High Infection Rates Research Articles

Exploring the impact of high salinity and parasite infection on antioxidant and immune systems in Coris julis in the Pityusic Islands (Spain)

Climate change associated with human activities alters marine ecosystems and causes imbalances and abrupt changes in sea conditions. Scarce freshwater resources for human consumption often prompt the construction of desalination plants, which discharge significant amounts of brine into the sea, potentially elevating salinity levels. Furthermore, global trade together with higher temperature and pollution can facilitate the spread of parasites. The aim of this study was to assess the potential effects of salinity, an abiotic stressor, and Scaphanocephalus sp. parasitic infection responsible for black spot disease, a biotic stressor, on Coris julis, a common fish in the Balearic Islands (Spain). Fish were sampled from an area affected by a desalination plant, one with a high rate of parasite infection and a control area, and biomarkers were analysed in the liver, gills and epithelial mucosa. Both salinity and the parasite induced increases in catalase (CAT) and glutathione s-transferase activities in the liver, while superoxide dismutase (SOD) did not show significant changes. The effects of salinity were evident to a greater extent in the gills with an increase in the activity of all enzymes, as well as in the production of reactive species. The effects of the parasite were mainly observed in the mucus with significant increases in CAT and SOD activities. Regarding immune response markers in the mucus, both stressors induced an increase in lysozyme and alkaline phosphatase activities, and in the case of the parasite, also an increase in immunoglobulins. Malondialdehyde, as an indicator of oxidative damage, remained unchanged. In conclusion, both abiotic and abiotic stress induce a stress situation in C. julis that responds by activating its antioxidant and immune defence mechanisms but does cause oxidative damage. The differential tissue response to different stressors highlights the value of analysing multiple tissues to detect early indicators of diverse impacts on marine fauna.

Optimizing central venous access devices insertion in thrombocytopenic patients: Balancing efficacy and safety.

Recently, the rising incidence of trauma, cancer, and critical illnesses has led to a growing necessity for Central Venous Access Devices (CVADs). Inserting CVADs in thrombocytopenic patients is still challenging. This study tries to shed light on the safety and associated risks of CVADs insertion in this high-risk group, with the ultimate goal of informing clinical practice and aiding in decision-making processes. This study was conducted as prospective cohort study from September 2020 to September 2023 in Mazandaran University of Medical Sciences, Iran. Individuals aged 18-80 years with a platelet count of less than 50,000/dL included and those designated for subcutaneous port procedures or on anticoagulant and antiplatelet therapy, excluded. Ultrasound-guided CVAD insertion using the Seldinger technique and SIC/FIC strategies performed for participants. Incidence of hemorrhagic complications post-CVAD insertion, requirement for blood product transfusions to amend platelet counts, frequency of non-bleeding complications, and complications related to blood product transfusions monitored. The study comprised 137 participants, 54% of whom were men, with an average age of 46.90 ± 15.70 years. No significant correlation was found between the site of CVAD placement (jugular vs femoral) and the incidence of major or minor bleeding. Femoral catheters were associated with a higher rate of infection. No complications related to transfusion of blood products or mortality seen, indicating that CVAD implantation can be safely performed in patients with thrombocytopenia or coagulation disorders. CVAD insertion in thrombocytopenic patients, even with platelet counts below 10 × 109/L, is safe and associated with minimal complications when performed under ultrasound guidance by experienced surgeons. This finding supports the use of a lower platelet count threshold for CVAD insertion than currently recommended in guidelines, potentially reducing the need for platelet transfusions prior to CVAD placement.

Use of routinely collected blood donation data for expanded HIV and Syphilis surveillance in Blantyre district, Malawi.

The World Health Organization recommends that all blood donations be screened for transfusion transmissible infections; these data are currently not incorporated into national disease surveillance efforts. We set out to use routinely collected data from blood donors in Blantyre district, Malawi to explore HIV and syphilis prevalence and identify sero-conversions among repeat donors. We conducted a retrospective cohort analysis of blood donation data collected by the Malawi Blood Transfusion Service from 2015 to 2021. All blood donations were routinely screened for HIV and syphilis. We characterized donor demographics as well as screening outcomes, including identifying sero-conversions among repeat donors who previously tested negative on their last donation. A total of 23,280 donations from 5,051 donors were recorded, with a median frequency of donations of 3 (IQR:2-6). Most donors were male (4,294; 85%) and students (3,262; 64.6%). Prevalence of HIV at first donation was 1.0% (52/5,051) and prevalence of syphilis was 1.6% (80/5,051); 52 HIV sero-conversions and 126 syphilis sero-conversions were identified, indicating an incidence rate per 1,000 person-years of 5.9 (95% CI: 4.7, 7.4) and 13.3 (95% CI:11.4, 15.4) respectively. Students had a lower prevalence of HIV and syphilis but higher risk of syphilis seroconversion. While blood donors are generally considered a low-risk population for HIV and syphilis, we were able to identify relatively high rates of undiagnosed HIV and syphilis infections among donors. Routinely collected data from national blood donation services may be used to better understand local HIV and syphilis epidemiology, with the potential to enhance disease surveillance systems. These findings may be used to identify priority prevention areas and populations in Blantyre district that can inform targeted interventions for improved disease prevention, testing and treatment.

Analysis of hepatitis B Virus Test results among blood donors in Chongqing, China

BackgroundHepatitis B virus (HBV) infection is a major concern regarding blood safety in countries with a high HBV prevalence, such as China. We aimed to understand the prevalence of HBV infection among blood donors in Chongqing and provide an important basis for developing appropriate blood screening strategies.MethodsDual enzyme-linked immunosorbent assays (ELISAs) for hepatitis B surface antigen (HBsAg) were conducted in parallel with nucleic acid testing (NAT) of donors. All HBsAg-reactive and/or HBV DNA-positive blood samples were tested for HBsAg and hepatitis B DNA levels.ResultsA total of 117,927 blood donor samples were collected from the Chongqing Blood Center between April 2020 and November 2020. In total, 473 HBV-ineligible samples were retained for HBsAg and DNA confirmation. A total of 272 samples were confirmed to be HBsAg+, including 2 HBV DNA − and 270 HBV DNA + samples. A total of 201 donations were HBsAg−, including 72 HBV DNA − samples. The rate of HBV infection was 65.33% (309/473) in men, which was significantly higher than that in women (p < 0.001). The HBV failure rate was higher among the first-time donors (p < 0.05). Of the 182 NAT R/HBsAg N/N samples (Nucleic acid test reactivity/2 anti-HBsAg tests negative), 37.91% (69/182) were false positives. The proportion of hepatitis B infections in the 18 NAT R/HBsAg N/R (Nucleic acid test reactivity/1 anti-HBsAg tests negative) samples was 94.44% (17/18), of which 50% (9/18) were occult HBV infection. A total of 95.83% (69/72) of the false positives were from the NAT R/HBsAg N/N group, and 58.33% (42/72) were first-time donors.ConclusionOur data showed a strikingly high HBV infection rate among blood donors in Chongqing. Double ELISA and single NAT can effectively prevent HBV leakage and improve blood safety. First-time donors have a high rate of HBV transplant failure; therefore, donors should be retained and recruited from low-risk groups.

Folklore and Sexuality Education: A Review of the Pedagogical Value of “Tselane le Dimo”

South African youths experience high rates of HIV infections and unintended pregnancies. In an effort to mitigate these challenges, the Department of Basic Education introduced Comprehensive Sexuality Education in its syllabus with an intention to equip learners with the necessary skills to manage their sexual behaviours. Despite this intervention, educators in the townships have been reluctant to teach this topic. Teachers’ reluctance is informed by cultural and religious sensitivities towards discussing sexual topics with minors. This article proposes that the reluctance towards teaching sexual education topics can be managed by relying on alternative methodologies of knowledge impartment. Since time immemorial, African societies have used folktales to impart knowledge between generations. We use a functional approach to evaluate the pedagogical value of “Tselane Le Dimo” in teaching sexuality education. We are conscious of the fact that the folktale does not contain explicit references to sex, but we argue through a sociological evaluation that the language used in the folktale references sex when it is viewed through the lens of colloquial language that is commonly used by youth. This article employs a qualitative approach in the evaluation of the pedagogical value of the folktale “Tselane le Dimo.” An interpretive phenomenological analysis is used to analyse the folktale. We use this analysis approach with the view that this folktale can be used as a tool for making sense of lived experiences. The findings indicate that words used in this folktale carry euphemistic value, which makes it possible to make references to sexual activities without being blunt about it.

One Year of Experience in the Orthopaedic and Trauma Surgical Care of War Refugees and Soldiers from Ukraine in a Maximum Care Trauma Centre.

According to the United Nations, around 8,400 people have been injured and over 5,800 killed on the Ukrainian side in the Ukraine war, which has been going on for over 14 months. Extensive humanitarian aid operations were carried out to support Ukraine, so that war-wounded people from Ukraine were also cared for in Germany. In a retrospective cohort study, 10 patients were examined who were treated in the department between February 24th 2022 and February 24th 2023, using the cloverleaf system from Ukraine.The average duration of inpatient treatment was 53.10 days. The average ISS was 23.7. The patients were operated on an average of 3.3 times in our institution. All patients received consultative psychological care. All patients were initially put into protective isolation until the results of a corona test and microbiological swabs were available. After preliminary protective isolation, further isolation had to be carried out in 5 cases due to germs requiring isolation. Eight patients were released to state accommodation. Three patients were transferred back to Ukraine at their own request.The treatment of war-injured patients from Ukraine represents a particular challenge. It absolutely requires an interdisciplinary treatment concept that, in addition to special trauma surgery and orthopaedic expertise, also requires plastic-reconstructive, microbiological and, last but not least, psychological care. Due to the high rate of infections requiring isolation, long, costly therapy with multiple revision operations is often necessary.

An outbreak of Mycoplasma pneumoniae in children after the COVID-19 pandemic, Shanghai, China, 2023.

During the coronavirus disease 2019 (COVID-19) pandemic, the infection of Mycoplasma pneumoniae (MP) decreased significantly. At the beginning of the summer of 2023, there was an increasing trend of MP infection in China and the MP pneumonia (MPP) is surging when it comes to the school season and lasts for several months which has attracted widespread attention. This study aims to investigate the prevalent characteristics of the MP and the difference between the COVID-19 pandemic and the post in Shanghai, China. The demographic information and the results of laboratory pathogen detection from July 2021 to May 2024 were collected and analyzed to find out the prevalent characteristics of MP. Two periods, during the COVID-19 pandemic and the post-pandemic, were divided and compared. The P1 genotyping and macrolide resistance-associated gene of 23 s rRNA were detected using the remaining MP-positive samples. During the COVID-19 pandemic, the prevalence of the MP has significantly decreased. Female children are more susceptible to MP infection than the male. The school-aged group (>6 years) had the highest infection rate. The rate of MP P1 genotype during post panel is higher than that during COVID-19 pandemic, which is dominant from July 2021 to May 2024, while the macrolide-resistant associated mutations (A2063G) keep high percentage during or post pandemic. After the COVID-19 pandemic, an outbreak of MP infection occurred from summer onwards in 2023 with children in Shanghai, China. Immunity debt and high rate of macrolide-resistance may take effects in this MP epidemic. Continuous surveillance of MP is necessary to help to alert the prevalence of MPP.

All-cause mortality and hospital admissions for nursing home residents during the COVID-19 pandemic: a Norwegian register-based cohort study

BackgroundThis paper investigates the consequences of the COVID-19 pandemic on mortality and hospitalization among nursing home residents in Norway. While existing evidence shows that nursing home residents were overrepresented among COVID-19-related deaths, suggesting inadequate protection measures, this study argues that the observed overrepresentation in mortality and hospitalization may partly stem from the inherent frailty of this demographic. Using nationwide administrative data, we assessed excess deaths and hospitalization by comparing pandemic-era rates to those of a pre-pandemic cohort.MethodsWe compared mortality and hospitalization rates between a pandemic cohort of nursing home residents as of September 2019 (N = 30,052), and a pre-pandemic cohort as of September 2017 (N = 30,429). Both cohorts were followed monthly for two years, beginning in September 2019 and 2017, respectively. This analysis was conducted at the national level and separately for nursing home residents in areas with low, medium, and high SARS-CoV-2 community transmission. Event studies and difference-in-difference models allowed us to separate the impact of the pandemic on mortality and hospitalization from secular and seasonal changes.ResultsThe pandemic cohort experienced a non-significant 0.07 percentage points (95% confidence interval (CI): − 0.081 to 0.221) increase in all-cause mortality during the 18 months following pandemic onset, compared to the pre-pandemic cohort. Moreover, our findings indicate a substantial reduction in hospitalizations of 0.27 percentage points (95% CI: − 0.464 to − 0.135) and a non-significant decrease of 0.80 percentage points (95% CI: − 2.529 to 0.929) in the proportion of nursing home residents hospitalized before death. The effect on mortality remained consistent across regions with both high and low levels of SARS-CoV-2 community transmission.ConclusionsOur findings indicate no clear evidence of excess all-cause mortality in Norway during the pandemic, neither nationally nor in areas with high infection rates. This suggests that early implementation of nationwide and nursing home-specific infection control measures during the pandemic effectively protected nursing home residents. Furthermore, our results revealed a decrease in hospitalizations, both overall and prior to death, suggesting that nursing homes adhered to national guidelines promoting on-site treatment for residents.

Risk factors for secondary infection after liver failure and effect of comprehensive nursing intervention.

In patients with liver failure (LF), the high rate of secondary infections, which are associated with poor prognosis, highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs. To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions. This retrospective study included 64 patients with LF, including 32 with and 32 without secondary infections. A questionnaire was used to collect data on age; laboratory parameters, including total and direct bilirubin, prothrombin time, blood ammonia, and other biochemical parameters; invasive procedures; and complications. Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care, whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes. The infection rate, which was not associated with age or complications, was significantly associated with biochemical parameters and invasive procedures (P < 0.05). The infection rate was 61.6% in patients who had undergone invasive procedures and 32.1% in those who had not undergone invasive procedures during the hospital stay. The infection rate was also significantly associated with the type of LF (P < 0.05), with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF. The nursing satisfaction rate was 58.3% in the uninfected group and 91.7% in the infected group, indicating significantly higher satisfaction in the infected group (P < 0.05). In patients with LF, the rate of secondary infections was high and associated with biochemical parameters and type of LF. Comprehensive nursing intervention can improve patient satisfaction.

Unraveling molecular mechanistic disparities in pathogenic visceral Leishmania resistance between reptiles and mammals through comparative transcriptomic analyses

Leishmaniasis is one of the most important neglected tropical parasitic diseases, manifesting various clinical forms depending on the parasite species and the genetic background of the host. In order to elucidate the underlying mechanisms of reptilian defense against pathogenic Leishmania species and to delineate the global gene expression profile alterations during host-pathogen interaction, we established experimental animal and cell models using both heterothermic lizards (Phrynocephalus przewalskii) and homothermic mammals (BALB/c mice) infected with pathogenic Leishmania infantum (high virulence HCZ strain) and Leishmania donovani (low virulence 801 strain). Overall, the lizards didn't show any obvious clinical symptoms or immune responses in vivo. Using RNA-seq methodology, differentially expressed genes identified in the HCZ and 801-comparison groups of P. przewalskii were primarily associated with arginine biosynthesis, the MAPK signaling pathway and the PI3K-Akt signaling pathway. In contrast, higher parasite loads, exacerbated hepatic inflammatory lesions and enhanced immune responses were observed in BALB/c mice, with DEGs predominantly associated with immunological diseases, innate and adaptive immune responses. By integrating transcriptional data from reptile and mammalian hosts, we elucidated the pivotal role of amino acid metabolism and lipid metabolism in parasite control. In contrast to findings from animal experiments, Leishmania parasites effectively infected peritoneal macrophages of lizards in vitro, demonstrating a high infection rate. Furthermore, we used RT-qPCR to detect changes in cytokine expression in macrophages and found that Th1-type cytokines were significantly upregulated in lizards, facilitating the clearance of the HCZ strain 24 hours post-infection. Conversely, cytokine expression was generally suppressed in BALB/c mice, allowing immune evasion by the parasites.

Prevalence and genotype distribution of HPV combined with cervical pathological results in women from Sichuan, China: A cross-sectional study based on post-vaccination period 2019 to 2023.

Human papillomavirus (HPV) screening and vaccination exert efficacy in controlling the progression of cervical cancer. Thus, examinations into HPV prevalence, age-stratified specificity, genotype distribution, and their correlation with pathological outcomes can furnish robust evidence for customizing high-quality population screening and management. A cohort of 17,923 women attending clinics in the Jintang area, Sichuan, from January 2019 through August 2023 were enrolled in the study. Genotyping of HPV was conducted using real-time polymerase chain reaction (RT-PCR). The epidemiology and the relationship between HPV infection and histologic/cytologic abnormalities were subjected to analysis. HPV infection was identified in 4387 women. The outpatient group exhibited a significantly higher HPV infection rate compared to the healthy examination group (26.5% vs. 17.5%, p < 0.05). The distribution of infection rates across different age groups exhibited a U-shaped pattern, with the highest infection rate in the group ≤20 years of age, succeeded by those >60 years of age. The 31-40 age group demonstrated the lowest prevalence of infection, but upon infection, its prevalence of the precancerous lesion CIN2-3 reached a maximum of 29.0%, constituting a novel finding. The most prevalent genotype was HPV52, followed by HPV16, 58, 53, 68, and 18. In the cytologic and histologic abnormalities group, the most common types were HPV52, 16, and 58. HPV16 predominantly appeared in high-grade intraepithelial neoplasia and carcinoma insitu, constituting over 60% of cases. While HPV type 52 was not individually detected in cervical cancer cases. And some other non-vaccine-covered HPV subtypes also showed high prevalence in Sichuan. The single infection rates of NH9-HPV (high-risk HPV subtypes covered by the non-nine-valent vaccine) in CIN2-3 and cervical cancer patients were 6.5% and 2.6%, respectively. Among them, HPV51, HPV53, HPV59, and HPV35 exhibited a significant preponderance, which even higher than HPV45 and HPV31 covered by the nine-valent vaccine types. And in NL9-HPV (low-risk HPV subtypes covered by the non-nine-valent vaccine), HPV42 accounted for the highest percentage in CIN2-3. A similar decreasing trend was observed in annual infection rates in the healthy examination population and in the 31-40 and 51-60 age groups, while the ≤20 age group showed an increase. Regarding type-specificity, HPV16 and HPV58 exhibited the most rapid declines. This study furnishes the latest insights into the characteristics of HPV infection rate, age distribution, and genotype prevalence in Sichuan.

High Rates of Nosocomial Infections and Antimicrobial Resistance in a Moroccan PICU: A Cause for Alarm

IntroductionThis study aimed to determine the epidemiology of nosocomial infections (NI), in a pediatric intensive care unit (PICU) and to define the risk factors associated with NI. MethodsWe performed a prospective descriptive and analytical monocentric study on the incidence of NI in PICU, between July 2021 and May 2022. Children with NI (cases) were compared with a matched controls without NI. Results: We analyzed 396 patients; 102 had NI. The global incidence of nosocomial infection is 44.7 % (incidence density of 10.6 per 1000 days of hospitalization). The incidence densities of Blood Stream infection, Pneumonia associated with mechanical ventilation, and urinary tract infection were 10/ 1000 days of CVC, 7,2/ 1000 of mechanical ventilation, and 11,1/ 1000 days urinary catheter. The overall microbiological profile of nosocomial infections is dominated by Gram negative bacilli in 78 % followed by Gram positive Cocci in 13 %. The most common agents in sepsis were Klebsiella pneumoniae. In pneumonias Acinetobacter Baumanii was the most common cause, and in UTI the most frequent agents were BGN especially Escherichia Coli (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, mechanical ventilation, bladder catheters), and use of antibiotics. ConclusionsThe incidence of NI acquired in this unit was high and was associated with extrinsic and intrinsic factors.

Nurse-Driven Process for the Successful Removal of Urinary Catheters Among Elderly Patients After Hip Fracture Surgery: A Quality Improvement Project.

Hip fracture is a major health concern and the use of an indwelling urinary catheter (IUC) constitutes a significant burden on elderly patients undergoing hip fracture surgery. The institution had a high rate of urinary tract infection (UTI) and IUC reinsertion after hip fracture surgery. A pre/post-implementation design was used for this quality improvement initiative. A nurse-driven process was developed and implemented to improve the successful removal of IUC among patients after hip fracture surgery. There was a significant reduction in post-operative urinary retention (P =.042), UTI rate (P =.047), and IUC reinsertion (P =.042) in the post-implementation group. IUC duration decreased by 1.1days, however this was not significant (P =.206). Nurse compliance with following the new process was 93.3%. The nurse-driven process designed for elderly patients following hip fracture surgery presents a promising approach to reducing IUC reinsertion rates and UTI.

COVID-19 infection and 2-year mortality in nursing home residents who survived the first wave of the pandemic

BackgroundDuring the first COVID-19 pandemic wave (1st CoPW), nursing homes (NHs) experienced a high rate of COVID-19 infection and death. Residents who survived the COVID-19 infection may have become frailer. This study aimed to determine the predictive value of having a COVID-19 infection during the 1st CoPW for 2-year mortality in NH residents.MethodsThis was a retrospective study conducted in three NHs. Residents who had survived the 1st CoPW (March to May 2020) were included. The diagnosis of COVID-19 was based on the results of a positive reverse transcriptase-polymerase chain reaction test. The collected data also included age, sex, length of residence in the NH, disability status, legal guardianship status, nutritional status, need for texture-modified food, hospitalization or Emergency Department visits during lockdown and SARS-COV2 vaccination status during the follow-up. Non-adjusted and adjusted Cox models were used to analyse factors associated with 2-year post-1st CoPW mortality.ResultsAmong the 315 CoPW1 survivors (72% female, mean age 88 years, 48% with severe disability), 35% presented with COVID-19. Having a history of COVID-19 was not associated with 2-year mortality: hazard ratio (HR) [95% confidence interval] = 0.96 [0.81–1.13], p = 0.62. The factors independently associated with 2-year mortality were older age (for each additional year, HR = 1.05 [1.03–1.08], p < 0.01), severe disability vs. moderate or no disability (HR = 1.35 [1.12–1.63], p < 0.01) and severe malnutrition vs. no malnutrition (HR = 1.29 [1.04–1.60], p = 0.02). Considering that vaccination campaign started during the follow-up, mortality was associated with severe malnutrition before and severe disability after the start of the campaign. Vaccination was independently associated with better survival (HR 0.71 [0.55–0.93], p = 0.02).ConclusionsHaving survived a COVID-19 infection during the 1st CoPW did not affect subsequent 2-year survival in older adults living in NHs. Severe malnutrition and disability remained strong predictor of mortality in this population, whereas vaccination was associated to better survival.

The first report of digenean infecting short mackerel (Rastrelliger brachysoma) from Chon Buri Province, the Gulf of Thailand

Rastrelliger brachysoma (Bleeker, 1851), the short mackerel, is a dietary staple and of significant economic demand in Southeast Asia and Thailand. However, the demand for short mackerel has precipitated an overfishing crisis, leading to a depletion of fish stocks. Overfishing, coupled with parasitism, may result in a decline in the population of R. brachysoma. Digenetic trematode infection is prevalent in marine fish and has a considerable impact on the overall health of the fish. Here, to identify digenetic trematodes infecting R. brachysoma, we aim to determine the identity, prevalence, and intensity of digenean infections in R. brachysoma from the Gulf of Thailand. A total of 194 short mackerel were obtained from Chon Buri Province, where digeneans were isolated and identified. The molecular identity of the digeneans was confirmed using the nuclear 28S rRNA gene. Of the 194 short mackerel, 100% were found to be infected with digeneans, comprising of Lecithocladium, Prodistomum, Opechona, and Aphanurus. Lecithocladium was the most prevalent (98%) and had the highest intensity of infection (37 mean intensity), followed by Prodistomum (75% prevalence and 17 mean intensity). Our study thus presents the first evidence of digeneans infecting the economically important short mackerel from the Gulf of Thailand. The high infection rate of digenetic trematodes may have implications on the health of R. brachysoma, further driving their population decline. These data underscore the importance of safeguarding fisheries resources in the Gulf of Thailand, and downstream conservation efforts are crucial for evidence-based management decisions to safeguard the long-term sustainability of fish resources.

The Effect of Warm Water Compress on the Vagina on the Healing of Perinium Wounds in Post Partum Mothers

Background: Based on data from the World Health Organization (WHO) in 2017, around 830 women died every day due to complications during pregnancy or childbirth. In Indonesia, 75% of women who give birth vaginally experience perineal wounds and some of these wounds have the potential to become infected. In the Tanjung Emas Community Health Center working area, out of 23 post partum mothers, 4 people (27%) experienced slow wound healing. One cause of infection is poor perineal care. The cause of the high infection rate is due to a decrease in the body's resistance in mothers who are susceptible to infection. To reduce the risk of maternal death globally from 216.1 million live births in 2015 to 70 per 100,000 live births in 2030.Purpose:The purpose of this research is to determine the effect of warm water compresses on the vagina on healing perineal wounds in post-partum mothers. Methods: The design of this research is a two-group post test only control group design. The population in this study was all postpartum mothers (0-40 days) from December-March 2024 who gave birth in the Tanjung Emas Community Health Center Working Area, namely 23 people. The sampling technique used is a non-probability sample using the sampling technique method in this research using purposive sampling, namely 8 intervention groups and 8 control groups.Results: The results of this study were that the average wound healing was 5.5 and in the Control Group 6.5 days with a mean difference of 1 day and SD = 0.926. The results of calculations using the Paired T-Test showed p value = 0.039 (p 0.05), which means Ho is rejected and Ha is accepted, meaning there is a significant influence between the effect of warm water compresses on the vagina on healing perineal wounds.Conclusion: Further research may be carried out to develop research on other effective methods for healing perineal wounds in pregnant women.

Features of Consistent Powassan Virus Lineage II Focus in Southern Maine, United States.

Powassan virus lineage II or deer tick virus (DTV) is a rare but increasingly reported human infection in the United States transmitted by Ixodes scapularis ticks. The virus is thought to be maintained in environmental foci that are optimal for tick and vertebrate reservoirs, but details on DTV ecology are poorly understood. We investigated DTV tick infection rates and reservoir host abundance in a focus of consistent DTV activity in Maine, USA. Host and tick abundance, vegetation, and microclimate conditions were measured in three forest sites representing increasing invasive understory infestation. Sites were selected representing native understory, mixed vegetation with some invasive Japanese barberry (Berberis thunbergii), and a highly invasive site dominated by Japanese barberry. Japanese barberry in the mixed vegetation site averaged 1 m in height with space between plants, whereas the highly invasive site had impenetrable Japanese barberry over 1.5 m. The DTV infection rate was greater in the highly invasive site. Density of I. scapularis ticks were significantly lower in the native forest site, and no DTV was found. Another feature of the DTV focus was more stable humid microclimate throughout the year compared with the other sites and a nearby continuous section of forest, consistent with reports from Connecticut, USA. We conclude that invasive Japanese barberry stands provide favorable and consistent microclimate conditions to maintain high DTV infection rates annually among questing I. scapularis ticks. Understanding environmental and landscape features that support high infection rates could lead to the identification of high-risk habitats for contracting DTV.

Etiology of bloodstream infections among pediatric patients in Bauchi metropolis, north-east Nigeria

Background: The prevalence of bacterial infections in children is increasing by the day, this gives a cause for concern regarding the high rate of bloodstream infection (BSI) and associated mortality in developing countries. Physical signs and symptoms may be useful but have limited specificity which would be addressed with bacteriologic blood culture. This study was aimed at determining the etiologic agents of bacteremia and the prevalence in pediatric patients aged 0-5years. Methods: Two hundred and sixty- two (262) blood samples were analyzed from children aged 0-5years, attending hospitals within Bauchi metropolis with features suggestive of septicemia. Samples were collected under aseptic conditions and automated blood culture was done on BacT/ALERT 3D Biomerieux, Germany. Positive blood culture was sub-cultured on blood agar and MacConkey agar and identified on Vitek2 (bioMѐrieux, France) automated system after gram staining. Changes in pathogen distribution according to age and gender were determined by the chi-square test and statistical significance confirmed if a two-tailed p-value was not more than 0.01. Results: Bacteria was isolated in 119 (45.4) of samples with highest rate among neonates 54(45.3). Staphylococcus aureus 21 (17.6) was the most predominant organism isolated across all age groups with a higher occurrence in patients&lt;1year old. A chi-square test of independence for culture positivity and age/gender at p&lt;.01 was not significant Conclusion: In this study both Gram-positive and Gram-negative bacteria are implicated in pediatric bloodstream infections. Staphylococcus aureus was the most predominant organism followed by members of the Enterobacterales (Enterobacter spp, Klebsiella spp and Escherichia coli).

Knee fusion versus above knee amputation as two options to deal with knee periprosthetic joint infection.

Periprosthetic joint infection (PJI) poses a significant challenge in total knee arthroplasty (TKA), with recurrence rates as high as 14-28%, leading to substantial morbidity and treatment costs. When conventional treatments fail, knee fusion and above-the-knee amputation (AKA) emerge as alternative options. Existing literature offers conflicting views on the efficacy and impact of knee fusion versus AKA with varied outcomes and limitations. This retrospective national study spanning 2010-2022 investigates Knee Fusion and AKA as options for addressing Knee PJI. Utilizing PearlDiver Patient Records Database, procedural, and reimbursement data on over 100million individuals from all the US was evaluated. Readmission rates, costs, and complications of the mentioned procedures were assessed using ICD-9 and ICD-10 codes within a 90-day period and one-year post-operation. Statistical analyses, including chi-square tests and regression models, were conducted using integrated R software. The study reveals a substantial escalation (p < 0.0001) in the proportion of patients opting for AKA compared to arthrodesis. While age as a demographic factor showed no significant difference, arthrodesis patients exhibited lower comorbidity scores (3.6 ± 2.9 vs. 4.6 ± 3.4, p < 0.001). Arthrodesis correlated with higher 90-day thromboembolism rates (9.2% vs. 7.3%, p < 0.001), blood transfusion requirements (23.2% vs. 14.4%, p < 0.001), and acute renal failure incidence (p = 0.008) but demonstrated lower rates of urinary tract infections (p = 0.047) and cerebrovascular accidents (p < 0.001). At 1 year, arthrodesis was associated with higher infection rates (38.7% vs. 36.4%, p < 0.001). Arthrodesis patients had significant increased 90-day and 1-year readmission rates and hospitalization costs ($12,732 vs. $18,826, p < 0.001). We found higher rates of 1-year thromboembolism, infection, acute renal failure, and readmission in the arthrodesis group. AKA patients had more sepsis and cerebrovascular accidents. A patient-centered conversation is best for persistent infections and failed revision TKA. Considering the patient's quality of life, goals, and health status, this discussion should cover each procedure's risks and complications.

Prevalence of Intestinal Helminthes among School-Aged Children in Ife Central Local Government, Nigeria: Implications for Targeted Interventions

Background: Soil-transmitted helminths (STHs) are a major health concern for children in developing countries. This study assesses the prevalence and intensity of STHs among pupils in private nursery and primary schools in Ile-Ife, Nigeria. Methods: The study was conducted in Ife Central LGA, Osun State, Nigeria, involving preschool and school-aged children from two private schools. A total of 55 samples, from 22 male and 33 female pupils, were analyzed for intestinal parasite ova to determine the prevalence of helminth infections among the children. Ethical approval was obtained from the Institute of Public Health, Obafemi Awolowo University, Ile-Ife. Consent was secured from parents or guardians. Samples were processed using the modified Kato-Katz technique and examined microscopically for soil-transmitted helminth (STH) eggs. Data was analyzed using descriptive statistics and chi-square tests, with significance set at p &lt; 0.05. Results: Among the 55 fecal samples collected, the overall prevalence of soil-transmitted helminth (STH) infections was 78.2%. Ascaris lumbricoides were the most prevalent helminth (76.4%), followed by Trichuris trichiuria (14.5%) and hookworms (5.5%). Females had a higher infection rate (81.8%) than males (68.2%). The prevalence of STH infections was highest among pupils aged ≥10 years (81.8%) and lowest among those aged 2-3 years (66.7%). Conclusion: This study highlights a significant burden of STH infections, particularly A. lumbricoides, among schoolchildren in Ile-Ife, Nigeria. The high prevalence necessitates targeted deworming and improved sanitation interventions to reduce the burden of these infections among children in this region.