Implementation Of Preventive Measures Research Articles

A cross-sectional study of SARS-CoV-2 antibodies among healthcare workers in a tertiary care hospital in Taiwan: implications for protection against the Omicron variants

BackgroundTaiwan, deeply impacted by the 2003 SARS outbreak, promptly implemented rigorous infection control and prevention (ICP) measures in January 2020 to combat the global COVID-19 pandemic. This cross-sectional serologic study was conducted among healthcare workers (HCWs) in a tertiary care hospital in Taiwan from August 1, 2022, to February 28, 2023. The study aimed to assess HCWs’ antibody responses to COVID-19 vaccination against Omicron subvariants BA.1, BA.4, and BA.5, considering variations in prior infection. Additionally, it evaluated the effectiveness of ICP and vaccination policies within the hospital setting in Taiwan.MethodsA cross-sectional serology study was conducted in Taiwan to investigate the seroprevalence rates of Omicron subvariants BA.1, BA.4, and BA.5 among HCWs. A total of 777 HCWs participated in this study. A structured questionnaire was collected to obtain the epidemiological characteristics and risk factors for potential exposure. Enzyme-linked immunosorbent assay was used to detect antibody responses. Serum samples were selected for protection against Omicron subvariants BA.1, BA.4, and BA.5 by using a pseudotyped-based neutralization assay.ResultsMore than 99% of the participants had received SARS-CoV-2 vaccination. Overall, 57.7% had been infected with SARS-CoV-2, with some being asymptomatic. The SARS-CoV-2 Anti-Spike S1 protein IgG (Anti-S) distribution was 40,000 AU/mL for 20.2% (157/777) of participants, with a mean ± standard deviation of 23,442 ± 22,086. The decay curve for Anti-S was less than 20,000 AU/ml after 120 days. The probability curve of 50% neutralization showed an Anti-S of 55,000 AU/ml. The optimum Anti-S was 41,328 AU/mL (equal to 5,869 WHO’s standard BAU/mL), with 86.1% sensitivity and 63.5% specificity.ConclusionsIn this significant study, 20.2% of HCWs achieved seroprotection against Omicron subvariants BA.1, BA.4, and BA.5. Their immunity against Omicron subvariants was further reinforced through recommended vaccinations and the development of natural immunity from SARS-CoV-2 exposure, collectively enhancing their protection against Omicron.

Maintenance of peri-implant health in general dental practice

The long-term maintenance or restoration of peri-implant tissues‘ health depends on the strategic implementation of preventive measures and interventions. These measures should be initiated before implant placement and continued throughout a patient's lifetime, as part of a tailored and comprehensive supportive peri-implant care (SPIC) programme. Central to the clinical efforts of maintaining and rehabilitating peri-implant tissues are several key factors, including the ongoing assessment and frequent monitoring of tissue health and stability, proactive oral health promotion, the control of risk factors and indicators and the provision of professional plaque biofilm removal. It is of paramount importance to underline that SPIC should not limit its scope exclusively to patients already in a state of peri-implant health; in fact, it is imperative that it should extend its protective effect to individuals who have been previously diagnosed and treated for peri-implant diseases, focusing on preventing its recurrence and progression, thereby avoiding further complications, such as implant loss.This narrative review presents an overview of the current literature on the maintenance of peri-implant tissues‘ health and the steps of SPIC providing insights into the critical factors to be considered when managing dental implant patients in the general dental practice.

Perioperative Management in Neuromuscular Diseases: A Narrative Review.

Patients with neuromuscular diseases are particularly vulnerable in the perioperative period to the development of pulmonary and cardiac complications, or medication side effects. These risks could include hypoventilation, aspiration pneumonia, exacerbation of underlying cardiomyopathy, arrhythmias, adrenal insufficiency, prolonged neuromuscular blockade, issues related to thermoregulation, rhabdomyolysis, malignant hyperthermia, or prolonged mechanical ventilation. Interventions at each of the perioperative stages can be implemented to mitigate these risks. A careful pre-operative evaluation may help identify risk factors so that appropriate interventions are initiated, including cardiology consultation, pulmonary function tests, initiation of noninvasive ventilation, or implementation of preventive measures. Important intraoperative issues include positioning, airway and anesthetic management, and adequate ventilation. The postoperative period may require correction of electrolyte abnormalities, control of secretions with medications, manual or mechanical cough assistance, avoiding the risk of reintubation, judicious pain control, and appropriate medication management. The aim of this review is to increase awareness of the particular surgical challenges in this vulnerable population, and guide the clinician on the various evaluations and interventions that may result in a favorable surgical outcome.

Identification of patients' smoking status using an explainable AI approach: a Danish electronic health records case study.

Smoking is a critical risk factor responsible for over eight million annual deaths worldwide. It is essential to obtain information on smoking habits to advance research and implement preventive measures such as screening of high-risk individuals. In most countries, including Denmark, smoking habits are not systematically recorded and at best documented within unstructured free-text segments of electronic health records (EHRs). This would require researchers and clinicians to manually navigate through extensive amounts of unstructured data, which is one of the main reasons that smoking habits are rarely integrated into larger studies. Our aim is to develop machine learning models to classify patients' smoking status from their EHRs. This study proposes an efficient natural language processing (NLP) pipeline capable of classifying patients' smoking status and providing explanations for the decisions. The proposed NLP pipeline comprises four distinct components, which are; (1) considering preprocessing techniques to address abbreviations, punctuation, and other textual irregularities, (2) four cutting-edge feature extraction techniques, i.e. Embedding, BERT, Word2Vec, and Count Vectorizer, employed to extract the optimal features, (3) utilization of a Stacking-based Ensemble (SE) model and a Convolutional Long Short-Term Memory Neural Network (CNN-LSTM) for the identification of smoking status, and (4) application of a local interpretable model-agnostic explanation to explain the decisions rendered by the detection models. The EHRs of 23,132 patients with suspected lung cancer were collected from the Region of Southern Denmark during the period 1/1/2009-31/12/2018. A medical professional annotated the data into 'Smoker' and 'Non-Smoker' with further classifications as 'Active-Smoker', 'Former-Smoker', and 'Never-Smoker'. Subsequently, the annotated dataset was used for the development of binary and multiclass classification models. An extensive comparison was conducted of the detection performance across various model architectures. The results of experimental validation confirm the consistency among the models. However, for binary classification, BERT method with CNN-LSTM architecture outperformed other models by achieving precision, recall, and F1-scores between 97% and 99% for both Never-Smokers and Active-Smokers. In multiclass classification, the Embedding technique with CNN-LSTM architecture yielded the most favorable results in class-specific evaluations, with equal performance measures of 97% for Never-Smoker and measures in the range of 86 to 89% for Active-Smoker and 91-92% for Never-Smoker. Our proposed NLP pipeline achieved a high level of classification performance. In addition, we presented the explanation of the decision made by the best performing detection model. Future work will expand the model's capabilities to analyze longer notes and a broader range of categories to maximize its utility in further research and screening applications.

Spatial distribution and environmental correlations of Culex pipiens pallens (Diptera: Culicidae)in Haidian district, Beijing.

Culex pipiens pallens Coquillett, 1898(Diptera: Culicidae)was the dominant health threat to mosquito species in Beijing, and it is important to unravel the spatial distribution and environmental correlations of Cx. pipiens pallens in Beijing. 3S technology methods and spatial statistics were used to clarify the distribution pattern. Subsequently, linear and spatial regression were performed to detect the environmental factors linked with the density of Cx. pipiens pallens. The same "middle peak" spatial distribution pattern was observed for Cx. pipiens pallens density at the community, subdistrict, and loop area levels in our study area. In addition, there were various correlated environmental factors at the community and subdistrict scales. At the community scale, the summary values of the Modified Normalized Difference Water Index (MNDWI) in 2 km buffer zone (MNDWI_2K) were negatively correlated, and the summary values of Normalized Difference Built-up Index (NDBI) in 800 m buffer zone (NDBI_800) was positively correlated to the Cx. pipiens pallens density. However, the summary values of Normalized Difference Vegetation Index and Nighttime Light Index significantly affected Cx. pipiens pallens density at the subdistrict scale. Our findings provide insight into the spatial distribution pattern of Cx. pipiens pallens density and its associated environmental risk factors at different spatial scales in the Haidian district of Beijing for the first time. The results could be used to predict the Cx. pipiens pallens density as well as the risk of lymphatic filariasis (LF) infection, which would help implement prevention and control measures to prevent future risks of biting and LF transmission in Beijing.

Global Re-emergence of Monkeypox: A Synoptic Review

AbstractAs the coronavirus disease 2019 pandemic continues to rage, the unprecedented manifold increase in monkeypox (mpox) cases throughout the world is raising qualms about a possible pandemic. As of January 2024, the disease has been reported in around 116 countries, with nearly 92,500 confirmed cases and 170 deaths. In this mini-review, we have endeavored to cover multiple aspects of the mpox disease. Mpox virus is an enveloped double-stranded DNA virus that belongs to the Orthopoxvirus genus. The disease is endemic in certain African countries. Until recently, however, the disease was rarely reported in Europe and the United States. In contrast to the previous outbreaks outside Africa, reported cases in the 2022 outbreak did not travel to the endemic areas. Superspreading events at mass gatherings, multiple-partner sexual encounters, and international travel were major drivers of the recent global outbreak of mpox. The 2022 mpox virus may have undergone accelerated evolution. It diverges from the related 2018 to 2019 viruses by around 50 single-nucleotide polymorphisms, some of which brought about amino acid changes in immunogenic surface glycoprotein B21. Differential diagnosis for mpox could be quite challenging since it can masquerade as a wide variety of illnesses. Worse still, some patients may be asymptomatic or show subtle symptoms. The infection is confirmed by conventional or real-time polymerase chain reaction on lesion material. Although there is no specific therapy approved for mpox infections, two antivirals (tecovirimat and brincidofovir) and vaccinia immune globulin may be used. Vaccines also provide protection against mpox when properly administered prior to exposure. Finally, the implementation of preventive measures is of paramount importance, especially in regions where mpox transmission is widespread and among high-risk populations.

Incidence and Factors Associated with Falls in Older People in a Long-Term Care Facility: A Prospective Study in Taiwan.

The effectiveness of applying a fall-risk assessment to prevent falls in residents of long-term care facilities has not been investigated. This prospective study enrolled elderly residents in a long-term care facility in Taiwan. Caregivers were provided with a health-status assessment and fall-risk data to enhance their fall-prevention practices. A multivariate analysis was performed to identify the factors associated with falls. A total of 123 subjects, including 68 and 55 for general and nursing-care models, respectively, were assessed. Their health status and risk of falls were provided to the care units to enhance their fall-prevention practices. Subjects in the nursing-care model had more dementia and more prescribed medications, worse physiologic conditions, and higher fall risk. Of them, 28 (23%) had subsequent falls. A univariate analysis showed that those with and without falls were similar in demographic characteristics, prescribed medications, physiologic function, and fall risk. There was a tendency for more falls in the nursing-care model residents (accounting for 61% of those who fell; p = 0.053). A regression analysis showed that gender (beta = 1.359; 95% confidence interval = 0.345-2.374; p = 0.010) and NPI score (beta = 0.101; 95% CI = 0.001-0.200; p = 0.047) were associated with the risk of falls. Residents at the long-term care facility had a significant risk of falls despite knowledge of their fall risk and the implementation of preventive measures. In this context of being aware of the risk, gender, and psychiatric symptoms were significantly associated with falls. Caregivers at long-term care facilities should implement further measures to prevent falls based on behavioral and psychological symptoms.

308 Awardee Talk: Prevention and mitigation of pathogens in feed and feed manufacturing systems

Abstract Prior to 2013, pathogen transmission through feed was focused primarily on bacteria and biosecurity was used to prevent adulterant entry into the ingredients and the feed mills. Following the porcine epidemic diarrhea virus (PEDV) outbreak in 2013, research focused on pathogen mitigation and control quickly became a subject of interest. Since PEDV, multiple endemic viruses and foreign animal diseases have been found to be transmissible in feed or feed ingredients. As African swine fever virus (ASFV) spread closer to the United States and endemic pathogens are a continued pressure on production systems, it is imperative that prevention measures are included in the feed supply chain and options for mitigation are fully elucidated for times of need. Previous research has demonstrated that preventative measures such as boot baths, lines of separation, showers, and changing clothes are effective measures when appropriately maintained. However, these protocols can seem costly and burdensome to employees, especially when the risk of disease transmission appears low. Employee training is difficult as disease transmission is difficult to visualize and exhibit the importance of each measure. Glo Germ, a florescent substance, is a cost-effective training tool which can demonstrate the efficacy of prevention protocols and can identify areas where biosecurity measures have not been properly utilized. Preventative measures are the first line of defense for feed manufacturing systems, but understanding and using mitigation techniques in the event of contamination can limit pathogen spread and protect the rest of the feed supply chain. Pelleting, as a method of thermal inactivation process, has recently been demonstrated to lessen the quantity of detectable viral RNA and decrease the risk of infection. The pelleting process, however, is a point-in-time mitigant and does not decrease the risk of product re-contamination as feed continues down the supply chain. The use of chemical mitigants, like formaldehyde, medium-chain fatty acids, and organic acids, can decrease the presence of bacterial and viral pathogens with longer-lasting mitigation properties. These mitigants can either be used in the feed itself, or as an addition to flushing batches which help disperse the chemical mitigants throughout the feed manufacturing equipment, thus reducing the risk of product re-contamination. In the event more drastic measures must be taken to eliminate pathogen presence from feed mills, gaseous fumigation and the use of portable heaters show promise as methods to decontaminate feed manufacturing equipment without the use of water or complete equipment breakdown. Overall, effective training and implementation of preventative measures are needed to provide pathogen-free feed to production systems, but continued research in mitigation and mill decontamination will further protect the feed supply chain in the event of pathogen contamination.

To study the awareness of needle stick injuries among healthcare workers in an area select of tertiary care hospital

Background: Needle stick injuries, or NSIs, refer to injuries produced by several types of needles, including hypodermic needles, blood collection needles, intravenous stylets, and needles used for connecting components of intravenous administration systems. Aims and Objectives: The study aimed to study the awareness of NSIs among healthcare workers (HCWs) in a selected area of a tertiary care hospital. Materials and Methods: A cross-sectional study was undertaken within the department of obstetrics and gynecology (OBG). The study’s target group was all HCWs of varied experience levels (n=272). This study employed a meticulously crafted questionnaire in the English language. The survey includes 22 items covering a variety of NSI-related topics. Subgroup analysis was conducted using the Pearson Chi-square test. Results: It was found that most of them were in the 20–30 age group (75%), the majority were females (72%), unmarried (61%), and from an urban background (85%). Almost all the participants (96%) were aware that NSIs are preventable. Similarly, 90% of the participants were aware that NSIs may cause the transmission of diseases, and 77% of the participants reported that they have training on biomedical waste management and its disposal. About 74% of the respondents stated that they had been exposed to NSIs. Conclusion: This study sheds light on the awareness levels and experiences of HCWs regarding NSIs in the OBG department. While a high level of awareness was observed, the study identified areas for improvement in the implementation of preventive measures, reporting practices, and post-exposure management.

Attention deficit hyperactivity disorder and dental traumatic injuries: a systemic review and meta-analysis.

The objective of this study was to assess whether individuals with attention deficit hyperactivity disorder (ADHD) exhibit a higher prevalence of traumatic dental injuries (TDIs) compared to those without ADHD through a systematic review and meta-analysis of the existing literature. A search strategy using the Medical Subject Heading (MeSH) vocabulary was employed for a comprehensive search across various databases, including PubMed, Scopus, Web of Science, Cochrane Library, and Embase. The Joanna Briggs Institute Summary was utilized for data collection. Additionally, quality assessment, meta-analysis, and bias control were conducted to ensure the reliability of the included studies. A meta-analysis was performed to consolidate the findings of the individual studies. The prevalence of TDIs among individuals with ADHD ranged from 9.6% to 68.2%, while in the healthy control group, it ranged from 0.8% to 44.7%. The meta-analysis findings revealed that individuals with ADHD had 1.98 times higher odds (OR = 1.98, ranging from 1.51 to 2.59 with 95% CI) of experiencing TDIs compared to individuals without ADHD. The findings of this study suggest a significant association between ADHD and an increased risk of TDIs. Individuals with ADHD were found to be nearly twice as likely to experience TDIs compared to those without ADHD. Efforts should not only be directed towards improving the oral health of this vulnerable group of individuals, but also healthcare practitioners need to be provided with opportunities to create awareness and implement preventive measures to mitigate the risk of TDIs among individuals with ADHD.

THE IMPORTANCE OF PARENTAL INVOLVEMENT IN THE ORAL HYGIENE OF CHILDREN AGED 3-5 YEARS

Given the high prevalence of caries in deciduous and permanent teeth in children worldwide, it is necessary to expand educational programs for students at various levels, to engage in health education initiatives targeting parents, teachers, and policymakers. Such efforts aim to foster interest and awareness among stakeholders involved in shaping health policies. Our study aimed to assess the efficacy of the "Form for recording oral hygiene skills of children aged 3 to 5 years," developed by our team, as a means to enhance children's oral hygiene proficiency. Following the implementation of preventive measures in the first group, we observed a notable enhancement in the oral hygiene index, decreasing from 1.71 to 1.55 points between the initial and final assessments. This improvement correlates with the advancement of children's practical skills with age, alongside the active involvement of parents in their children's oral care routines. In the second group, the hygiene index significantly worsened with each examination. A comparison of this index between the groups at the second and third examinations revealed a significant difference. Children were also divided into groups, which we monitored according to the state of oral hygiene. In the first group, 45.7% of children had good oral hygiene during the first examination, 53.3% during the second, and 72.4% during the third. This rise can be attributed to a decrease in cases of children exhibiting poor hygiene, dropping from 20% to 6.9%. In the second group, children with good hygiene decreased from 51.4% to 28%. The group average remained satisfactory at each visit, but the number of children with poor hygiene increased from 14.3% to 52%. All of the above is aimed at reducing caries of temporary teeth, which is the main unresolved issue of modern pediatric dentistry.

Multistate outbreaks of salmonellosis linked to contact with backyard poultry-United States, 2015-2022.

Contact with backyard poultry (i.e., privately-owned, non-commercial poultry) was first associated with a multistate outbreak of salmonellosis in 1955. In recent years, backyard poultry-associated salmonellosis outbreaks have caused more illnesses in the United States than salmonellosis outbreaks linked to any other type of animal. Here, we describe the epidemiology of outbreaks from 2015-2022 to inform prevention efforts. During 2015-2022, there were 88 multistate backyard poultry-associated salmonellosis outbreaks and 7866 outbreak-associated illnesses caused by 21 different Salmonella serotypes. Salmonella Enteritidis accounted for the most outbreaks (n = 21) and illnesses (n = 2400) of any serotype. Twenty-four percent (1840/7727) of patients with available information were <5 years of age. In total, 30% (1710/5644) of patients were hospitalized, and nine deaths were attributed to Salmonella infection. Throughout this period, patients reported behaviours that have a higher risk of Salmonella transmission, including kissing or snuggling poultry or allowing poultry inside their home. Despite ongoing efforts to reduce the burden of salmonellosis associated with backyard poultry, outbreak-associated illnesses have nearly tripled and hospitalizations more than quadrupled compared with those in 1990-2014. Because this public health problem is largely preventable, government officials, human and veterinary healthcare providers, hatcheries, and retailers might improve the prevention of illnesses by widely disseminating health and safety recommendations to the public and by continuing to develop and implement prevention measures to reduce zoonotic transmission of Salmonella by backyard poultry.

Molecular Epidemiology of Coronavirus Disease and its Effect on the Hematological Profile in District Kech, Balochistan

The coronavirus disease (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This study aimed to investigate the occurrence of COVID-19 in district Kech, associated risk factors, clinical presentation, and its effect on blood cells. A structured questionnaire was designed to collect the data and the samples were investigated by RT-PCR. In total, 575 suspects were screened, among which 64 (11.16%) had COVID-19 infection, 40.6% were males, and 59.4% were females. An increased positivity of 53.12% was measured in the younger age group (15-30 years) and the lowest (18.75%) was noticed in elders &gt; 50 years. 95.3% of the patients were newly infected, and 7.7% had a contact history with COVID-19-infected patients. The clinical symptoms, such as fever, cough, nausea, vomiting, and diarrhea, were identified in 89.1%, 67.2%, 51.6%, 46.9%, and 12.5%, respectively. The prominent clinical features, like fever, cough, nausea, diarrhea, chest distress, chest pain, and psychological stress were observed. Noticeably, 10.9% of obesity and 7.8% of asthma patients were co-infected with COVID-19 disease including 39.1% of cases showed psychological trauma. Leucocytosis and a decrease in hemoglobin concentration and platelets were determined in COVID-19-infected patients. A significant effect was observed on the hematological profile, however, the effect was severe in the older age group (&gt;50 years). The results suggest that the large population of the study area is infected by SARS-CoV-2, appealing to the need for surveillance on a large scale and the implementation of preventive measures to control further dissemination of the disease.

The Current State of Knowledge on Osteoporosis in Holocaust Survivors and Their Descendants.

Starvation in early life can cause poor bone health and metabolic aberrations in bone minerals, leading to abnormal bone development. Holocaust survivors have been exposed to starvation and malnutrition before and during World War II. This paper aims to provide the current state of knowledge on the osteoporosis risk in Holocaust survivors and their descendants. The PubMed and Scopus databases were searched. Papers that reported original data on the risk of osteoporosis in Holocaust survivors and in their offspring were included in the study. Ten studies were included in this review. The majority of studies were case-control ones (n=7) versus two self-reported and one longitudinal study. Despite the limited cohort numbers and the small number of studies in the literature, the data showed a potential increased risk of osteoporosis in Holocaust survivors and especially in their descendants. The review of these studies showed a higher prevalence of osteoporosis among Holocaust survivors and their offspring. Knowledge of the trans-generational inheritance of osteoporosis in the descendants of Holocaust survivors should increase the awareness of primary care health workers on osteoporosis screening and early diagnosis and implementation of preventive measures, including adequate vitamin D and calcium supplementation, and pharmacological treatment.

Improving awareness of foreign domestic workers during the COVID-19 pandemic using infographics: An experience during the crisis

The COVID-19 epidemic is a significant humanitarian crisis witnessed in contemporary times, necessitating the exploration of techniques and approaches that might augment the capabilities of individuals within society to mitigate the adverse consequences of this pandemic. Domestic workers have always been an important part of societal structure, and it is essential to ensure their awareness about the perils of the pandemic as well as implement preventive measures. This is crucial in order to effectively address the hazards associated with the ongoing epidemic. The primary objective of this study was to assess the efficacy of infographic technology in augmenting the level of knowledge among foreign domestic workers on the COVID-19 epidemic. The present study employed a quasi-experimental design to examine and compare the effects of infographic technology on the experimental group, while the control group received only public awareness messages disseminated to all citizens and residents. The study sample comprised (16) foreign domestic workers, who were assigned to the two research groups through a random allocation process. The development of the COVID-19 pandemic awareness scale was conducted. The measurement scale consisted of three dimensions: the cognitive awareness dimension, including a set of (12) statements; the performative awareness dimension, comprising a set of (8) statements; and the psychological awareness dimension, comprising a set of (10) statements. The findings demonstrated the superiority of the experimental group, which used the infographic approach, over the control group in fostering awareness of the COVID-19 epidemic throughout its three dimensions among the participants of the study. The study suggested the need of expanding the utilization of infographics in an attempt to enhance knowledge and awareness of the COVID-19 pandemic, alongside the establishment of varied databases for migrant domestic workers. The objective is also to develop an extensive digital awareness strategy about the impacts of the COVID-19 epidemic, so as to include an increased number of informative infographics.

Detection of a neglected tropical disease: Case report of Heavy &lt;i&gt;Tunga penetrans&lt;/i&gt; lesions on the feet of a thirteen-year-old boy from a community in Lagos, Nigeria

Tungiasis is a neglected tropical disease (NTD) arising from an ectoparasitic infection of the skin of its host by the gravid female Tunga species. The prevalence can spike to about 60% in impoverished regions of South America, the Caribbean, and Sub-Saharan Africa. Instances of severe cases are rare. However, according to the consistent pattern of Tunga penetrans distribution, majority of lesions are carried by a few numbers of hosts. Limited research has been conducted in endemic areas of Nigeria, and in Badagry, wherein a prevalence rate of 21.2% was recently documented. In this report, we detail a severe case of Tungiasis in Jegeme, an endemic community within the Badagry Local Government area of Lagos, which was observed during part of an active surveillance conducted from August 2021 to November, 2021. The case involved a 13-year-old boy who reported several lesions containing embedded fleas on his limbs. Extraction and microscopic examination of the wound revealed eggs and adult forms of Tunga flea. This case highlights the persistence of severe tungiasis within this endemic community, underscoring the link between the infection and extreme poverty. Tungiasis is likely to remain endemic in such resource-poor setting where extreme poverty limits access required to prevent infestation. Appropriate response to infestation to reduce morbidity should be implemented. Improved links between locals in endemic populations and healthcare providers, coupled with increased awareness, and implementation of preventive measures is crucial.

Trends in the prevalence and incidence of Crohn’s disease in Japan and the United States

PurposeThis study is to describe patient demographic characteristics and estimate annual prevalence and incidence rates of Crohn’s disease (CD) in Japan and the United States (US).MethodsTwo large employment-based healthcare claims databases (Japan Medical Data Center [JMDC] in Japan and Merative MarketScan [Merative] in the US) were used to identify patients with CD from 2010 to 2019. Cases were confirmed using an algorithm based on diagnostic with/without treatment codes. The Merative population was used for sex and age standardization of annual prevalence and incidence rates estimated from the JMDC.ResultsPatients with CD were generally younger in Japan than in the US at diagnosis (mean 33.6 vs. 39.4 years) and 71.5% were male versus 45.1% in the US. Annual prevalence per 100,000 population increased substantially in both countries, from 34.2 in 2010 to 54.5 in 2019 in Japan (standardized) and 163.3 to 224.2 in the US. Prevalence rates increased in both males and females in all age groups between 6 and < 65 years. Annual incidence rate per 100,000 person-years was almost fourfold higher in the US than Japan (21.0 vs. 5.5 [standardized] in 2019) but remained stable in both countries over time in both sexes and in all age groups.ConclusionThe epidemiology of CD differs between Japan and the US. Research to understand the basis of these differences could help to identify at-risk groups in each country, and guide implementation of preventive measures.

Trends and projections in fall death in the Netherlands from 1990 to 2045

BackgroundIncreasing life expectancy in high-income countries has been linked to a rise in fall mortality. In the Netherlands, mortality rates from falls have increased gradually from the 1950s, with some...

Primary surgical prevention of lymphedema.

Lymphedema in the upper and lower extremities can lead to significant morbidity in patients, resulting in restricted joint movements, pain, discomfort, and reduced quality of life. While physiological lymphatic reconstructions such as lymphovenous anastomosis (LVA), lymphovenous implantation (LVI), and vascularized lymph node transfer (VLNT) have shown promise in improving patients' conditions, they only provide limited disease progression control or modest reversal. As lymphedema remains an incurable condition, the focus has shifted towards preventive measures in developed countries where most cases are iatrogenic due to cancer treatments. Breast cancer-related lymphedema (BCRL) has been a particular concern, prompting the implementation of preventive measures like axillary reverse mapping. Similarly, techniques with lymph node-preserving concepts have been employed to treat lower extremity lymphedema caused by gynecological cancers. Preventive lymphedema measures can be classified into primary, secondary, and tertiary prevention. In this comprehensive review, we will explore the principles and methodologies encompassing Lymphatic Microsurgical Preventive Healing Approach (LYMPHA), lymphovenous anastomosis (LVA), lymphaticolymphatic anastomosis (LLA), vascularized lymph node transfer (VLNT), and lymph-interpositional-flap transfer (LIFT). By evaluating the advantages and limitations of these techniques, we aim to equip surgeons with the necessary knowledge to effectively address patients at high risk of developing lymphedema.

Young hearts, early risks: novel cardiovascular biomarkers in former very preterm infants at kindergarten age.

Preterm birth is associated with long-term cardiovascular morbidity and mortality. In adults, fibroblast growth factor-23 (FGF-23), α-Klotho, and secretoneurin have all garnered attention as cardiovascular biomarkers, but their utility in pediatric populations has not yet been ascertained. The aim of this pilot study was to evaluate these novel cardiovascular biomarkers and their association with indicators of cardiovascular impairment in the highly vulnerable population of former very preterm infants. Five- to seven-year-old children born at < 32 weeks' gestation were eligible for the study. Healthy same-aged children born at term served as controls. Biomarkers were quantified in fasting blood samples, and echocardiographic measurements including assessment of aortic elastic properties were obtained. We included 26 former very preterm infants and 21 term-born children in the study. At kindergarten age, former very preterm infants exhibited significantly higher plasma concentrations of biologically active intact FGF-23 (iFGF-23; mean 43.2 pg/mL vs. 29.1 pg/mL, p = 0.003) and secretoneurin (median 93.8 pmol/L vs. 70.5 pmol/L, p = 0.046). iFGF-23 inversely correlated with distensibility of the descending aorta. In preterm-born children, iFGF-23 and secretoneurin both offer prospects as valuable cardiovascular biomarkers, potentially allowing for risk stratification and timely implementation of preventive measures. Former very preterm infants have increased plasma concentrations of the novel cardiovascular biomarkers intact fibroblast growth factor-23 (iFGF-23) and secretoneurin at kindergarten age. Increases in iFGF-23 concentrations are associated with decreased distensibility of the descending aorta even at this early age. Monitoring of cardiovascular risk factors is essential in individuals with a history of preterm birth. Both iFGF-23 and secretoneurin hold promise as clinically valuable biomarkers for risk stratification, enabling the implementation of early preventive measures.