Reduce Infection Risk Research Articles

N13 Development of an interactive vaccination guide for Canadian Inflammatory Bowel Diseases nurses to use with immunosuppressed patients with IBD: Insights into the process & practical applications

Abstract Background Inflammatory Bowel Disease (IBD) is a chronic, immune-mediated condition requiring complex management, often with immunosuppressive therapies. These therapies increase infection risk, making vaccination vital. Given the complexities of immunosuppressive therapies and vaccine considerations, IBD nurses need support to provide vaccination-related guidance to patients. The Canadian IBD Nurses (CANIBD) group developed an interactive vaccination guide to support IBD nurses in this role and shares the process, lessons learned, and practical applications. Methods The interactive vaccination guide, developed by CANIBD and infectious disease specialists, is a web-based resource hosted by Crohn’s and Colitis Canada (https://canibdvaccination.ca/). With greater access to technological resources, such as computers-on-wheels and electronic tablets, the paper-based format became under-utilized. Transitioned to an interactive web-based format in 2024, the guide was redesigned to optimize usability. The development process involved a scoping review of updates in vaccination, including COVID-19 vaccination guidelines. This review was conducted by 2 IBD nurse practitioners and 2 infectious disease specialists in pediatric and adult care. The CANIBD board members approved a budget for web development after reviewing a business proposal. The project took 12 months to complete, involving multiple virtual meetings among collaborators and web designers. Results The vaccination guide includes updated content on: 1) identifying immunocompromised patients; 2) live vaccines; 3) inactivated vaccines; 4) COVID-19 vaccines; 5) travel vaccines; and 6) vaccinations for family members of immunocompromised patients. Designed for ease of use, the guide enables IBD nurses to provide timely, real-time vaccination support to patients and families. It ensures appropriate and comprehensive care plans for immunocompromised patients and is regularly updated as new data emerges. Conclusion The vaccination guide has proven valuable for IBD care. Its interactive, question-based design simplifies vaccination recommendations, supporting patients and families in staying protected. By incorporating the latest vaccine updates and addressing family vaccination needs, the guide reduces infection risk, enhances patient care, and reinforces CANIBD’s commitment to advocacy and healthcare collaboration. Future plans include evaluating the guide’s usability and expanding its reach to other healthcare providers, such as physicians and pharmacists.

Recent Developments in Ventricular Assist Device Therapy.

The evolution of left ventricular assist devices (LVADs) from large, pulsatile systems to compact, continuous-flow pumps has significantly improved implantation outcomes and patient mobility. Minimally invasive surgical techniques have emerged that offer reduced morbidity and enhanced recovery for LVAD recipients. Innovations in wireless power transfer technologies aim to mitigate driveline-related complications, enhancing patient safety and quality of life. Pediatric ventricular assist devices (VADs) remain a critical unmet need; challenges in developing pediatric VADs include device sizing and managing congenital heart disease. Advances in LVAD technology adapted for use in right ventricular assist devices (RVADs) make possible the effective management of right ventricular failure in patients with acute cardiac conditions or congenital heart defects. To address disparities in mechanical circulatory support (MCS) access, cost-effective VAD designs have been developed internationally. The Vitalmex device from Mexico City combines pulsatile-flow technology with a paracorporeal design, utilizing cost-effective materials like silicone-elastic and titanium, and features a reusable pump housing to minimize manufacturing and operational costs. Romanian researchers have used advanced mathematical modeling and three-dimensional (3D) printing to produce a rim-driven, hubless axial-flow pump, achieving efficient blood flow with a compact design that includes a wireless power supply to reduce infection risk. In conclusion, MCS continues to advance with technological innovation and global collaboration. Ongoing efforts are essential to optimize outcomes, expand indications, and improve access to life-saving therapies worldwide.

Fusion MRI/Ultrasound-Guided Transperineal Biopsy: A Game Changer in Prostate Cancer Diagnosis.

Background/Objectives: Multiparametric-Magnetic Resonance Imaging(mp-MRI) presents the ability to detect clinically significant cancer, aiming to avoid biopsy if the results are negative or target an abnormal lesion if a suspected lesion of the prostate is found. Recent guidelines recommend the performance of 12 standard biopsies along with 3 to 5 targeted biopsies in suspected prostate lesions, depending on the size of the prostate lesion. In addition, prostate biopsy can be performed by either the transperineal or the transrectal approach. The aim of this comprehensive review is to highlight the role of both standard and targeted MRI/Ultrasound (US) fusion transperineal biopsy (TPB) in the diagnostic approach of prostate cancer cases, to report its diagnostic efficacy and complication rates and to suggest the promising usage of MRI/US fusion TPB in the future. Methods: A comprehensive review of the existing literature, including systematic reviews, meta-analyses, and clinical guidelines, was conducted to compare the efficacy and safety of transperineal and transrectal approaches in prostate cancer detection. Special emphasis was placed on mp-MRI-guided targeted biopsy and its combination with systematic sampling. Results: Prostate biopsy via the transperineal approach is related to increased detection rates, especially for anterior lesions, and decreased infection risk compared to the transrectal approach, while complication rates (hematuria, hemospermia, etc.) remain similar. Due to lower infection rates via the transperineal route, the performance of prostate biopsy using the transperineal approach is strongly recommended. Finally, transperineal fusion MRI/US biopsy can be valuable for repeat biopsies in patients who had an initial negative biopsy or for the follow-up of patients that undergo active surveillance. Conclusions: MRI/US fusion-guided TPB represents a significant advancement in prostate cancer diagnostics, combining improved precision with reduced infection risks. Although TPB presents higher detection rates for anterior prostatic lesions and lower post-biopsy infection rates, there is no significant difference in cancer detection rates compared to TRB. Targeted training and investment may reduce long-term expenses of TPB by lowering hospitalizations, antibiotic usage, and related costs. Future research should further refine this approach and explore its integration with emerging technologies like artificial intelligence for enhanced lesion targeting and diagnostic accuracy.

Prevalence and Individualized Risk Factors of E. bieneusi and E. intestinalis Infections Among People Living with HIV (PLHIV) with Diarrhea in Ecuador: Insights from a Single-Center Cross-Sectional Study.

Background: Microsporidia, particularly E. bieneusi and E. intestinalis, are emerging opportunistic pathogens that pose significant health risks to immunocompromised individuals, especially people living with HIV (PLHIV). Despite the global recognition of microsporidia's impact, there has been limited research on their prevalence and associated risk factors in Ecuador. This study aimed to investigate the prevalence and identify risk factors associated with microsporidia infections among PLHIV with diarrhea in Ecuador. Methods: A cross-sectional study was conducted at the José Daniel Rodríguez Infectious Hospital in Guayaquil, Ecuador, between April 2021 and May 2022. A total of 85 PLHIV with diarrhea were included in the analysis. Fecal samples were tested for microsporidia using fast-hot Gram chromotrope staining, immunofluorescence microscopy, and transmission electron microscopy. Logistic regression was performed to assess the association between demographic, clinical, and behavioral factors and microsporidia infection. Results: The prevalence of microsporidia infections among the study population was 18.8%. Logistic regression analysis identified significant associations with age ≥ 60 years (OR = 19.169, p = 0.036), female sex (OR = 10.491, p = 0.028), and non-adherence to antiretroviral therapy (OR = 8.466, p = 0.077). Marginally significant associations were observed for substance use (OR = 0.262, p = 0.094) and high/very high HIV viral load (≥10,000 copies/mL, OR = 0.457, p = 0.094). CD4 count and marital status showed descriptive trends but were not statistically significant. Conclusions: This study highlights the burden of microsporidia infections among PLHIV in Ecuador and underscores the need for targeted public health interventions. Strategies should prioritize older individuals, females, and those with poor ART adherence to reduce infection risk. Future research is needed to explore additional risk factors and refine precision medicine approaches for this population.

Prevention and Management of Postoperative Infection After Anterior Cruciate Ligament Reconstruction: A Narrative Review.

Background: Postoperative infection following anterior cruciate ligament reconstruction (ACLR) is a rare yet severe complication that can compromise patient outcomes, leading to prolonged recovery, graft failure, and knee dysfunction. Although infection rates are reported to be less than 2%, it remains essential to implement strategies to reduce infection risk and improve surgical outcomes. Methods: This review explores current evidence on the prevention of infections in ACLR, emphasizing the importance of timely antibiotic prophylaxis and vancomycin presoaking of grafts, which has been associated with a substantial reduction in infection rates. Results: Empirical antibiotic therapy should be started immediately after joint aspiration when infection is suspected. Treatment must prioritize culture-specific antibiotic regimens to optimize patient outcomes. Surgical intervention with arthroscopic debridement and irrigation needs to occur as soon as the diagnosis of infection is made. Often, this is performed with a focus on retaining the graft in order to preserve knee stability, if possible. Careful intraoperative management, along with the aid of infectious disease specialists, is paramount to help optimize outcomes following infection after ACLR. Conclusions: This review emphasizes the need for treatment protocols and highlights areas for future research to establish clear guidelines on infection after ACLR, especially with decisions of graft retention versus removal.

Early mobilisation after hip fracture surgery reduces the risk of infection: an inverse probability of treatment weighted analysis.

Mobilisation within the first day following hip fracture surgery is recommended. However, an in-depth analysis of the association between early mobilisation and the risk of infection is lacking. To examine the association between early mobilisation and the subsequent risk of hospital-treated infections following hip fracture surgery. Using nationwide registries, we included 36229 patients aged ≥65 who underwent surgery for hip fracture (2016-21). Exposure was time from surgery to first mobilisation in hours. Outcomes were any hospital-treated infection, pneumonia, urinary tract infection and sepsis within 2-30days and reoperation due to surgical-site infection within 2-365days of surgery. We calculated cumulative incidences (risks), risk differences (RD) and hazard ratios (HR) with 95% confidence intervals (CIs) using the inverse probability of treatment (IPT) weighted method to account for confounding. Overall, 27174 (75%) patients were mobilised ≤24h, 2890 (8%) between 24 and 36h, and 6165 (17%) were mobilised >36h of surgery or had no registration of mobilisation time.In the weighted analysis, the risk of any infection was 12.9% (CI 11.7%-14.2%) in patients mobilised 24-36h of surgery and 10.9% (CI 10.5%-11.7%) in those mobilised ≤24h, corresponding to RD of 2.0% (CI 0.7-3.3) and HR of 1.2 (CI 1.1-1.3). Similar associations were observed for pneumonia and urinary tract infection but not for sepsis and reoperation. Infection is a common complication after hip fracture surgery. Mobilisation within 24h is clearly associated with reduced infection risk. Our results emphasise the importance of early mobilisation and suggest a possible pathway for reducing complications and mortality after hip fracture.

Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Aged 70 Years and Older: A Systematic Review and Meta-Analysis.

Allogeneic hematopoietic cell transplantation (allo-HCT) is a potential cure for many hematological malignancies. Historically, older adults were not considered eligible for allo-HCT due to increased toxicity and mortality concerns. This systematic review and meta-analysis aim to explore the outcomes of allo-HCT in patients aged 70 years or older. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search was performed on PubMed, Cochrane Register of Controlled Trials, and Clinicaltrials.gov using MeSH terms and keywords for "Hematopoietic Stem Cell Transplantation" AND "Outcome Assessment" from the date of inception to June 30, 2024. Our search produced 102 articles. After excluding irrelevant and review articles during primary and secondary screening, eight original studies reporting outcomes of allo-HCT in patients aged 70 years or older were included. The survival data were retrieved from Kaplan-Meier (KM) curves using an online plot digitizer tool to calculate the overall survival (OS) and disease-free survival (DFS). The pooled KM curves were plotted and analyzed using the "MetaSurvival" package of R software version 4.2.1. Proportions and 95% confidence intervals (CIs) were extracted as well. A total of 2519 patients aged 70 years or older with allo-HCT were included in the analysis. The included patients' age ranged from 70 to 84 years, and 68% were male. Median follow-up was 23.2 (0.4 to 122.5) months. The combined median OS was 14.84 months (95% CI: 11.61 to 19.50), with OS rates at 6, 12, 24, and 36 months of 71.8%, 54.5%, 41.9%, and 34.9%, respectively. The estimated pooled mean OS was 28.62 months (95% CI: 23.41 to 31.44). The pooled median DFS was 10.54 months (95% CI: 7.93 to 14.17), with DFS rates at 6, 12, 24, and 36 months of 61.5%, 47.5%, 37%, and 30.6%, respectively. The estimated pooled mean DFS was 24.45 months (95% CI: 18.30 to 23.74). The relapse rate ranged from 28% to 55.6%, while non-relapsed mortality ranged from 5.6% to 42%. The acute graft versus host disease (GvHD) incidence varied from 9.3% to 32%, while chronic GvHD rates ranged from 10% to 43%. Allo-HCT provides promising outcomes for patients aged 70 or older with transplant-eligible diseases. Disease progression, followed by infections, is the leading cause of mortality, underscoring the need for improved post-transplant care, including optimized GvHD regimens and strategies to reduce infection risk.

The role of digital health in pandemic preparedness and response: securing global health?

Digital health technologies, such as mobile applications, wearable devices, and electronic health record systems, have significantly enhanced global health security by enabling timely data collection and analysis, identifying infectious disease trends, and reducing infection risk through remote services. This study assesses the role of digital health in pandemic preparedness and global health security response. It examines the application of digital health to early detection, surveillance, and data management in patient care. We gathered data from scholarly articles published between 2019 and 2024 (found in PubMed, Science Direct, Google Scholar, and Web of Science), reports from the WHO, and case studies of recent pandemics. Topics discussed include digital health technologies, their use, benefits, and issues. We paid special attention to gathering the informed opinions and perspectives of specialists from various fields, including public health, technology, and government. The commentary synthesises these findings to offer suggestions for incorporating digital health into future pandemic preparedness and response. Digital tools improve communication, combat fake news, and reach the public, but data protection and public health remain challenges. Integration requires extensive research and collaboration between governments and the private sector. The COVID-19 outbreak demonstrated the importance of digital technology in outbreak management, patient care, communication, and data sharing. As the world transitions into the post-pandemic phase, it will be important to build on these innovations and prepare for the challenges ahead in order to strengthen healthcare systems for future pandemics.

A scoping review of mesenchymal stem cell metabolites: Implications for oral wound healing

Mesenchymal stem cell (MSC) metabolites show considerable promise in enhancing oral wound healing due to their regenerative properties, including anti-inflammatory, collagen-promoting, and angiogenesis-stimulating effects. This scoping review consolidates current research on MSC metabolites, focusing on their roles in accelerating wound closure, reducing infection risk, and improving tissue integrity within the unique environment of the oral cavity. The findings reveal that while MSC metabolites offer a novel therapeutic approach with significant potential benefits, challenges such as variations in metabolite and quality need to be addressed to ensure consistent clinical outcomes. This review highlights the need for further studies to refine MSC metabolite applications, aiming to improve wound healing treatment efficacy in dentistry and oral health care.

In Vitro and In Vivo Evaluation of rPET/Cu-Alg Nanofibers for Anti-Infective Therapy

With the growing interest in nanofibers and the urgent need to address environmental concerns associated with plastic waste, there is an increasing focus on using recycled materials to develop advanced healthcare solutions. This study explores the potential of recycled poly(ethylene terephthalate) (PET) nanofibers, functionalized with copper-enhanced alginate, for applications in wound dressings. Nanofibers with desirable antimicrobial properties were developed using chemical recycling and electrospinning techniques, offering a sustainable and effective option for managing wound infections and promoting healing. SEM and FT-IR analyses confirmed that the obtained nanofibers possess optimal physicochemical properties, including well-organized morphology, appropriate dimensions, and structural integrity. Biological evaluations revealed significant antimicrobial activity, with the materials effectively inhibiting microbial adherence and biofilm formation while maintaining good biocompatibility in both in vitro and in vivo studies. These findings highlight the potential of recycled PET-based nanofibers as advanced wound dressing materials to reduce infection risks and support tissue regeneration in clinical applications.

Environmental Exposures Associated with Enteropathogen Infection in Six-Month-Old Children Enrolled in the ECoMiD Cohort along a Rural-Urban Gradient in Northern Ecuador†.

Enteropathogens are major contributors to mortality and morbidity, particularly in settings with limited access to water, sanitation, and hygiene infrastructure. To assess transmission pathways associated with enteropathogen infection, we measured household environmental conditions and assayed 22 enteropathogens using TaqMan Array Cards in stool samples from 276 six-month-old children living in communities along a rural-urban gradient in Northern Ecuador. We utilized multivariable models, risk factor importance, and distance-based statistical methods to test factors associated with infection. Most children (89%) carried at least one pathogen, and 72% carried two or more. Bacterial infections (82% of participants) were more common than viruses (58%) or parasites (9.1%). Infants living in the urban site had decreased infection risks compared to those in rural locations. Improved water and sanitation were most predictive of reduced infection risk. Improved water was associated with decreased enterotoxigenic E. coli prevalence, and improved sanitation was associated with lower prevalence of any infection and specifically norovirus. Animal exposure was associated with increased Salmonella prevalence. Children measured during the rainy season had fewer viral and more bacterial infections. Identifying environmental exposures associated with specific pathogen outcomes provides insights into transmission pathways, which contribute critical information for developing effective strategies to improve child health.

SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study.

The use of antibody titers against SARS-CoV-2, as a method of estimating subsequent infection following infection or vaccination, is unclear. Here, we investigate whether specific levels of antibodies, as markers of adaptive immunity, can serve to estimate the risk of symptomatic SARS-CoV-2 (re-) infection. In this real-world study, laboratory data from individuals tested for SARS-CoV-2 antibodies under routine clinical conditions were linked through tokenization to a United States medical insurance claims database to determine the risk of symptomatic/severe SARS-CoV-2 infection outcomes. Antibody titer levels were determined using the Elecsys® Anti-SARS-CoV-2 S assay. Study outcomes included the first symptomatic SARS-CoV-2 infection (per ICD-10 diagnostic codes, occurring≥7days post-antibody titer test), and severe SARS-CoV-2 infection, characterized by adverse outcomes including hospitalization, intensive care unit admission, intubation, mechanical ventilation, or death within 30days of infection. All outcomes were assessed for 12months following antibody measurement. Hazard ratios of subsequent symptomatic and severe infections were estimated using Cox regression with inverse probability weighting. Of 268,844 individuals with antibody data (April 2021-June 2022), those with levels≥0.8 to<1,000U/mL had a 42% reduced risk of symptomatic infection within 12months, compared with<0.8U/mL (HR=0.58, 95%CI [0.55, 0.61]). The risk decreased by 53% (HR=0.47, 95%CI [0.45, 0.49]) with≥1000 to<2500U/mL and by 62% (HR=0.38 [0.36, 0.39]) for≥2500U/mL. Risk of severe SARS-CoV-2 outcomes was also reduced. Subgroup analyses showed a consistent association between antibody levels and infection risk, by immune status and age. Clinically meaningful thresholds of antibody titers varied between Delta and Omicron infections. Higher antibody titer levels indicated reduced risk of developing symptomatic or severe COVID-19. Titers of≥2500 U/mL indicated a 62-87% reduced infection risk. The quantitative determination of antibody titers allowed scaling of the correlate of risk to new variants.

A Psychosocial Critique of the Consequences of the COVID-19 Pandemic on UK Care Home Staff Attitudes to the Flu Vaccination: A Qualitative Longitudinal Study.

Background/Objectives: Vaccinating care home staff is essential to protect vulnerable residents by reducing infection risks and creating a safer care environment. However, vaccine hesitancy amongst staff remains a challenge, particularly since the COVID-19 pandemic raised concerns about side effects and vaccination mandates. This study examines how the pandemic influenced flu vaccine hesitancy amongst UK care home staff. Methods: Data were collected from the FluCare trials conducted over the 2021-22 and 2022-23 winter seasons to explore the impact of concurrent mandatory and non-mandatory COVID-19 vaccination policies on flu vaccine uptake. A total of 52 interviews (21 from the feasibility study and 31 from the randomised control trial) were conducted with care home managers and staff. Thematic analysis identified key themes shaping staff attitudes toward flu vaccination. Results: Four central themes emerged regarding the impact of the pandemic on staff attitudes and the contextual influences shaping vaccine hesitance: (i) tension between autonomy and morals in vaccination decisions; (ii) the COVID 'craze' and the displacement of the flu vaccine; (iii) the role of the COVID 'craze' in staff vaccine fatigue; and (iv) conspiracies, (mis)information, and the significance of trust. Psychosocial theories on decision making and health behaviour were used to further interpret the findings. Conclusions: Our findings suggest that post-COVID-19 interventions in care home setting should address the issues of autonomy, vaccine fatigue, and trust to enhance vaccine uptake. Understanding these factors could support more effective strategies to address hesitancy amongst care home staff in future vaccination campaigns.

Antibiotic prophylaxis in oral implant surgery in Germany: a cross-sectional study

PurposeProphylactic antibiotics are used in dental implants to reduce infection risk and implant failure, especially benefiting patients with risk factors. However, evidence suggests that using clindamycin or extending antibiotics postoperatively has an unfavorable risk–benefit ratio.MethodsThis national cross-sectional study analyzed antibiotic prophylaxis during implant insertion across Germany. Dentists from the German Society for Oral Implantology (DGOI) provided demographic information and data on the next 10 consecutive implant patients, including age, sex, risk factors, type of implantation, and antibiotic details.Results103 dentists participated, providing data on 1040 patients. Most dentists were male and aged 30–64. Patients were evenly split between genders, with an average age of 51 years. Antibiotics were administered in 87.6% of all cases, more frequently for patients undergoing bone augmentation (OR 7.01, p < 0.0001), immediate (OR 3.11, p = 0.002) or delayed (OR 5.30, p < 0.0001) implant insertion, and those with cardiovascular disease (OR 3.24, p = 0.009). 74.8% of implantologists tended to use antibiotic prophylaxis routinely, while the remaining implantologists decided on a case-by-case basis. Implantologists primarily used aminopenicillins for 63.8% of prescriptions and clindamycin for the remaining 35.6%. Additionally, 78.8% of patients with prophylaxis received postoperative, multi-day treatments.ConclusionsThe study reveals extensive antibiotic use for perioperative prophylaxis in implant surgery, often not justified by current recommendations, particularly concerning the choice of antibiotic (e.g., clindamycin) and duration (e.g., postoperative use). Specialized clinical guidelines and targeted training for dentists on antibiotic prophylaxis are needed.Graphical

Employee Management in Dairy Farms Associated with Bulk Tank Somatic Cell Count and New Mastitis Infection Risk.

For decades, bovine mastitis and milk quality have been a focus area for research, agricultural extension, and dairy processors worldwide, yet employee management as a factor in udder health management has received limited attention. This is mainly because the focus has previously been on more classical areas covered by the National Mastitis Council Mastitis Control Program (NMC 10-point plan) in English-speaking countries. Therefore, we wanted more background information on employee management on dairy farms, to identify the human factor of udder health management. The method of investigating employee management and the impact of employee management on udder health was conducting a study of 88 Danish dairy farms with hired employees and parlor or rotary milking systems. An interview-based questionnaire on individual dairy farmers' human resource management was developed based on the current literature and multiple discussions among the authors. The results we found through analyzing associations between the dependent variable BTSCC and employee management, using a regression model, was that providing a generic SOP was associated with a 21,600 cells/mL increase in BTSCC, with estimates in the range (507; 42,674 cells/mL). We also analyzed, applying a Poisson model, that there was a 0.16% reduction in new infection risk if the training was based on a herd-specific SOP and educated employees. In contrast, we identified a 0.15% increase in new infection risk in herds where SOPs were available but not incorporated, both modest but significant results. In conclusion, farms with educated employees and trained by an SOP achieve the lowest new infection risk, but education has no impact on BTSCC.

HIV Infection Among Adolescent Girls and Young Women in Sub-Saharan Africa: Philosophical Perspectives of Sociostructural Risk Factors

Background and Objective Sociostructural risk factors influence human immunodeficiency virus (HIV) infection outcomes among adolescent girls and young women (AGYW) aged 15–24 in Sub-Saharan Africa. The philosophical perspectives on sociostructural risk factors can be helpful in reducing new HIV infections in this age group. This review aims to describe these perspectives to guide the development and implementation of targeted interventions at preventing new HIV infection among AGYW, while addressing age-gender inequalities in HIV infection risk reduction. Methods This literature review examined philosophical perspectives on sociostructural risk factors of HIV infection from June 1981 when improvements in HIV knowledge regarding clinical course and epidemiology began to November 2023. We utilized literature from peer-reviewed papers and books on HIV risk factors and infection outcomes among AGYW, gathered from search engines like PubMed, Google Scholar, and Medline. Results The philosophy of sexuality is linked to sociostructural tenets like seduction, early marriage, adultery, and prostitution. Ubuntu’s philosophy is influenced by Western culture, such as pornography and adolescent marriages. Realism is linked to sexual violence, HIV stigma, and unfavorable health policy decisions. The philosophy of health integrates natural and holistic phenomena to address HIV infection. Conclusion and Implications for Translation The literature reviews suggest that addressing philosophical issues like seduction, early marriages, adultery, prostitution, pornography exposure, sexual violence, and unfavorable policies are crucial for reducing new HIV infection among AGYW and recommend the Ministries of Health to review and adopt these considerations in their respective national HIV prevention guidelines.

P08 Study on the impact of COVID-19 infection in patients with moderate-to-severe plaque psoriasis on biologics: a tertiary centre experience in India

Abstract Introduction As the world faced COVID-19 pandemic, significant concerns were raised regarding its impact on specific patient groups due to paucity of real-world evidence. Individuals with psoriasis undergoing biologic therapy face heightened vulnerability to severe disease. This study aimed to examine the effects of COVID-19 infection on patients with moderate-to-severe plaque psoriasis treated with biologic agents. Materials and Methods Medical records of patients with moderate-to-severe plaque psoriasis undergoing biologic treatment at a tertiary care centre were retrospectively reviewed from March 2021 to June 2021. Patients with confirmed COVID-19 infection, identified through positive polymerase chain reaction tests, were included. Data on patient demographics, disease characteristics, symptoms, and vaccination status were collected and analysed. Results Among 34 infected patients (26 males, 8 females), median age was 50 years (range: 18–70) with a median psoriatic disease duration of 12 years (range: 12–32). Median psoriasis area and severity index (PASI) was 14, with 22.2% of patients having psoriatic arthritis. Comorbidities included overweight (34.4%), obesity (39.2%), dyslipidaemia (24.4%), diabetes mellitus (11.7%), arterial hypertension (7.0%), and coronary artery disease (2.3%). Most patients experienced mild COVID-19 symptoms; 3 required hospitalization due to dyspnoea and hypoxia. At the time of infection, 80% had received at least one dose of mRNA vaccine. Conclusion Our findings suggest that patients receiving biologic therapy for psoriasis did not exhibit a higher risk of severe COVID-19 outcomes. Also, biologic treatment did not appear to impact disease severity adversely indicating potential benefits such as reduced infection risk and milder symptoms. Continuation of biologic therapy in psoriasis patients, even during the pandemic, is essential for effective disease management. Patient education and counselling regarding hesitancy are equally important in such difficult times.

Protective environment strategies for hematopoietic stem cell transplantation: progress and prospects

With the progress of hematopoietic stem cell transplantation technology, the reduction of pretreatment intensity, the shortening of bone marrow suppression time and the reduction of infection risk, especially the physical and psychological stress for doctors and patients caused by rigorous protection procedures, the protective environment strategies need improvement. It has been found that, regardless of whether total environment protection is implemented, there is no significant difference in the outcomes of chemotherapy patients with neutropenia. Therefore, the traditional protective environment strategies are being improved. The protective environment strategies for hematopoietic stem cell transplantation patients have developed rapidly in the past two decades, from the replacement of laminar flow equipment by high-efficiency filtration devices to the development of home care after transplantation. In this article, the progress in protective environment strategies for hematopoietic stem cell transplantation patients is reviewed and further reflect, providing reference for future improvement.

The Usefulness of Vascularized Flap Craniotomy for Open-Wound Depressed Skull Fractures

BACKGROUND AND IMPORTANCE: Free bone flap craniotomy for open-wound depressed skull fractures poses a high risk of infection due to free bone fragments. This risk escalates in the presence of compound fractures with accompanying dural injuries. The primary objectives in managing depressed skull fractures include infection prevention and the correction of cosmetic deformities. This report describes the efficacy of vascularized flap craniotomy, which preserves blood flow to bone fragments, in reducing infection risks. CLINICAL PRESENTATION: In this study, we present a 54-year-old man with a head injury and a Glasgow Coma Scale score of 8. He had an open wound in the left parietal temporal area and depressed skull fractures with compound bone fragments. The patient underwent vascularized flap craniotomy, focusing on maintaining blood supply to the bone fragments, resulting in successful wound healing without acute infections. CONCLUSION: Vascularized flap craniotomy is an effective surgical option for treating open-wound depressed skull fractures, potentially reducing the risk of infection by maintaining blood flow to bone fragments. Further studies are required to validate its efficacy in larger patient populations.

Shoulder &amp; Elbow

The December 2024 Shoulder &amp; Elbow Roundup360 looks at: Predicting recurrence of instability after a primary traumatic anterior shoulder dislocation; Predictors of surgery and long-term outcomes in nonoperative management of full-thickness rotator cuff tears; Reverse shoulder arthroplasty viable despite acquired acromial compromise, but higher infection risk noted; LP-PRP reduces retear rates in rotator cuff repair but shows no functional outcome advantage; Long-term clinical outcomes of arthroscopic supraspinatus tendon repair using the single anchor tension band technique – minimum five-year follow-up; Arthroscopic stabilization for anterior shoulder dislocation shows low recurrence rates regardless of prior dislocations; ORIF outperforms arthroplasty for complex radial head fractures: mid-term outcomes; Routine use of surgical helmet systems may not reduce infection risk in shoulder arthroplasty.