Standardized Data Collection Form Research Articles

Evaluation of mpox contact tracing activities and data collection in EU/EEA countries during the 2022 multicountry outbreak in nonendemic countries.

To control human-to-human mpox transmission during the 2022 outbreak, European Union (EU)/European Economic Area (EEA) countries conducted case investigation and contact tracing (CT). We aimed to provide an overview of CT activities, describe CT data collection practices, and identify related facilitators, barriers, and potential opportunities for improvement. Between April 03, 2023 and May 12, 2023, a survey was distributed to CT stakeholders in 30 EU/EEA countries, asking about mpox CT activities and data collection and requesting to rank enablers, barriers, and improvements for CT on a five-point Likert scale. The 139 respondents from 27 countries indicated having performed case investigations (96%, n = 133), backward CT (88%, n = 122), forward CT (87%, n = 121), and follow-up on contacts' outcomes (77%, n = 107). Sixty percent (n = 80/134) used standardized data collection forms and 73% (n = 91/124) used databases. The highest-rated enablers were clear guidelines (mean = 3.9), quick access to laboratory results (3.6), and sufficient expertise (3.6). Highly rated barriers were inability to contact contacts (3.0) or cases (2.5) and lack of staff (2.4). The most needed improvements were availability of staff (3.5), expertise on affected populations (3.4) and data reporting tools and systems (3.3). To improve CT of mpox and diseases with similar transmission patterns, EU/EEA countries should increase workforce capacity in public and sexual health, offer training on CT operations and communication with affected communities, and use common CT data collection tools and systems.

Thrombocytopenia and its Severity in Plasmodium Vivax Positive Patients

Background: Plasmodium vivax, one of the four species of human malaria parasites, is responsible for a considerable portion of malaria cases. While P. vivax is often considered less severe than Plasmodium falciparum, it is not without its complications. Thrombocytopenia is a common hematological complication associated with malaria infections, including those caused by P. vivax. Objective: To evaluate the severity of thrombocytopenia and relationship between thrombocytopenia and demographic factors, such as age and gender, in Plasmodium vivax positive patients. Study Design: Cross sectional study. Settings: Medicine OPD of Liaquat University of Medical and Health Sciences / Jamshoro and Muhammad Medical College, Mirpur Khas Pakistan. Duration: Six months from May 2022 to October 2022. Methods: Individuals aged over 12 years of either gender with a confirmed diagnosis of Plasmodium vivax were included. A single blood sample was collected from each participant for platelet count analysis, and demographic details and platelet counts were recorded using standardized data collection forms. Thrombocytopenia was defined as a platelet count below a predetermined threshold (e.g., <150,000 platelets/μL). All the information was collected via study proforma and SPSS version 26 was used for the analysis. Results: The participants had a mean age of 29.07 years. 122 individuals (61.3%) were male, and 77 individuals (38.7%) were female. Thrombocytopenia was highly prevalent in patients with a positive diagnosis of Plasmodium vivax, with a frequency of 83.4%. Among the affected individuals, 18.6% had mild thrombocytopenia, 38.2% had moderate thrombocytopenia, and 25.6% were observed with severe thrombocytopenia. According to the thrombocytopenia and its severity based on age and gender the p-values of 0.069 and 0.656 indicates no significant association of age and gender with thrombocytopenia severity. Conclusion: Study revealed a significant frequency of moderate to severe thrombocytopenia in individuals diagnosed with Plasmodium vivax infection and tends to be of moderate to severe intensity, without significant correlation of age and gender.

Predicting Length of Hospital Stay Following Adult Cardiac Surgery: A Prospective Observational Study

INTRODUCTION: Despite life-saving benefits, adult cardiac surgery presents challenges due to potential for extended hospital stays and resource strain. Accurately predicting length of stay (LOS) is crucial for efficient resource allocation and patient discharge planning. The study aims to assess factors associated with LOS following adult cardiac surgery and proposed a model for predicting LOS after adult cardiac surgery. MATERIALS AND METHODS: A prospective observational study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center from September 2019 to May 2021, enrolling 249 adults undergoing cardiac surgery. A prospective observational study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center from September 2019 to May 2021, enrolling 249 adults undergoing cardiac surgery. Non-probability consecutive sampling was employed and a standardized data collection form was used to record patient-related, cardiacrelated, operation-related, and postoperative characteristics including LOS. Descriptive statistics and multivariate analysis were employed to meet the objectives. RESULTS: The study reported a median length of hospital stay as 10 days with interquartile range 6 days. Patients who experienced prolonged LOS (>13 days) after cardiac surgery accounted for 21.70% of the total sample. In an adjusted relationships, only female sex (AOR= 1.957; 95% CI: 1.022 - 3.745), previous cardiac surgery (AOR: 2.684, 95% CI: 1.314 - 7.885), active IE (AOR: 23.187, 95% CI: 2.467 - 217.969), and ECA (AOR: 3.891, 95% CI: 1.135 - 13.332) were identified as significant predictors of prolonged postoperative LOS. CONCLUSIONS: By understanding the factors influencing LOS following cardiac surgery, clinicians can optimize care plans and resource allocation, ultimately improving patient outcomes.

MEASURING IMPLEMENTATION FIDELITY OF THE TRANSITIONAL CARE MODEL IN THE MIRROR-TCM TRIAL

Abstract Examining the fidelity to the implementation of multi-component evidence-based interventions is essential but challenging. To capture the application of the Transitional Care Model (TCM) as designed, an advanced practice registered nurse (APRN)-led, team-based, care management strategy in a replication RCT conducted in three diverse health systems, an innovative method was utilized. This session describes the procedures, challenges, and decision-making processes associated with measuring the fidelity of the implementation of TCM’s core components over the trial. Standardized data collection forms were created for the APRNs to document the TCM elements addressed during each contact with and on behalf of the hospitalized older adults and their caregivers who had been randomly assigned to the TCM group (N=480). Measurable performance expectations for each element were established a priori (e.g., a minimum of 9 in-person visits). A dichotomous variable was created for each of the 38 elements making up the 10 TCM components which were provided monthly to each site to monitor their intervention implementation. Since not all elements were applicable to all older adults, the overall patient-level fidelity score required scaling to standardize the maximum fidelity score to 38. The individual components were inherently weighted according to their complexity as reflected by their respective number of elements. The average overall patient-level fidelity score was 34.2 (standard deviation: 3.5), median = 34.7. Higher fidelity scores indicated implementation of the minimum dose of the intervention elements. The findings provide critical insight into how to develop measures of implementation fidelity for complex multi-component evidence-based interventions.

Efficacy and Safety of Continuous Glucose Monitoring and Intermittently Scanned Continuous Glucose Monitoring in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Interventional Evidence.

Traditional diabetes self-monitoring of blood glucose (SMBG) involves inconvenient finger pricks. Continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems offer CGM, enhancing type 2 diabetes (T2D) management with convenient, comprehensive data. To assess the benefits and potential harms of CGM and isCGM compared with usual care or SMBG in individuals with T2D. We conducted a comprehensive search of MEDLINE, Embase, the Cochrane Library, Web of Science, and bibliographies up to August 2023. We analyzed studies meeting these criteria: randomized controlled trials (RCT) with comparison of at least two interventions for ≥8 weeks in T2D patients, including CGM in real-time/retrospective mode, short-/long-term CGM, isCGM, and SMBG, reporting glycemic and relevant data. We used a standardized data collection form, extracting details including author, year, study design, baseline characteristics, intervention, and outcomes. We included 26 RCTs (17 CGM and 9 isCGM) involving 2,783 patients with T2D (CGM 632 vs. usual care/SMBG 514 and isCGM 871 vs. usual care/SMBG 766). CGM reduced HbA1c (mean difference -0.19% [95% CI -0.34, -0.04]) and glycemic medication effect score (-0.67 [-1.20 to -0.13]), reduced user satisfaction (-0.54 [-0.98, -0.11]), and increased the risk of adverse events (relative risk [RR] 1.22 [95% CI 1.01, 1.47]). isCGM reduced HbA1c by -0.31% (-0.46, -0.17), increased user satisfaction (0.44 [0.29, 0.59]), improved CGM metrics, and increased the risk of adverse events (RR 1.30 [0.05, 1.62]). Neither CGM nor isCGM had a significant impact on body composition, blood pressure, or lipid levels. Limitations include small samples, single-study outcomes, population variations, and uncertainty for younger adults. Additionally, inclusion of <10 studies for most end points restricted comprehensive analysis, and technological advancements over time need to be considered. Both CGM and isCGM demonstrated a reduction in HbA1c levels in individuals with T2D, and unlike CGM, isCGM use was associated with improved user satisfaction. The impact of these devices on body composition, blood pressure, and lipid levels remains unclear, while both CGM and isCGM use were associated with increased risk of adverse events.

Feasibility of monitoring Global Breast Cancer Initiative Framework key performance indicators in 21 Asian National Cancer Centers Alliance member countries

The Global Breast Cancer Initiative (GBCI) Framework, launched by the World Health Organisation (WHO) in 2023, emphasises assessing, strengthening, and scaling up services for the early detection and management of breast cancer. This study aims to determine the feasibility of monitoring the status of breast cancer control in the 21 Asian National Cancer Centers Alliance (ANCCA) countries based on the three GBCI Framework key performance indicators (KPIs): stage at diagnosis, time to diagnosis, and treatment completion. We reviewed published literature on breast cancer control among 21 ANCCA countries from May to July 2023 to establish data availability and compiled the latest descriptive statistics and sources of the indicators using a standardised data collection form. We performed bivariate Pearson's correlation analysis to measure the strength of correlation between stage at diagnosis, mortality and survival rates, and universal health coverage. Only 12 (57%) ANCCA member countries published national cancer registry reports on breast cancer age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). Indonesia, Myanmar, and Nepal had provincial data and others relied on WHO's Global Cancer Observatory (GLOBOCAN) estimates. GLOBOCAN data differed from the reported national statistics by 5-10% in Bhutan, Indonesia, Iran, the Republic of Korea, Singapore, and Thailand and >10% in China, India, Malaysia, Mongolia, and Sri Lanka. The proportion of patients diagnosed in stages I and II strongly correlated with the five-year survival rate and with the universal health coverage (UHC) index. Three countries (14%) reported national data with >60% of invasive breast cancer patients diagnosed at stages I and II, and a five-year survival rate of >80%. Over 60% of the ANCCA countries had no published national data on breast cancer staging, the time interval from presentation to diagnosis, and diagnosis to treatment. Five (24%) countries reported data on treatment completion. The definition of delayed diagnosis and treatment completion varied across countries. GBCI's Pillar 1 KPI correlates strongly with five-year survival rate and with the UHC index. Most ANCCA countries lacked national data on cancer staging, timely diagnosis, and treatment completion KPIs. While institutional-level data were available in some countries, they may not represent the nationwide status. Strengthening cancer surveillance is crucial for effective breast cancer control. The GBCI Framework indicators warrant more detailed definitions for standardised data collection. Surrogate indicators which are measurable and manageable in country-specific settings, could be considered for monitoring GBCI indicators. Ensuring UHC and addressing health inequalities are essential to early diagnosis and treatment of breast cancer. Funding for this research article's processing fee (APC) will be provided by the affiliated institution to support the open-access publication of this work. The funding body is not involved in the study design; collection, management, analysis and interpretation of data; or the decision to submit for publication. The funding body will be informed of any planned publications, and documentation provided.

Learning from new colorectal cancers: a qualitative synthesis of significant event reports.

Colorectal cancer is the second leading cause of cancer-related mortality in the UK and a significant contributor to morbidity and mortality worldwide. Early diagnosis provides opportunities for intervention and improved survival. Significant event analysis (SEA) is a well-established quality improvement method for learning from new cancer diagnoses. To provide additional insights into diagnostic processes for colorectal cancer and to identify areas for improvement in patient care pathways. Fifty-three general practices across Pennine Lancashire, England, submitted one or more SEA reports as part of an incentivised scheme. A standardised data collection form was used to collate learning points and recommendations for improvements. In total, 161 reports were analysed using an inductive framework analysis approach. There was an overarching theme of building vigilance and collaboration between and within general practices and secondary care. The following four main sub-themes were also identified: education; individualised and flexible care; ownership and continuity; and communication. These findings provide additional insights into colorectal cancer pathways from a primary care perspective. Practices should be supported in developing protocols for assessment and follow-up of patients with varying presentations. Screening and access to investigations are paramount for improving early diagnosis; however, a flexible diagnostic approach is required according to the individual circumstances of each patient.

Prevalence and Antimicrobial Resistance Pattern of Bacterial Strains Isolated from Patients with Urinary Tract Infection in Al-Wahda Hospital in Derna City/Libya

Background: Urinary tract infection (UTI) is One of the most prevalent infectious diseases in human, where the study aimed to identify the most uropathogen that caused UTIs ,and its the antimicrobial resistance pattern. Methods: the samples were collected from January and December 2021 using a standard data collection form, where the patient outcome records were mined for information on the patients' gender, age, isolated organisms, and susceptibility test results, then statistical analysis was done. Results: 266 from 463 samples were identified as S. aureus 14.3% , in addition, the antibacterial resistance rats showed that the highest resistance was against ampicillin/Sulbactam, ceftazidine, and meropenem 79%, while, the lowest was against ciprofloxacin 40%. Conclusion: The study showed that S. aureus is the primary cause of UTIs in Derna city, as a result of consuming antibiotics randomly, which resulted in an increase in spread and resistance of S. aureus.

Patterns of Care Among Adolescents and Young Adults Treated for Acute Lymphoblastic Leukemia: A Retrospective Study across Diverse US Practices

Background. Studies have demonstrated superior outcomes in adolescents and young adults (AYAs, age 15-39 years) with T-cell and B-cell/Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) who are treated using pediatric-inspired regimens (PIRs). However, some AYAs continue to be treated with non-PIR or adult regimens (ARs) that are associated with less favorable outcomes. The extent to which hospitals and physicians in the United States (US) have adopted PIRs to treat ALL in AYA patients is not known. Additionally, limited knowledge exists about factors associated with use of AR. The objective of this study was to describe patterns of care in AYAs with newly diagnosed ALL, and identify patient, physician and hospital-level characteristics associated with use of PIRs vs. ARs in these patients. Methods. This retrospective study analyzed data collected from medical charts of AYAs with ALL across varied cancer care settings in the US. Patients were identified by treating oncologists, who were board certified in the relevant specialty and had 3-40 years of post-residency practice experience. Physicians were not eligible to participate if they were associated with a pharmaceutical company or a healthcare/government agency in paid capacity. Patients were included based on the following criteria: newly diagnosed with ALL, 15-39 years at diagnosis, and treated with frontline PIR or AR between January 2016 and April 2022. Patients with a prior history of cancer were excluded. Standardized data collection forms were used by participating physicians to collect patient and clinical characteristics, treatment patterns, and site characteristics. Physicians were compensated for participation for each completed chart. Descriptive statistics (mean, standard deviation [SD], frequency, percentages) were used to describe these characteristics. Chi-square and multivariate logistic regression analyses were conducted to evaluate potential associations of these variables with AR use. The study received IRB (Advarra, Inc.; IRB#: 00000971) exempt status. Results. The analytic sample consisted of 378 eligible patients. Patients were treated by 178 physicians, of which 16.8% were pediatric oncologists, 59.3% were adult oncologists, and 23.9% treated patients of all ages. The majority of patients were treated at adult centers (82 [21.1%]) or centers that treat patients of all age groups (279 [71.7%]); 24 patients (6.2%) were treated at pediatric centers. Approximately three-quarters (73.8%) were treated at academic centers and one quarter (26.2%) at community centers. Of the 378 patients, 230 (61%) patients were treated with a PIR and 148 (39%) with an AR. The proportions were similar for both B-cell/Ph- patients (71.3% and 28.3%, respectively) and T-cell phenotypes (46.5% and 53.4%, respectively). Children's Oncology Group (COG)-based protocols were the most common PIR used (60.4%) followed by CALGB 10403 (23%). Among those receiving ARs, HyperCVAD-based regimens was most commonly used (n=125 [84.7%]). Of patients receiving HyperCVAD, 85.6% did not receive any immunotherapy. In univariate analyses, the use of an AR was significantly higher in subgroups of older AYAs (20-39y), males, and patients with public insurance. AYAs who were obese, had CNS involvement at diagnosis, T-cell immunophenotype, Ph+, Ph-like, or early T-cell precursor (ETP) were associated with AR use. Patients treated at non-pediatric centers, small-medium size hospitals (&amp;lt;500 beds), or those treated by non-pediatric oncologists (those who treat adult only or both adult and pediatric patients) were more likely to receive AR (Table 1). In multivariate analysis, patient factors independently associated with use of an AR included older age, obesity, Ph+, and Ph-like. Patients treated at small/medium size hospitals or non-pediatric centers were also significantly more likely to receive an AR vs. PIR (Table 2). Conclusions. The study provides “real-world” insights into treatment approaches used for AYAs with ALL across diverse cancer care settings. Nearly one-half of AYAs with T-cell ALL and one-third of AYAs with B-cell/Ph- ALL received AR. Additional studies are needed to understand the reasons behind the limited uptake of PIR, especially among older AYAs and in smaller and adult treatment settings.

Hepatitis B virus infection in patients presenting for immunosuppressive cancer therapy with and without underlying HIV infection

IntroductionReactivation of hepatitis B virus (HBV) infection induced by immunosuppressive cancer therapy is associated with fulminant liver disease and death. While national guidelines recommend HBV screening and antiviral prophylaxis for patients with cancer prior to initiating immunosuppressive therapy, compliance with these measures is unclear. This study characterized the burden of HBV infection among patients diagnosed with gynecological or dermatological cancers, with or without underlying HIV infection, before initiating immunosuppressive therapy. MethodsBetween 2016 – 2018, we recruited study patients from the Dr George Mukhari Academic Hospital in Tshwane, South Africa. Demographic (age, sex) and clinical data (HIV test results, HIV antiviral regimen, type of cancer) were recorded using a standardized data collection form. All participants were tested for HBV surface antigen (HBsAg), and antibodies to the surface (anti-HBs) and core antigens (anti-HBc). For detection of HBV DNA, a nested polymerase chain reaction was used to amplify polymerase gene fragments which were Sanger-sequenced and analyzed using bioinformatics software. All statistical analyses were performed using R version 4.1.0 (2021-05-18) and R studio version 2022.07.2. ResultsStudy participants were predominantly female (96.3%, 103/107) with a median (IQR) age of 50 (17.5) years. Cervical cancer was the most frequent cancer diagnosis (72%). Over half (52.3%; 56/107) of the participants were HIV positive and all but four (92.9%) on highly active antiretroviral therapy at the time of enrollment. The prevalence of chronic hepatitis B in the study population was 11.2% [95% CI:6.2-19.1], increasing to 14.3% [95% CI:6.8-26.8] in the HIV positive sub-population. The overall prevalence of occult HBV infection was 20% [95% CI:12.8-29.7], 57.9% [95% CI:33.97-78.9] of whom tested negative for all serological markers. Phylogenetic inference showed that all polymerase gene sequences generated in this study were sub-genotype A2. Mutational analysis did not reveal any drug resistance-associated amino acid variations in this study. ConclusionThese findings suggest that chronic and occult HBV infections are more prevalent among cancer patients with or without underlying HIV infection compared to what has previously been reported for the general South African population. This underscores the need to scale-up universal HBV serological and molecular screening with timely institution of prophylaxis prior to initiating immunosuppressive cancer therapy.

Endoscopic Evaluation among Patients Presenting with Upper Gastrointestinal Tract Bleeding

Background: Bleeding from the upper gastrointestinal tract is a critical medical condition that requires prompt diagnosis and management. Endoscopic evaluation plays a pivotal role in identifying the source of bleeding, determining its severity, and guiding appropriate interventions. Objective: The objective of this study was to conduct a comprehensive endoscopic evaluation in patients who have presented with bleeding originating from the upper gastrointestinal tract. Study Design: Descriptive cross-sectional study. Settings: Department of Gastroenterology, Islamic International Medical College, Rawalpindi Pakistan. Duration: Study duration was 7 months from November 2021 to April 2022. Methods: Patients who were 18 years of age or older and presented with active or recent upper gastrointestinal bleeding, regardless of gender, and were scheduled for endoscopic examination, were incorporated into the study. Upper gastrointestinal endoscopies were performed. The procedure was involving the direct visualization of the esophagus, stomach, and duodenum using an endoscope. Any visible lesions or bleeding sources were documented. Data regarding the location and nature of bleeding sources and the endoscopic diagnosis were recorded in a standardized data collection form and analyzed by SPSS version 26. Results: The study included 59 patients with a mean age of 52.27 years. Esophageal endoscopic findings revealed "Grade I to III Esophageal varices (EV) being less common (3.4%, 11.9%, and 13.6% respectively). LAX LEs, esophagitis and Hiatus hernia were observed in 10.2%, 3.4%, and 6.8% of cases. Rarer findings, including Venules, Ecstatic vein, Candidiasis, and various combinations, each accounted for 1.7% of cases. Portal hypertension gastropathy was the most prevalent condition (20.3%), followed by Antral gastritis (45.8%), Erosive gastropathy (10.2%), and other less frequent conditions, such as fundal varices, GOVI varices, diffuse gastritis and Ulcer. Grade II and III EV, and PHTN gastropathy, were significantly more prevalent among males, while Antral gastritis was notably higher among females (p &lt; 0.05). Although the endoscopic findings did not show any statistically significant differences based on gender (p &gt; 0.05). Conclusion: PHTN gastropathy, antral gastritis, grade III EV and erosive gastropathy were the most common conditions among patients with Hematemesis, along with less frequent findings like grade I to III Esophageal varices, Venules, Ecstatic vein, Candidiasis, and combinations of these conditions.

Relationship between clinical symptom profiles and COVID-19 infection status during Delta-dominant period versus Omicron-dominant period—analysis of real-world data collected in Hiroshima Prefecture, Japan

ObjectivesThe present study investigates the diagnosis and prediction of COVID-19 based on clinical symptoms, and corresponding difference between the Delta- and Omicron-dominant periods, using data collected at polymerase chain reaction (PCR) centers in Hiroshima Prefecture, Japan. MethodsData was collected using a J-SPEED-style COVID-19 standard data collection form. The analysis was done in two directions: calculating the likelihood ratio that clinical symptoms will manifest in "infected" versus "non-infected" individuals and calculating the diagnostic odds ratio (OR) of infection for those who have symptoms compared to those without symptoms. ResultsCOVID-19 was more strongly associated with smell and taste disorders during the Delta-dominant period, and muscle pain during the Omicron-dominant period. An age-specific analysis of likelihood and diagnostic ORs found cold-like symptoms had the lowest ability to diagnose COVID-19, and the lowest predictability of COVID-19 with children during both periods. The likelihood and diagnostic ORs of other symptoms for COVID-19 were highest in adults and lowest in those over 65. ConclusionSymptoms are an important indicator of COVID-19, but the association between specific symptoms and COVID-19 is dependent on the dominant variant of the virus.

Epidemiology and Antimicrobial Resistance Patterns of Urinary Tract Infections: A Cross-Sectional Study from Southwestern Saudi Arabia.

Background: Urinary tract infections (UTIs) are a prevalent form of urinary tract diseases affecting individuals of all ages and genders. In the Kingdom of Saudi Arabia (KSA), UTIs are a significant burden on the healthcare system, comprising 10% of all infections and ranking as the second leading cause of emergency department admissions. Despite this, limited research has been conducted in Saudi Arabia, particularly in Jazan Province, located in the southwestern region. Methods: This retrospective, cross-sectional study encompassed individuals with positive urine cultures who sought care at a tertiary hospital in Jazan between January 2022 and March 2023. A standardized data collection form was utilized to retrieve relevant information from microbiology lab test results and patients' electronic medical records. Variables such as sex, urine sample collection date, bacterial isolates, antibiotic sensitivity, and resistance were collected using the data collection form. Data were analyzed using SPSS software, version 23.0 (IBM Corp., Armonk, NY, USA). Results: A total of 1082 urinary bacterial samples were isolated and identified. Females accounted for more bacterial infections (62.66%) than males (37.34%). Gram-negative bacteria represented 94% of all isolated strains. The most prevalent pathogens associated with UTIs were Escherichia coli (47.97%), Klebsiella pneumoniae (24.58%), and Pseudomonas aeruginosa (11.55%). Antimicrobial resistance patterns indicated the presence of extended-spectrum beta-lactamase (ESBL) (30.13%), carbapenemase-resistant Enterobacter (CRE) (1.94%), methicillin-resistant Staphylococcus aureus (MRSA) (0.74%), and vancomycin-resistant Enterococci (VRE) (0.18%). UTI incidence demonstrated a higher prevalence in September (13%) compared to other months in 2022. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the predominant Gram-negative multidrug-resistant organisms (MDRO), accounting for 34.42%, 13.95%, and 1.63% of the population. Conclusions: The prevalence of UTIs caused by antibiotic-resistant microbes is notable in Jazan. Consistent with findings from other regions, Escherichia coli remains the most common causative pathogen of UTIs, displaying a seasonal pattern that warrants attention. Approximately 35% of reported cases involve MDRO, with ESBLs accounting for 30%. These results should raise concerns among healthcare officials, highlighting the necessity for further investigations into factors contributing to the circulation of MDRO in Jazan.

Clinical tools to assess functional capacity before elective non-cardiac surgery: a scoping review protocol.

The objective of this scoping review is to map the evidence on clinical tools to assess functional capacity prior to elective non-cardiac surgery. Functional capacity is a strong prognostic indicator before surgery, which can be used to identify patients at elevated risk of postoperative complications. Yet, there is no consensus on which clinical tools should be used to assess functional capacity in patients prior to non-cardiac surgery. This review will consider any randomized or non-randomized studies that evaluate the performance of a functional capacity assessment tool in adults (≥18y) prior to non-cardiac surgery. For studies to be included, the tool must be used clinically for risk stratification. We will exclude studies on lung and liver transplant surgery, as well as ambulatory procedures performed under local anesthesia. The review will be conducted in line with the JBI methodology for scoping reviews. A peer-reviewed search strategy will be used to query relevant databases (ie, MEDLINE, Embase, EBM Reviews). Additional sources of evidence will include databases of non-peer-reviewed literature and the reference lists of included studies. Two independent reviewers will identify eligible studies in 2 stages: stage 1, based on titles and abstracts; and stage 2, based on full texts. Information on study details, measurement properties, pragmatic qualities, and/or clinical utility metrics will be charted in duplicate onto standardized data collection forms. The results will be presented using descriptive summaries, frequency tables, and visual plots that highlight the extent of evidence and remaining gaps in the validation process of each tool. https://osf.io/6nfht.

One musculoskeletal health: towards optimizing musculoskeletal health in Egypt—how to be a bone and muscle builder by the Egyptian Academy of Bone Health and Metabolic Bone Diseases

AbstractBackgroundMusculoskeletal disorders are common problems that affect the elderly. They severely restrict mobility and dexterity, resulting in early retirement from work, lower levels of well-being, and reduced ability to participate in society. With the increase in life expectancy, the older populations are dreaming of active, painless, and independent lives in the face of functional limitations that are the result of various comorbidities with age progression.Main textThe aim of the study is to highlight aging changes in the musculoskeletal system, risk factors that may have a negative impact on musculoskeletal, as well as strategies to optimize musculoskeletal health in the elderly. A narrative review was conducted through a series of literature searches in the database MEDLINE/PubMed focusing on musculoskeletal health. The search terms used were “muscle building,” “bone building,” “osteoporosis,” “osteopenia,” “sarcopenia,” “osteosarcopenia,” “fractures,” “falls,” “functional ability,” “nutrition,” “diet,” “obesity,” “comorbidity,” and “medication.” Data extraction was carried out by the investigators using a standardized data collection form with subsequent discussion among the authors. Peer-reviewed observational controlled and non-controlled studies (case–control and cohort studies) were selected. The data collected in the selected articles were all related to musculoskeletal health.ConclusionMany of the changes in the musculoskeletal system result more from disuse than from simple aging. Less than 10% of the Egyptian population participate in regular exercise, and the most sedentary group is older than 50 years of age. Long-term regular exercises may reduce the loss of bone and muscle mass and prevent age-associated increases in body fat.

Outcomes of catheter-directed thrombolysis versus systemic thrombolysis in the treatment of pulmonary embolism: a meta-analysis.

To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) versus systemic thrombolysis (ST) in the treatment of pulmonary embolism (PE). The Cochrane Library, PubMed, and Embase databases were searched to collect the literature on the comparison of the results of CDT and ST in the treatment of PE from the beginning of their records to May 2020, and meta-analysis was performed by STATA software (version 15.1). Using standardized data-collection forms, the authors screened the studies and independently extracted data, and assessed the quality of the studies using the Newcastle-Ottawa Scale for cohort studies. Cohort studies that examined the following results were included in the current study: in-hospital mortality, all-cause bleeding rate, gastrointestinal bleeding rate, intracranial hemorrhage rate, the incidence of shock, and hospital length of stay. A total of eight articles, with 13,242 participants, involving 3962 participants in the CDT group and 9280 participants in the ST group were included. CDT compared with ST in the treatment of PE can significantly affect in-hospital mortality rate [odds ratio (OR) = 0.41, 95% CI: 0.30-0.56, P < 0.05], all-cause bleeding rate (OR = 1.20, 95% CI: 1.04-1.39, P = 0.012), gastrointestinal bleeding rate (OR = 1.43, 95% CI: 1.13-1.81, P = 0.003), the incidence of shock (OR = 0.46, 95% CI: 0.37-0.57, P < 0.05), and hospital length of stay [standard mean difference (SMD) = 0.16, 95% CI: 0.07-0.25, P < 0.05]. However, there was no significant effect on intracranial hemorrhage rate in patients with PE (OR = 0.70, 95% CI: 0.47-1.03, P = 0.070). CDT is a viable alternative to ST in the treatment of PE, as it can significantly reduce in-hospital mortality rate, all-cause bleeding rate, gastrointestinal bleeding rate, and incidence of shock. However, CDT may prolong hospital length of stay to a certain extent. Further research is needed to evaluate the safety and efficacy of CDT and ST in the treatment of acute PE and other clinical outcomes.

PEG-asparaginase treatmentregimens for acute lymphoblastic leukaemia in children: a network meta-analysis.

PEG-asparaginase treatmentregimens for acute lymphoblastic leukaemia in children: a network meta-analysis.

Effects of marital self-disclosure on marital relationship and psychological outcome for cancer patients: a systematic review.

Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses. This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability. The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions' long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.

Epidemiology of Gram-Negative Bloodstream Infections in the United States: Results From a Cohort of 24 Hospitals.

To address knowledge gaps in management of Gram-negative bloodstream infection, the Antibiotic Stewardship Implementation Collaborative was established consisting of programs from 24 academic and community hospitals across the United States. A retrospective cohort study was conducted of unique adult patients with Gram-negative bloodstream infection hospitalized at participating hospitals from January to December 2019. Patient level and microbiologic data were collected via electronic medical record review with a standardized data collection form and data dictionary. Data analysis was largely descriptive. The Pearson χ2 test to compare categorical variables and the Wilcoxon rank sum test for continuous variables were used. In total, 4851 bacterial isolates from 3710 eligible unique patients were included in the cohort. Most common source of infection was the urinary tract (47.9%). Source control was achieved in 84% of cases. Escherichia coli (2471, 51.0%) was the most common Gram-negative organism recovered. Antibiogram combining isolates from all participating centers with species-level susceptibilities and source specific antibiograms for isolates from urinary, respiratory, and intraabdominal source were created. Northeast sites contributed the most extended spectrum beta-lactamase (ESBL) producing organisms (73%), but West sites had the highest percentage of ESBL producers of total isolates (16%). A statistically significant difference in percentage of ESBL-producing organisms in Whites vs. non-Whites (14.6 % and 9.5 %, respectively, P<0.01) was observed. While the present study was conducted pre-pandemic, it highlights the need for stewardship data collaboratives to enhance our understanding of the antimicrobial resistance patterns.

Characteristics of out-of-hospital cardiac arrest patients in Riyadh province, Saudi Arabia: a cross-sectional study.

Little work has been done on out-of-hospital cardiac arrest (OHCA) in Saudi Arabia. Our goal is to report the characteristics of OHCA patients and predictors of bystander cardiopulmonary resuscitation (CPR). This cross-sectional study utilized data from the Saudi Red Crescent Authority (SRCA), a governmental emergency medical service (EMS). A standardized data collection form based on the "Utstein-style" guidelines was developed. Data were retrieved from the electronic patient care reports that SRCA providers fill out for every case. OHCA cases that were attended by SRCA in Riyadh province between June 1st, 2020 and May 31st, 2021 were included. Multivariate regression analysis was performed to assess independent predictors of bystander CPR. A total of 1,023 OHCA cases were included. The mean age was 57.2 (±22.6). 95.7% (979/1,023) of cases were adults and 65.2% (667/1,023) were males. Home was the most common location of OHCA [784/1,011 (77.5%)]. The initial recorded rhythm was shockable in 131/742 (17.7%). The EMS mean response time was 15.9 min (±11.1). Bystander CPR was performed in 130/1,023 (12.7%) and was more commonly performed in children as compared to adults [12/44 (27.3%) vs. 118/979 (12.1%), p = 0.003]. Independent predictors of bystander CPR were being a child (OR = 3.26, 95% CI [1.21-8.82], p = 0.02) and having OHCA in a healthcare institution (OR = 6.35, 95% CI [2.15-18.72], p = 0.001). Our study reported the characteristics of OHCA cases in Saudi Arabia using EMS data. We observed young age at presentation, low rates of bystander CPR, and long response time. These characteristics are distinctly different from other countries and call for urgent attention to OHCA care in Saudi Arabia. Lastly, being a child and having OHCA in a healthcare institution were found to be independent predictors of bystander CPR.