Medical Center For Treatment Research Articles

MАR-test and Spermiological Research Indices

Antisperm antibodies are detected in 3% to 25% of cases in men and women diagnosed with infertility. They can also be diagnosed in 1–10% of healthy fertile men. The presence of a high titer of AST is one of the factors of male infertility, which can be «hidden», i. e. not cause symptoms and deterioration of the overall spermogram. The objective: to analyze the results of sperm testing in men with antisperm antibodies, which were detected by MAR-test. Material and methods. A retrospective analysis of the examination results of 555 men was conducted on the basis of the Medical Center for Infertility Treatment in Chernivtsi. Spermograms were examined according to WHO recommendations in 2000, using an inverted microscope Olympus CKX41 in a Broker chamber. Determination of the percentage of sperm coated with antisperm antibodies was performed using the MAR-test (MAR-test, MAR-mixed antiglobulin reaction). Results. If we calculate the percentage of patients in whom we assume the connection between the presence of antisperm antibodies and undertaken surgery, genital infections and allergy history, we get only 48.3% of cases. It has been found that most changes in sperm counts correlate with the percentage of sperm that are coated with IgG. These data indicate that increased IgG levels play an important role in the development of pathospermia. A negative medium-strength correlation was found between the percentage of Category A sperm and the percentage of IgG-coated sperm. Persistence of IgG in semen is accompanied by a probable decrease in the morphological quality of sperm. Conclusion. In 52% of patients it was not possible to establish the etiological factor for the presence of Ig in the ejaculate. It has been found that most changes in sperm counts correlate with the percentage of sperm that are coated with IgG. It has been determined that an increase in the level of IgA and IgG leads to a probable increase in the percentage of pathological sperm forms and decrease in sperm motility. In the presence of 30% of sperm that are coated with IgG, with a probability of 95%, the ejaculate of patients will have 100% of pathologicoalr mf s of sperm.

Marketing Medical Marijuana in Florida: A Research Methodology

On November 8th, 2016 Amendment 2 was approved by 71% of voters making Florida the 26th state to enact a medical marijuana law. Medical marijuana treatment centers are the only entities in the state that are authorized to cultivate, process, and dispense medical marijuana. Medical marijuana laws vary widely across states, making it extremely difficult to learn from the twenty-five states that have already enacted these laws. Medical marijuana laws also have no history to draw upon that provides evidence of best practices. There remains a scarcity of research conducted in real-time on medical marijuana policies while medical marijuana policy is being developed and implemented at a furious pace (Lamonica, et. al., 2016). Florida also has a specific need to evaluate medical marijuana policies and develop best practices. The fastest growing group of marijuana users in the US are older Americans and Florida has the largest population of older Americans in the country.

Оцінка просторового розподілу механічних властивостей тканин передньої черевної стінки за даними характеру їх деформування при максимальних функціональних навантаженнях

The purpose of the study was to investigate the changes in the mechanical properties of the anterior abdominal wall at maximum functional loads. Materials and methods. The study was conducted on 112 volunteers aged 18 to 49 years old who were examined and treated in the surgical department of the Medical Diagnostic and Treatment Center "Medion" Poltava for the period from June 2020 to May 2021. There were 60 women (53.6 %), and 52 (46.4%) men. Volunteers were divided into 2 groups: the main group (n=58), which underwent the analysis of movement and deformation changes of the anterior abdominal wall during maximal abdominal inflation during the examination, and the control group (n=54), which were operated laparoscopically due to the schedule. Results and discussion. The results of the study showed the following changes in the mechanical properties of the tissues of the anterior abdominal wall: the average deformation in the longitudinal direction was 6% in the main group and 12% in the control one; deformations in the transverse direction were 3% in the main group and 8% in the control group; deformation in the longitudinal direction exceeded the deformation in the transverse by 38-54% (on average by 46%); the area of the anterior abdominal wall in the main group increased by 10%, and in the control one – by 22% (on average by 16%). During the studies, the anterior abdominal wall underwent greater stresses in the transverse orientation than in the longitudinal one (anisotropy coefficient ~2). The Young's modulus of anterior abdominal wall in the sagittal plane is defined as 23.5±2.6 kPa, while in the transverse – 42.5±7.0 kPa. The mechanical properties of human anterior abdominal wall tissues differed along and across the white line of the abdomen: the modulus of elasticity of anterior abdominal wall tissues, with the same force of impact, in the longitudinal direction is less than the transverse average of 44% (p >0.05). That is, the longitudinal stiffness of the anterior abdominal wall is lower than the transverse one. The maximum strength of the anterior abdominal wall is across the white line of the abdomen, and the greatest elasticity – along. The anterior abdominal wall in women showed increased elasticity compared to men, while the stiffness of the anterior abdominal wall tissue in men in both directions was statistically significantly higher than in women (p >0.05). Conclusion. Reconstruction of the spatial distribution of the mechanical properties of anterior abdominal wall tissues according to the nature of their deformation at maximum functional loads provides an additional opportunity to assess the biomechanics of anterior abdominal wall. The mechanical properties of the musculo-aponeurotic structures of anterior abdominal wall in humans differ in the longitudinal and transverse directions. They have the greatest elasticity in the longitudinal direction, and the maximum rigidity and strength in the transverse direction. The strength of the anterior abdominal wall tissue in men is higher, and the elasticity is less than in women. Changes in the mechanical anisotropic characteristics of anterior abdominal wall tissues at maximum functional loads should be taken into account when performing the anterior abdominal wall alloplasty technique

BIO MEDICAL WASTE MANAGEMENT

The main purpose of this research is to identify the quantum of the medical waste generated and various methods involved in their disposal. The Indian Government has introduced Bio medical rules and its amendments in 2016 which dictate effective management of waste to prevent the diseases. These wastes have to be collected, segregated and then transported to the common bio medical waste treatment centre or if possible can be reduced at the source itself minimizing the quantity. It should not be dumped, landfilled, mixed with other municipal solid waste thereby creating a menace to the general public. If possible, it is to be considered for recycling or reuse in case of plastic medical waste.The study discusses about the quantity of waste collected in the 4 colour code categories namely yellow, red, blue and white. It also checks whether proper collection and disposal methods are followed thus creating awareness in the management of waste.

Evaluation of the results of patients who applied to the Çukurova University, Medical Genetics Department for prenatal diagnosis and determination of genetic counseling principles

Background/aim The aim of this study was to summarize the experiences of a single medical center for genetic diagnosis and treatment of prenatal patients.Materials and methods This study includes a retrospective data analysis of 2843 prenatally investigated cases using invasive methods during a 6-year period (2013–2019) at a single tertiary care center.Results Chromosomal abnormalities were detected in 80 out of 1221 amniotic fluid samples;,178 out of 1608 chorionic villus samples, and 1 out of 14 cordocentesis samples. The most common chromosomal abnormality was trisomy 21. At least one mutation was detected in 63 of the 152 molecular tests performed on fetuses. Conclusion Clinical procedures such as ultrasounds and genetic tests are able to provide a better clinical follow-up for pregnant women about the possible congenital anomalies or any genetic condition, with proper genetic counseling and testing methodology.

Lessons learned from reviewing a hospital\u2019s disaster response to the hydrofluoric acid leak in Gumi city in 2012

BackgroundThis study analyzed the characteristics of hydrogen fluoride-exposed patients (HFEPs) treated in the emergency department (ED) of a local university hospital, and reviewed the hospital’s disaster response according to space, staff, supplies, and systems (4Ss).MethodsThis retrospective observational chart review and descriptive study included 199 HFEPs among 2588 total ED patients who visited a local university emergency medical center for treatment between September 27, 2012 and October 20, 2012, following a hydrofluoric acid leak at the Hube Globe factory in Gumi City, Republic of Korea. Descriptive results concerning the 4Ss were obtained by interviewing ED specialist staff physicians on duty during the study period. In accordance with American Burn Association criteria, patients requiring burn center referral were assigned to the major burn group (MBG) as severe condition.ResultsDuring the acute phase (within 8 h after leak initiation), there were 43 patients in the ED, which was staffed with 3 doctors and 3 nurses, without 4S resources. Of these 43 patients, there were 8 HFEPs (100%) in the MBG and 0 in the non-MBG (NMBG). During the subacute phase (24 h after the acute phase), there were 262 patients in the ED including 167 HFEPs, of whom 45 (26.95%) were in the MBG and 122 (73.05%) were in the NMBG. The ED was then staffed with 6 doctors (3 on day shift and 3 on night shift) and 10 nurses (3 on day shift, 4 on evening shift, and 3 on night shift), and no 4S resources were available. Throughout the study period, no 4Ss were available. First, there was no expansion of ED space or secured disaster reserve beds. Second, there was no increase in manpower with duty time adjustments or duty relocation for ED working personnel. Third, there was no logistics reinforcement (e.g., antidote or personal protective equipment). Fourth, there were no disaster-related measures for the administration department, decontamination zone setup, safety diagnostic testing, or designated disaster triage implementation.ConclusionsThe hospital’s disaster response was insufficient for all aspects of the 4Ss. Detailed guidance concerning a hospital disaster management plan is required.

164 Molecular genetic diagnosis for early pregnancy renal anhydramnios

Early pregnancy renal anhydramnios (EPRA) occurs when congenital anomalies of the kidneys and urogenital tract (CAKUT) result in fetal anuria and absence of amniotic fluid prior to 22 weeks gestational age. The underlying etiologies of these conditions include environmental and multi-genetic factors. In this study, we sought to elucidate the genetic underpinnings of EPRA through prenatal chromosomal microarray (CMA), multi-gene panel testing, and whole-exome sequencing (WES). We hypothesized a low diagnostic yield consistent with the previously reported genetic diagnostic yield for CAKUT. We performed a retrospective cohort study of all patients referred to our tertiary-care medical center for evaluation and treatment under the Renal Anhydramnios Fetal Therapy (RAFT) trial (NCT03101891) from 11/2018 to 9/2020. The medical records of patients undergoing RAFT evaluation were reviewed for prenatal or postnatal diagnostic testing results, and three-generation pedigrees were reviewed to identify additional affected family members. During the study period, 64 patients were referred to the RAFT trial, and 32 (50%) presented for evaluation. Prenatal diagnosis was completed via karyotype (n=5), CMA (n=18), and/or WES (n=5) in 22 patients (69%), and 10 patients declined diagnostic testing. Diagnostic results were identified in 4/22 (18%) cases, including 1 fetus with an abnormal karyotype (47,XXX), 2 with pathogenic CMA findings (a 15q26.1 deletion and a 2q21.1 duplication), and 1 with a pathogenic heterozygous variant in GREB1L identified on postnatal WES. Pedigree review revealed CAKUT presentations in additional family members in 7/32 (22%) cases. Genetic diagnosis was achieved for 4 EPRA-affected pregnancies in the RAFT trial cohort. Future research is needed, including whole-exome sequencing of all presenting cases, to identify novel causative mutations and enable improved reproductive decision-making and better genetic and obstetric care provision for at-risk couples and affected fetuses.

Congenital Cytomegalovirus Infection Initially Managed as Congenital Rubella Syndrome

Congenital cytomegalovirus (CMV) infection (cCMV) is challenging to differentiate from congenital rubella syndrome (CRS) clinically. Virus detection and serological tests are needed. However, they are often not readily available or are expensive. This is a case of a five-month-old male with bilateral cataracts. He was jaundiced at birth and started having seizure episodes at one month of age. He was also diagnosed with right inguinal hernia and had abnormal bilateral hearing tests. Both eyes were noted to have leukocoria at two months of age. There was dazzle on both eyes and sclerae were anicteric. Examination revealed dense cataracts on both eyes, but their ocular ultrasound results were essentially normal. Due to the bilateral hearing loss and bilateral cataracts, CRS was initially considered despite the absence of heart abnormality since there were reported CRS cases without the complete triad. However, possible coinfection or another disease was considered due to the presence of jaundice, seizures, and hernia, which were never seen in our previous CRS patients nor were reported in the literature. The patient underwent cataract extraction on both eyes without intraocular lens implantation (IOL) as recommended for CRS cataracts to prevent severe inflammation. TORCH (TOxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex) test was negative for rubella but positive for CMV. As such, the patient would have benefitted from early IOL implantation. The patient was then referred to a national medical center for possible treatment. However, since the patient already tested negative for CMV polymerase chain reaction (PCR) there, systemic antiviral therapy was no longer initiated. This case presented the challenge of clinically differentiating cCMV and CRS.

Association between childhood parental rearing, sexual partnerships, social support and posttraumatic stress disorders (PTSD) among young HIV-positive MSM

ABSTRACT We aimed to assess the effect of childhood parental rearing on post-traumatic stress disorder (PTSD) among young HIV-positive men who have sex with men (MSM), as well as the mediation effect of social support on this association. A convenient sampling method and questionnaire-based survey were used to recruit eligible participants from the Wuhan Medical Treatment Center from 20 December 2018 to 28 February 2019. Bivariate analyses were used to investigate the correlations between PTSD and childhood parental rearing, the number of sexual partners and social support. Mediation analyses were used to investigate the mediation of social support. Totally, 142 eligible MSM participated in our study, with prevalence of PTSD being 33.10%. It was found that maternal warmth (M1) and maternal favoring (M5) were positively correlated with social support. Paternal rejection (F5) was positively correlated with PTSD. The effects of M1 and M5 on PTSD were completely mediated by social support. The effects of paternal favoring (F4) and M5 on PTSD were completely mediated by subjective social support, and the effects of F5 and M1 were completely mediated by social support utility. Social support was an important mediator between parental rearing and PTSD.

Why Go NANO on COVID-19 Pandemic?

Although treating COVID-19 is shown to be challenging, NANOtechnology is around the corner to overcome potential drawbacks. The use of NANOtechnologies will definitely shape the worldwide approaches and tools to treat COVID-19. Here we highlight the importance of going NANO on the COVID-19 pandemic.

Clinical and Epidemiological Characteristics of COVID-19 Patients in Chongqing China

Objectives: To study in-depth the clinical and epidemiological characteristics of pneumonia resulting from COVID-19 and provide evidence for effective public health decisions.Methods: This was a retrospective, single-center research study. Participants were enrolled from patients presenting at the Chongqing Public Health Medical Treatment Center from Jan 24 to Feb 7, 2020, and were confirmed as having COVID-19.Results: A total of 114 COVID-19 patients (99 mild, 4 severe, 11 critical) of which 56 (56/114; 49.1%) were male, 58 (58/114; 50.9%) were female with a mean age of 46.05 years. Twenty nine (29/114; 25.44%) patients suffered from chronic diseases. Neutrophils counts in 23.68% (27/114) of patients were abnormally low and abnormally high in 21.05% (24/114). Erythrocyte sedimentation rate and the C-reactive protein levels were abnormally elevated in 76.5% (62/81) and 62.9% (66/105) of patients, respectively. Creatine kinase isoenzymes (CK-MB), pro-brain natriuretic peptide (pro-BNP) and troponin levels were above the normal range in 7.10% (8/112), 66.7% (10/15), and 100% of patients, respectively. The percentage of patients in which the partial pressure of oxygen (PaO2)/fraction of inspired O2(FiO2) ratio exceeded 200 was 60%. A total of 91 (91/114; 79.82%) patients displayed severe bilateral pneumonia, 52 (52/114; 45.61%) exhibited ground-glass opacity, and pulmonary consolidation was observed in 4 (3.51%) patients. Differences in shortness of breath, insomnia, inappetence, the procalcitonin (PCT) levels, FiO2 and PaO2/FiO2 among the three groups were statistically significant (p < 0.05). Differences between the mild and severe groups was observed in neutrophil and lymphocyte counts, CD4 expression, and levels of C-reactive protein, alanine aminotransferase, aspartate aminotransferase and albumin (P < 0.05). Between the mild and critical groups, differences were observed in neutrophils, platelets, and CD4 expression (P < 0.05). A difference in C-reactive protein levels between severe and critical groups was also found (P < 0.05).Conclusions: In the majority of cases no gender differences were observed and mostly the symptoms were mild. Evidence of efficient human-to-human virus transmission was found. The elderly with comorbidities were more prone to develop into severe or critical illness. Age and comorbidity may be risk factors for poor outcome.

Machine Learning Based Sentiment Text Classification for Evaluating Treatment Quality of Discharge Summary

Patients’ discharge summaries (documents) are health sensors that are used for measuring the quality of treatment in medical centers. However, extracting information automatically from discharge summaries with unstructured natural language is considered challenging. These kinds of documents include various aspects of patient information that could be used to test the treatment quality for improving medical-related decisions. One of the significant techniques in literature for discharge summaries classification is feature extraction techniques from the domain of natural language processing on text data. We propose a novel sentiment analysis method for discharge summaries classification that relies on vector space models, statistical methods, association rule, and extreme learning machine autoencoder (ELM-AE). Our novel hybrid model is based on statistical methods that build the lexicon in a domain related to health and medical records. Meanwhile, our method examines treatment quality based on an idea inspired by sentiment analysis. Experiments prove that our proposed method obtains a higher F1 value of 0.89 with good TPR (True Positive Rate) and FPR (False Positive Rate) values compared with various well-known state-of-the-art methods with different size of training and testing datasets. The results also prove that our method provides a flexible and effective technique to examine treatment quality based on positive, negative, and neutral terms for sentence-level in each discharge summary.

Esophageal cancer: How far is close enough?

e19049 Background: According to Surveillance, Epidemiology, and End Results (SEER) data, 5-year survival of esophageal cancer (EC) improved from 4.1% to almost 20% from 1975 to 2016, however, this is still poor compared to other cancers. Chitti et al describe temporal changes in EC mortality by geographic region across the United States (U.S.) and concluded that disparities exist. Other studies described survival disparities for rural communities specific to small cell lung carcinoma, cervical cancer, and breast cancer. Hung et al determined that 1 in 5 rural Americans lived &gt; 60 miles from a medical oncologist. Studies performed outside of the U.S. described no difference in survival with travel distance. No studies on this topic have focused on gastrointestinal malignancy. Our study aimed to associated travel distance with travel time to a medical oncology treatment center as time can vary greatly with similar distances. We focused specifically on esophageal cancer considering its high mortality rate and significant effect on quality of life. Methods: We performed a descriptive analysis of a retrospective cohort (January 2008 – August 2019) of all individuals diagnosed with esophageal cancer using data from the institutional Oncology Tumor Registry, a regional cancer registry, and the electronic health records (EHR) of patients throughout a rural integrated health system in Pennsylvania. We geocoded home addresses using Google Maps Geocoding application programming interface (API) and the average driving distance and time to the nearest medical oncology treatment center was calculated using the Google Maps Distance Matrix API. Travel time compared to cancer stage was also assessed. Addresses listed over 100 miles were evaluated for documentation accuracy via the EHR. Results: A total of 1157 adult patients diagnosed with esophageal cancer was evaluated; of these, 433 had a documented outpatient chemotherapy infusion site visit. The mean travel distance to a medical oncology treatment center was 19.8 miles with a median of 16 miles; this correlated with a mean travel time of 28.2 minutes. Seventy-five percent of the population lived within 26 miles of an outpatient oncology center. The maximum distance traveled was 139 miles, which was confirmed via EHR chart review. Conclusions: This study shows that a rural population may not necessarily experience disparity in travel distance and time to a medical oncology treatment center. This was an exploratory study and further analysis will be needed to see if there was any statistically significant difference in survival based on distances when stratified by stage, age, treatment modality, etc.

Intravenous immunoglobulin significantly reduces exposure of concomitantly administered anti-C5 monoclonal antibody tesidolumab.

Awareness of drug-drug interactions is critical in organ transplant recipient management. However, biologic agents interfering with monoclonal antibodies is not widely considered. We report the effect of high-dose intravenous immunoglobulin (IVIg) on safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of the human anti-C5 monoclonal antibody tesidolumab (LFG316) in end-stage renal disease patients awaiting kidney transplant. In this single-center, phase 1, open-label, parallel-group study, 8 patients were assigned to receive either single-dose tesidolumab+IVIg or tesidolumab alone, with 56-day follow-up. Within-group PK parameters were consistent. Mean tesidolumab exposure decreased 34%, clearance increased 63%, and half-life decreased 41% comparing tesidolumab+IVIg to tesidolumab alone. IVIg influence on tesidolumab elimination was most evident in the first 3weeks. Complete suppression of both total and alternative complement activities was maintained for 4weeks in the tesidolumab alone group and for 2weeks in the tesidolumab+IVIg group. Tesidolumab was well tolerated. IVIg infused before tesidolumab affected tesidolumab PK and PD, resulting in a shortened period of full complement activity inhibition. These findings suggest a clinically relevant impact of IVIg on monoclonal antibody clearance and indirectly hint at an IVIg mechanism of action in treating autoimmune diseases and allosensitization by accelerating pathogenic IgG antibody degradation. Trial registration number: NCT02878616.

Discharge pharmacotherapy for Type 2 diabetic inpatients at two hospitals of different tiers in Zhejiang Province, China.

To look into the discharge pharmacotherapy for type 2 diabetics admitted to two general hospitals of different ranks and inspect current real-world management of discharge pharmacology and its related factors. Type 2 diabetics admitted to a tertiary general hospital (Ningbo Medical Treatment Centre Lihuili Hospital, LHLH) or a secondary general hospital (Simen Hospital, SMH) for intensification of their anti-diabetics were included for retrospective analysis. Patients' demographics, clinical characteristics, admission diabetes therapy and discharge diabetes pharmacology were analyzed and compared among patients in each hospital as well as between two hospitals. 391 patients from LHLH and 164 patients from SMH were included for analyzing. Compared with patients from LHLH, patients from SMH were older, more illiterate and had higher HbA1c concentrations. While there was a nearly equal split of oral anti-diabetes drugs (OADs)-only and Insulin treatment in LHLH's discharge pharmacotherapy, insulin treatment dominated SMH's. Basal-and-bolus insulin assumed the majority of SMH's insulin regimens but only accounted for less than 20% of LHLH's. The principal discrepancy in OADs-only treatment existed in the utilization of newer classes of OADs. Cost and body mass index (BMI) were the main differentiating factors among OADs-only treatments while duration, BMI and HbA1c differ among insulin treatments at LHLH. Clinical characteristics didn't significantly differ among OADs-only treatments and HbA1c was the only differentiating factor among insulin treatments at SMH. Overall, hospital, duration, HbA1c, and vascular diseases were main factors that affect discharge pharmacology. Great disparities exist in the discharge pharmacotherapy at two hospitals. Diabetes management is mostly glucose-oriented at SMH while multifactorial considerations were reflected in LHLH's discharge pharmacotherapy. Besides differences in patients' demographics, medication availability and diagnosis of early-stage vascular complications, lack of practical algorithm for discharge management in T2DM may be the underlying deficiency and a key part for future improvement.

High Incidence of Asymptomatic SARS-CoV-2 Infection, Chongqing, China

Background: SARS-CoV-2 has been a global pandemic, but the emergence of asymptomatic patients has caused difficulties in the prevention of the epidemic. Therefore, it is significant to understand the epidemiological characteristics of asymptomatic patients with SARS-CoV-2 infection. Methods: In this single-center, retrospective and observational study, we collected data from 167 patients with SARS-CoV-2 infection treated in Chongqing Public Health Medical Center (Chongqing, China) from January to March 2020. The epidemiological characteristics and variable of these patients were collected and analyzed. Findings: 82.04% of the SARS-CoV-2 infected patients had a travel history in Wuhan or a history of contact with returnees from Wuhan, showing typical characteristics of imported cases, and the proportion of severe COVID-19 patients was 13.2%, of which 59% were imported from Wuhan. For the patients who was returnees from Wuhan, 18.1% was asymptomatic patients. In different infection periods, compared with the proportion after 1/31/2020, the proportion of asymptomatic patient among SARS-CoV-2 infected patient was higher(19% VS 1.5%). In different age groups, the proportion of asymptomatic patient was the highest(28.6%) in children group under 14, next in elder group over 70 (27.3%). Compared with mild and common COVID-19 patients, the mean latency of asymptomatic was longer (11.25 days VS 8.86 days), but the hospital length of stay was shorter (14.3 days VS 16.96 days). Conclusion: The SARS-CoV-2 prevention needs to focus on the screening of asymptomatic patients in the community with a history of contact with the imported population, especially for children and the elderly population. Funding Statement: This work was supported by the National Key Research and Development Program (No.2016YFC1101100) and National Science Fund for Distinguished Young Scholars (No. 31625011). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was approved by the Ethics Committee of Chongqing Public Health Medical Treatment Center (NO.2020-018-01-KY), informed consent was allowed to be waived.

Research on the effectiveness and safety of kinesiotaping in middle-aged and elderly military patients for reducing acute and chronic myofascial pain

Introduction. In a medical center for rehabilitation treatment, the vast majority of military patients are people of middle age (45–59 years according to the WHO classifi cation) and older. Many of them participated in combat activities, special operations, and had injuries of various limitation periods. With age, the number of degenerative changes in the connective tissue, musculoskeletal system, and nervous system increases, which creates biomechanical conditions for the occurrence of acute and chronic pain syndrome of varying intensity. The goal of research — to study the effectiveness and safety of kinesiotherapy in patients of middle and older age groups with acute and chronic pain syndrome.Materials and methods. From February 2017 to July 2018, a prospective study was carried out in the Medical Center for Rehabilitation Treatment (Korolev), P. V. Mandryka Central Military Clinical Hospital. Patient selection and sampling was carried out by the continuous method. 154 military patients underwent treatment at the Medical Center for Rehabilitation Treatment (Korolev), P. V. Mandryka Central Military Clinical Hospital under our supervision. All patients suffered from acute and chronic pain. Kinesiotherapy was used as a treatment method. All patients were assessed for the severity of pain before treatment, on the fi rst and fi fth days. The safety of the method was evaluated by observing local irritation reactions and systemic allergic reactions.Results. Kinesiotherapy in the treatment of military patients with acute and chronic pain syndrome allows to reduce the severity of pain, in accordance with the results of the assessment on the fi rst and the fi fth days (differences are statistically signifi cant, p&lt;0,05, Student′s t-test). This treatment method showed high (69,4 %) effectiveness and safety (not a single case of systemic allergic reactions, 4,1 % of cases with local irritation reactions).Conclusion. This treatment method can be used in cases of acute and chronic myofascial pain syndrome in a hospital setting in middle-aged and older patients. Its use is possible both for quick and prolonged improvement (during 5 days) of the patients′ condition.

Phenotypic and molecular characterisation of a novel species, Mycobacterium hubeiense sp., isolated from the sputum of a patient with secondary tuberculosis in Hubei of China.

A new fast-growing mycobacterium, designated strain QGD101T, was isolated from the sputum of an 84-year-old man suspected of tuberculosis in Wuhan Medical Treatment Center, Hubei, China. This strain was a gram-staining-negative, aerobic, non-spore-forming and catalase-positive bacterium, which was further identified as the NTM by PNB and TCH tests. The moxifloxacin and levofloxacin exhibited strong suppressing function against QGD101T with MIC values of 0.06 and 0.125 µg/ml after drug susceptibility testing of six main antimicrobial agents on mycobacteria. Based on the sequence analysis of 16S rRNA, rpoB, hsp65 and 16S-23S rRNA internal transcribed spacer, the strain QGD101T could not be identified to a species level. Mycobacterium moriokaense ATCC43059T that shared the highest 16S rRNA gene sequence similarity (98%) with strain QGD101T was actually different in genomes average nucleotide identity (78.74%). In addition, the major cellular fatty acids of QGD101T were determined as C18:1ω9c, C16:0 and C18:2ω6c. The DNA G + C content was 64.9% measured by high performance liquid chromatography. Therefore, the phenotypic and genotypic characterisation of this strain led us to the conclusion that it represents a novel species of mycobacteria, for which the name Mycobacterium hubeiense sp. nov. (type strain QGD101T = CCTCCAA 2017003T = KCTC39927T) was proposed. Thus, the results of this study are very significant for the clinical diagnosis of tuberculosis and future personalised medicine.

Clinical and imaging features of acute histoplasmosis

Objective: To investigate the clinical and imaging characteristics of acute histoplasmosis. Methods: The clinical and imaging data of 10 patients with acute histoplasmosis were studied. Their clinical and imaging characteristics were analyzed. All the patients returned from a South American republic in April 2019 and were treated at the Chongqing public health medical treatment center. Results: All the 10 patients were male, aged 30-56 years old, with an average age of 43.8 years old. Four of them were engaged in soil clearing, 2 in gas cutting, 2 in moving tools, and 2 in inspection. The disease in all the 10 patients was caused by inhaling a large amount of bacteria-bearing dust in a short time, with an incubation period of 9-13 days, and the main clinical manifestations were fever, insomnia, dizziness, headache, cough, poor appetite, rash and diarrhea. One patient's head CT showed extensive thickening and increased density of bilateral frontotemporal, parietal and occipital meninges, while the other 9 patients showed no obvious abnormalities. Chest CT findings were as follows: (1) Multiple nodular shadow: the chest CT findings of 4 patients were miliary nodular shadow with diffuse distribution in both lungs. Most of the nodules were less than 5 mm in diameter and distributed evenly or unevenly. CT findings of 6 cases showed scattered nodular shadows in both lungs, with diameters ranging from 2 to 15 mm, and obvious distribution in subpleural and inferior lobes of both lungs. (2) Consolidation shadow: in 2 cases, the size of the shadow was uneven and the density increased, mainly distributed in the subpleura and the lower lobe of both lungs. (3) Ground glass density shadow: mainly distributed around nodules, halo signs can be seen around some nodules. (4) Mediastinum and/or hilar lymph nodes were enlarged. (5) Pleural effusion: a small amount of pleural effusion was found in 4 cases. (6) Pericardial effusion in 3 cases. Abdominal CT showed splenomegaly in 8 cases and hepatomegaly in 1 case. Conclusions: Acute histoplasmosis has no specificity in clinical manifestations. However, there are still some features in CT manifestations, including multiple nodules in both lungs accompanied by halo, enlarged liver, spleen and mediastinal lymph nodes, and multiple serous cavity effusions.

Knowledge, attitudes, and practices about dengue among pupils from rural schools in an endemic area in Colombia

Introduction: Dengue is a public health problem in tropical and subtropical regions of the world. Studies on dengue in rural areas are scarce since the disease is considered mainly urban.Objective: To determine the knowledge (K), attitudes (A) and practices (P) of dengue in an endemic area in Colombia.Materials and methods: We conducted a cross-sectional study with 515 pupils (7-16 years old) in 34 rural schools in Anapoima and La Mesa municipalities during 2011. Each KAP category was evaluated independently by a scoring system and then categorized into high, medium or low.Results: Pupils recognized knowledge variables such as the symptoms (fever, bone pain), transmission route (mosquito bites), and mosquito breeding sites (uncovered wáter tanks, solid waste). Average scores on attitude were high in both municipalities indicating a well-developed perception of disease severity. Seeking treatment in medical centers and self-medication for fever management and the use of mosquito net and space-spraying of insecticides were the most frequently identified practices.Discussion: This is the first KAP dengue study performed in a rural area in Colombia and as such it contributes to the understanding of dengue perceptions by the inhabitants of these areas. It showed a medium level of knowledge about dengue and a lower level of preventive practices in pupils from rural schools. It also showed that pupils considered space-spraying as crucial for vector control. The presence of the vector in rural areas of the country underlines the need to improve surveillance and education to more effectively control the vector and promote prevention methods including community participation.