rest periods at their workshop. Also, manual handling of heavy loads, repetitive tasks and force exertion were the identified factors. Ergonomic and MSD awareness among workers should be increased through training. In addition, govermnents should investigate more in other to reduce or eliminate risk factors leading to musculoskeletal disorders. Members of the Panteka village committee can use the research's findings to enhance the working environment for mechanics. Therefore, Mechanics will need to be educated more on risk factors associated with MSDs.

Состояние системы глазной поверхности у детей с аномалиями рефракции

Purpose. To evaluate subjective signs and objective clinical symptoms of disorders of the ocular surface system in children with refractive errors. Material and methods. 76 children (152 eyes) with ametropia aged 8 to 18 years were examined. All patients were divided into 2 groups: group 1 – 30 patients aged 8 to 11 years, group 2 – 46 patients aged 12 to 18 years. The severity of the subjective signs of the "dry eye" syndrome and the state of visual comfort were assessed using an online survey developed by the authors. Objectively, the state of the ocular surface system was examined by invasive methods (Schirmer I test, Schirmer II test, Norn test), as well as non-invasive methods using a keratograph (non-invasive tear breakup time, tear meniscus height, meibography, assessment of the severity of hyperemia of the bulbar conjunctiva). In 20 patients (40 eyes) osmometry of the lower lacrimal meniscus was performed. Results. According to a survey of 76 patients, 34 patients (44.7%) had minor disorders of the ocular surface system, 25 patients (32.9%) had moderate disorders, 7 patients (9.2%) had severe disorders, and 10 patients (13.2%) – significantly severe disorders. The indicators of the main tear secretion in the younger age group differ slightly from the standards, while in the older age group they exceed them by 2 mm, the total tear production in both groups of the study was slightly lower than the age standards. The obtained values of reflex tear production are sharply reduced in both study groups, at the age of 12–18 years the deviation is more significant. The average tear film osmolarity in the group of 20 patients aged 12–18 years was 302.75 mOsm/l, which corresponds with adult standards, however, in 6 patients from this group, the values exceeded the standards up to 332 mOsm/l, which is typical for moderate severity dry eye syndrome. It has been established that the indicators of tear film stability measured by both invasive and non-contact methods have similar values. In the group of children from 12 to 18 years old, the indicators are at the lower limit of the norm, however, the spread of the results indicates that there were patients with reduced indicators in the group. The number of eyes with loss of meibomian glands ducts of the 1st degree in the group of children aged 12–18 years was 31.5%, while in the younger group it was 26.7%. A mixed injection of the conjunctiva in the form of hyperemia of the 2nddegree was observed in 10.8% of the eyes in the older group, while in the other group only in 3.4% of the eyes. If more significant subjective chnges were detected, in combination with a deviation from the norms in clinical trials, it was advisable to prescribe age-appropriate drug therapy to patients to correct these conditions. Conclusion. When evaluating the subjective signs of a disorder of the state of the ocular surface system in children, special attention should be paid to the procedure for collecting an anamnesis and quantitative assessment of symptoms. Even in the absence of complaints, it is necessary to conduct an objective, preferably non-invasive study of the stability of the tear film, the state of the meibomian glands, and, if necessary, tear production. When a complex of subjective signs of moderate severity is detected, it is necessary to conduct an explanatory conversation with patients and their parents, paying attention to the aspects of eliminating risk factors for the development of disorders of the ocular surface system. Key words: ocular surface system, tear secretion, tear film stability, meibography

Osteosarcopenia and Pain: Do We Have a Way Out?

Osteosarcopenia (OSP) is a geriatric syndrome characterized by the coexistence of osteoporosis and sarcopenia and associated with an increased risk of fragility fractures, disability, and mortality. For patients with this syndrome, musculoskeletal pain represents the most significant challenge since, in addition to limiting the individual's functionality and promoting disability, it has a huge psychological burden involving anxiety, depression, and social withdrawal. Unfortunately, the molecular mechanisms involved in the development and persistence of pain in OSP have not yet been fully elucidated, although immune cells are known to play a key role in these processes. Indeed, they release several molecules that promote persistent inflammation and nociceptive stimulation, resulting in the gating of ion channels responsible for the generation and propagation of the noxious stimulus. The adoption of countermeasures to counteract the OSP progression and reduce the algic component appears to be necessary, providing patients with a better quality of life and greater adherence to treatment. In addition, the development of multimodal therapies, based on an interdisciplinary approach, appears to be crucial, combining the use of anti-osteoporotic drugs with an educational programme, regular physical activity, and proper nutrition to eliminate risk factors. Based on this evidence, we conducted a narrative review using the PubMed and Google Scholar search engines to summarize the current knowledge on the molecular mechanisms involved in the pain development in OSP and the potential countermeasures to be taken. The lack of studies addressing this topic highlights the need to conduct new research into the resolution of an ever-expanding social problem.

Hormone Replacement Therapy Does Not Eliminate Risk Factors for Joint Complications following Total Joint Arthroplasty: A Matched Cohort Study

Aging causes a reduction in testosterone and estrogen, which is linked to diminished bone mineral density. Hormone replacement therapy and its effect on the outcome of joint arthroplasties is unclear. The purpose of this study was to analyze the impact of testosterone replacement therapy (TRT) and estrogen replacement therapy (ERT) on the medical and joint outcomes of total hip (THA) and total knee arthroplasties (TKA). A retrospective cohort study was conducted using the PearlDiver database. Patients who received TRT or ERT perioperatively were matched to controls. Rates of 90-day medical complications and 2-year joint complications were queried. Patients who received TRT had an increased risk of revision, periprosthetic joint infection, and pooled joint complications within 2 years following a THA and increased rates of septic and aseptic revisions, and aseptic loosening after TKA compared to the control cohort. Patients receiving ERT had increased rates of aseptic loosening and pooled joint complications within 2 years following THA and increased rates of all-cause revisions and pooled joint complications after TKA. Patients who received TRT demonstrated significantly higher rates of revision rates and PJI. Patients who received perioperative ERT were significantly more likely to have increased risks of revision rates and joint infections.

Change in the incidence of intestinal diseases caused by parasitic protozoa in the Mexican population during the period (2015-2019) and its association with environmental and socioeconomic risk factors.

Diarrheal diseases are one of the main health problems worldwide, especially in developing countries with poor health systems, high rates of poverty, and poor nutrition. The main causative agents of diarrheal disease are bacteria, viruses, and parasites; among the latter, the intestinal protozoa Giardia and Entamoeba stand out. In the present work, a observational analysis of the national surveillance data of amebiasis, giardiasis, and other protozoan intestinal infections was carried out. The data issued by the Directorate General of Epidemiology was analyzed to establish its relationship with geography, socioeconomic, and environmental conditions in Mexico during the 2015-2019 period. New cases of amebiasis decreased by 25.03% between 2015 and 2019, while giardiasis and other protozoan intestinal infections remained constant; in all cases, incidence was higher in females than in males, and children under 5 years of age were the most affected. The contribution of environmental conditions (seasonality, temperature, and humidity) and socioeconomic factors in the number of protozoan intestinal infection cases was assessed by a multivariable regression model using a backward selection procedure. Peaks in cases were observed in spring and summer, which are characterized by warm and humid climates. Additionally, states with high humidity and annual average temperature contribute to a notably higher incidence of these parasites, especially annual average temperature, as demonstrated through multivariable linear regression models. Moreover, the majority of these states have the largest population living in poverty with inadequate measures for the distribution, dispensing, and sanitation of water. These data are essential to incidence rate monitoring and focus efforts on eliminating risk factors and improving health programs in Mexico.

PREVALENCE AND CAUSES OF RECURRENT PEPTIC ULCER

Background:Peptic ulcer disease (PUD) is a common disease of the gastrointestinal tract characterized by mucosal damage due to the secretion of pepsin and gastric acid. The current study aimed to determine the prevalence and causes of recurrent peptic ulcer. Methods:The current study adopted an exploratory study design in order to determine the prevalence and causes for recurrent peptic ulcer disease in individuals and predict an outcome. The participants for the current study were individuals belonging to the age group 18-75. This age group is chosen as the major influence of peptic ulcer disease is observed within this group.For the current study, questionnaire was adopted for data collection, which was also categorized as a study tool. Results:Study included 589 participants. It is noticed that most of participants (n= 530, 90.1%) strongly agree that they visit the doctor periodically to check on their health. Previous item has the highest rank followed by participants follow smoking lifestyle (n= 526, 89.4%). On the other hand, the least rank item on which participants strongly disagreed was participants suffered from soreness or bleeding from their stomach (n= 249, 42.4%). This gives a prevalence of 42.4% of peptic ulcer disease among study participants. Conclusion:Peptic ulcer illness burdens health care systems, which urge for adequate treatment to limit recurrence and effects. H. pylori, smoking, and aspirin usage are risk factors for 5-year peptic ulcer recurrence. Long-term PUD hazards include smoking and aspirin. Avoiding risk factors reduced the recurrence rate of H. pylori eradication, acid suppression medication, and surgery. This shows how eliminating risk factors may enhance long-term performance. Proper PUD treatment requires multicenter research to prevent recurrence and repercussions.

Risks in the activity of business entities: the concept of analysis and management

The article identifies a list of risks that have an impact on the activities of modern enterprises. It is proposed to improve their classification. In particular, based on the use of the method of generalization and critical analysis, the identified risks are divided into objective and subjective risks based on causality, and systemic and non-systemic based on frequency of occurrence. The classification characteristic for objective risks is their irreversibility and direct impact on changes in the financial state of the enterprise, and for subjective risks - the human factor (they include risks that arise as a result of unqualified actions of responsible persons). Thanks to this, using modeling and formalization, an approach to analyzing the level of sensitivity of economic entities to risks was formed and its indicators and their critical values were substantiated. The graphic method is applied to form the concept of financial risk management based on their analysis. The essential content of the indicator of the level of sensitivity of the economic entity to risks, which is identified as a measure of the vulnerability of the economic entity in the process of its activity to the negative effects of the internal and external environment, is substantiated. Grouping, graphical approach and generalization were used to implement the proposal regarding the methodology and structure of the financial risk analysis process. The application of this approach will allow the company's management to develop a system of measures to eliminate risk factors in order to preserve its stable financial condition.