Treatment Centers Research Articles

Bleeding and quality of life in people with Glanzmann thrombasthenia—insights from the Glanzmann’s 360 study

BackgroundGlanzmann thrombasthenia (GT) is a rare platelet function disorder that results in severe bleeding. We assessed clinical symptoms and psychological parameters to identify the unmet needs associated with GT. ObjectivesGlanzmann’s 360 is a mixed-methods study designed to give a contemporary snapshot of the impact of living with GT. MethodsThe study comprised a self-completion online survey complemented by interviews conducted with affected individuals and carers recruited via social media and hemophilia treatment centers. ResultsThe survey was completed by 88 people with GT and 29 carers of children/young people with GT aged <16 years. The population ranged in age from <2 years to >70 years; 56% were female. Although 47% had been diagnosed with GT under the age of 2 years, 12% were diagnosed after 20 years of age. For 82%, a bleeding phenotype was apparent by the age of 5 years. Most respondents (88%) had experienced at least one bleed in the past week. Bleeding disproportionally affected women. Bleeds resulted in frequent hospital contact and considerable psychological distress: 26% of the population had scores suggestive of low self-esteem, while 30% met criteria suggestive of symptomatic depression. Exploratory analyses suggest that bleed experiences are associated with impaired health-related quality of life. ConclusionThe Glanzmann’s 360 study reveals the significant physical, psychosocial, and quality-of-life impairments that are likely to be linked to the frequent bleeds experienced by those with GT. Clinicians treating people with GT should promote access to multidisciplinary comprehensive care, including psychosocial support.

Editorial Comment: Urologist-Administered MRI-Guided Transurethral Ultrasound Ablation of the Prostate Using a Mobile Treatment Center: A Case Series

Editorial Comment: Urologist-Administered MRI-Guided Transurethral Ultrasound Ablation of the Prostate Using a Mobile Treatment Center: A Case Series

Achieving The Nutritional Goal Of Burn Patients In A Referral Hospital In The Northern Region Of Brazil

Background: Burns represent a significant health challenge, not only due to the pain and suffering they cause, but also due to metabolic complications. Oral nutritional therapy is a powerful tool in the recovery of these patients, as the burn requires double the energy demands. Therefore, achieving the nutritional goal in burn patients should be considered a priority in clinical management. Materials and Methods: Patients admitted to the Burn Treatment Center at a reference hospital in the North region were evaluated. For nutritional diagnosis, the gold standard tools for nutritional risk analysis were applied, Nutritional Risk Screening (NRS-2002) for adults and Screening Tool for Risk on Nutritional Status and Growth (Strongkids, 2012) for children. These are validated low-cost and non-invasive methods. Monitoring the achievement of VET and protein was carried out through food records and the percentages achieved in accordance with the prescribed calories and proteins were calculated. Results: 22 adult patients were evaluated. Of these, 15 men and 7 women, with an average age of 35.8 years. The assessment revealed 7% malnourished, 67% eutrophic, 33% obese and 13% obese. Adults averaged 2026 cal/day with 112% VET attainment and 90g protein with 125% intake. It is worth highlighting the joint action of nutrition professionals with the prescription of hypercaloric and hyperprotein preparations to adapt to the needs recommended for burn patients, in addition to Oral Nutritional Therapy (ONT), with an increase of 600cal/day and 40g of proteins. The use of hypercaloric and hyperprotein supplementation in burn patients is a strong ally in diet therapy, given the catabolic state and high risk of depletion. Among the children's audience, 7 children were served: 4 boys and 3 girls, an average age of 4.4 years. The nutritional diagnosis showed 85% in eutrophy, and 15% in nutritional risk. The VET of this group was on average 1215 cal and 39g of protein. Children achieved an average of 142% of daily VET and 175% of protein needs. To this end, 85% used TNO, accounting for 300 cal and 7.6 g of additional protein to the oral diet. Conclusion: Achieving the nutritional goals prescribed for burn patients has a significant impact on the meffectiveness of treatment

Breaking barriers: Assessing the feasibility and acceptability of telemedicine-assisted buprenorphine induction for opioid use disorder in India

Background: Telemedicine-assisted buprenorphine (BNX) induction (TABI) has the potential to reduce the treatment gap for opioid use disorder. Aim: This study investigated the acceptability and feasibility of TABI in India. This was a retrospective study from a specialized addiction treatment center in a teaching hospital. Methods: TABI was introduced in November 2022; patients enrolled till May 2023 were included in the analysis. Feasibility was assessed by the proportion of patients who completed the TABI program, continued treatment for at least 3 months, and self-reported nonprescription opioid use during and after TABI. Acceptability was measured by patient satisfaction with TABI. Results: Sixty patients were enrolled: Fifty-three patients (88.3%) were retained during the TABI program, and 50 patients (83.3%) remained in treatment at the 3-month follow-up. Thirty-five patients (58.3%) reported using nonprescription opioids during TABI, and 28 patients (46.7%) reported such use after completing the program. Thirty-five (58.3%) were satisfied with the program, and 15 (25%) said they would recommend it to others. Patients who missed scheduled in-person appointments (P &lt; .001) at 1 week, did not return unused BNX-naloxone (P &lt; .001), and were not satisfied (P = .004) were more likely to report nonprescription opioid use. Those who attended the in-person follow-up at 1 week (P = .004) and were satisfied (P = .01) and did not use nonprescription opioids either during (P = .003) or after (P &lt; .001) TABI were more likely to be retained in treatment at 3 months. Conclusion: The study shows TABI’s acceptability and feasibility in a specialized addiction treatment setting; further research is needed for broader applicability.

Isoniazid resistance pattern among pulmonary tuberculosis patients in Bangladesh: An exploratory study

ObjectivesIn high tuberculosis (TB) burden countries such as Bangladesh, research and policy tend to focus on rifampicin (RIF)-resistant TB patients, leaving RIF-sensitive but isoniazid (INH)-resistant (Hr-TB) patients undiagnosed. Our study aims to determine the prevalence of INH resistance among pulmonary TB patients in selected health care facilities in Bangladesh. MethodsThis study was conducted across nine TB Screening and Treatment Centres situated in Bangladesh. Sputum samples from 1084 Xpert-positive pulmonary TB patients were collected between April 2021 and December 2022 and cultured for drug susceptibility testing. Demographic and clinical characteristics of Hr-TB and drug-susceptible TB patients were compared. ResultsAmong available drug susceptibility testing results of 998 culture-positive isolates, the resistance rate of any INH regardless of RIF susceptibility was 6.4% (64/998, 95% CI: 4.9–8.2). The rate was significantly higher in previously treated (21.1%, 16/76, 95% CI: 12.0–34.2) compared with newly diagnosed TB patients (5.2%, 48/922, 95% CI: 3.8–6.9) (p < 0.001). The rate of Hr-TB was 4.5% (45/998, 95% CI: 3.3–6.0), which was also higher among previously treated patients (6.6%, 5/76, 95% CI: 1.4–13.5) compared with newly diagnosed TB patients (4.3%; 40/922, 95% CI: 3.1–5.9) (p 0.350). Most importantly, the rate of Hr-TB was more than double compared with MDR-TB (4.5%, 45/998, vs. 1.9%, 19/998) found in the current study. DiscussionThis study reveals a high prevalence of Hr-TB, surpassing even that of the multi-drug-resistant TB in Bangladesh. This emphasizes the urgent need to adopt WHO-recommended molecular tools at the national level for rapid detection of INH resistance so that patients receive timely and appropriate treatment.

The impact of working patterns and extended treatment hours on work-life balance: a qualitative study into therapeutic radiographers’ lived experience at a Cancer Treatment Centre

The impact of working patterns and extended treatment hours on work-life balance: a qualitative study into therapeutic radiographers’ lived experience at a Cancer Treatment Centre

Architecture designing of digital twin in a healthcare unit.

Objectives: This study proposes a novel architecture for designing digital twins in healthcare units. Methods: A systematic research methodology was employed to develop architecture design patterns. In particular, a systematic literature review was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework to answer specific research questions and provide guidelines for designing the architecture. Subsequently, a case study was designed and analyzed at a chemotherapy treatment center for outpatients. Results: System architecture knowledge was distilled from this real-world case study, supplemented by existing software and systems design patterns. A novel five-layer architecture for digital twins in healthcare units was proposed with a focus on the security and privacy of patients' information. Conclusion: The proposed digital twin architecture for healthcare units offers a comprehensive solution that provides modularity, scalability, security, and interoperability. The architecture provides a robust framework for effectively and efficiently managing healthcare environments.

Risk Factors for COVID-19 Mortality in Epidemic Treatment Centers: A Case-Control Study from Decentralized Regions of Senegal

Introduction: The COVID-19 pandemic is an emerging viral zoonosis caused by SARS-CoV2. It is responsible for a systemic infection in humans, primarily respiratory. In Senegal, the Thiès Region confirmed its first case on March 14, 2020. The second epidemic wave occurring in 2021 was marked by high fatality, justifying our study on the factors associated with deaths among COVID-19 patients hospitalized at the Epidemic Treatment Centers (CTE) of the Regional Health Directorate of Thiès (Senegal). Patients and Methods: Unmatched case-control study, 1 case to 2 controls, relating to COVID-19 deaths recorded in the Thiès Regional Health Directorate from January 1 to December 31, 2021. All patients who tested positive for COVID-19 (PCR/Antigenic test) hospitalized in CTEs were included. All confirmed COVID-19 patients who died were referred to as “cases,” and all recovered patients as “controls.” The sampling of deaths was exhaustive, standardized sociodemographic, clinical, therapeutic and evolutionary data collected from patient files after a pilot trial with quality control. The data was entered on kobo collect and analyzed on Epi info7. Quantitative variables (mean, standard deviation) and qualitative variables (proportions. Measures: odds ratio, chi2 or Fisher exact test, significance threshold set at p&lt;0.05) were used. Results: A total of 348 patients were recruited in this study including 116 deaths and 232 recovered, the average age was 68.9 years +/- 14.24 for the deceased patients compared to 61.5 +/- 14.24 for the recovered, with male predominance in both groups. The most common clinical signs (cases/controls) were dyspnea (98.3/84.49%), fever (71.5/68.1%), asthenia (57.8/65.4%). and cough (52.6/58.1%). Complications were dominated by acute respiratory distress (87.9/3.8%), (11.2%/0.4%) and pulmonary embolism (03.5/0%). The factors associated with deaths found after multivariate analysis by logistic regression were male sex (OR: 4.11, 95% CI : 1.45 – 11.61 and p = 0.0076), patients aged over 60 years (OR=1.77, 95% CI: 1.0018-3.1438, p=0.049), complications such as stroke (OR=31.00; 95% CI: 5.69-168.73 and p=0 .0001), shock (OR22.61; 95% CI: 1.44-353.67 and p=0.026) and acute respiratory distress syndrome (OR: 204.09 95% CI : 70.44-591.30 and p = 0.000). Conclusion: The factors associated with COVID-19 deaths in the CTEs of Thiès Region are age, male gender, the presence of complications; stroke in particular, the state of Shock and ARDS.

Prognostic Factors in Limited-Stage Small Cell Lung Cancer

The impact of patient-specific, disease-related, and social factors on outcomes in limited-stage small cell lung cancer (LS-SCLC) is not well defined. A post hoc secondary analysis of such factors from the Cancer and Leukemia Group B (CALGB) 30610-Radiation Therapy Oncology Group (RTOG) 0538 trial may impact future trial design. To assess the comprehensive demographic, disease-related, treatment-related, and social factors for potential associations with survival outcomes and understand whether specific subpopulations may benefit from radiotherapy (RT) dose escalation in LS-SCLC. This post hoc secondary analysis of a randomized clinical trial included 638 adults with LS-SCLC treated at 186 unique treatment sites with at least 1 accrual for all patients from March 15, 2008, to December 1, 2019; 313 patients were randomized to receive RT twice daily to a dosage of 45 Gy for 3 weeks and 325 to receive RT once daily to a dosage of 70 Gy for 7 weeks. Data were locked February 28, 2022, and analyzed from November 28, 2022, to June 4, 2024. Twice-daily RT or once-daily RT. Multivariable Cox proportional hazards models evaluated the association of treatment groups and other risk factors with progression-free survival (PFS) and overall survival (OS). Patient-specific factors included age, sex, and Eastern Cooperative Oncology Group performance status. Disease-related factors included tumor, nodal, and overall cancer stages. Treatment-related factors included type of chemotherapy, timing of concurrent RT, RT technique, and prophylactic cranial irradiation. Social factors included marital status and treatment center accrual volume. Among 507 patients (260 [51.3%] female and 247 [48.7%] male; mean [SD] age, 62.6 [7.9] years) included in the multivariate survival analysis, with a median follow-up of 4.7 (IQR, 3.7-7.1) years, female sex was associated with improved OS (hazard ratio [HR], 0.73 [95% CI, 0.58-0.91]; P = .006), while being 70 years or older was associated with decreased OS (HR, 1.50 [95% CI, 1.14-1.98]; P = .004). Neither age nor sex was associated with PFS. When compared with those with N1 disease, OS and PFS were worse in patients with N2 (HRs, 1.64 [95% CI, 1.19-2.26]; P = .002 and 1.36 [95% CI, 1.02-1.81]; P = .04, respectively) and N3 (HRs, 2.03 [95% CI, 1.40-2.93]; P < .001 and 1.63 [95% CI, 1.17-2.26]; P = .004) disease. Compared with stage II cancer, OS was worse for stage IIIA (HR, 1.65 [95% CI, 1.17-2.31]; P = .004) and stage IIIB (HR, 1.94 [95% CI, 1.34-2.83]; P < .001). Compared with high-volume accrual centers, treatment at low- or middle-volume accrual centers was associated with worse PFS (HRs, 1.94 [95% CI, 1.33-2.82; P < .001] and 1.44 [95% CI, 1.15-1.82; P = .002], respectively) and worse OS (HRs, 1.55 [95% CI, 1.03-2.32; P = .03] and 1.33 [95% CI, 1.04-1.70; P = .02], respectively). This secondary analysis of the CALGB 30610-RTOG 0538 randomized clinical trial of patients with LS-SCLC found associations between female sex or being younger than 70 years and improved overall survival and between advanced nodal stage or treatment at low- or middle-volume accrual centers and worse outcomes. These findings suggest that stratification by nodal stage, clinical stage, and age should be considered in future randomized trials. ClinicalTrials.gov Identifier: NCT00632853.

Mathematical analysis of Ebola considering transmission at treatment centres and survivor relapse using fractal-fractional Caputo derivatives in Uganda

In this article, we seek to formulate a robust mathematical model to study the Ebola disease through fractal-fractional operators. The study thus incorporates the transmission rate in the treatment centers and the relapse rate, since the Ebola virus persists or mostly hides in the immunologically protected sites of survivors. The Ebola virus disease (EVD) is one of the infectious diseases that has recorded a high death rate in countries where it is endemic, and Uganda is not an exception. The world at large has suffered from this deadly disease since 1976 when it was declared epidemic by the World Health Organization. The study employed fractal-fractional operators to identify the epidemiological patterns of EVD, especially in treatment centers and relapse. Memory loss and relapse are mostly observed in EVD survivors and this justifies the use of fractional operators to capture the true dynamics of the disease. Through dynamical analysis, the model is proven to be positive and bounded in the region. The model is further explicitly shown to have a solution that is unique and stable. The reproduction number was duly computed by using the next-generation matrix approach. By taking EVD epidemic cases in Uganda, the study fitted all parameters to real data. It has been shown through sensitivity index analysis that the transmission rate outside treatment centers and relapse have a significant effect on the endemic state of the disease, as they lead to an increase in the basic reproduction ratio.

SEROPREVALENCE OF TOXOPLASMA GONDII AMONG CANCER PATIENTS IN AL-AMAL CENTER FOR TREATMENT OF CANCER PATIENTS IN TAIZ CITY, YEMEN

The current study was done in Taiz city during the period from March 2019 to march 2020, this study aimed to determine the prevalence of Toxoplasma gondii infection among cancer patients and to determine the association of T. gondii seropositivity in cancer patients with gender, age and number of chemical doses in Al-Amal Center for Treatment of Cancer Patients in Taiz governorate, Yemen, using serological test by rapid devise Toxo-kits method. A total of 368 blood samples from cancer patients were collected and examined for anti-Toxoplasma gondii IgG and IgM antibodies. The overall T. gondii seroprevalence, including both Immunoglobulin G (IgG) and Immunoglobulin M (IgM) positive individuals was 42.12% (155/368). The seroprevalence rate of IgG and IgM antibodies was 41.58% (153/368) and 14.13% (52/368), respectively. Regarding sex, no statistically significant difference was found, with 65 seropositive out of 148 (43.92%) in males and 90 out of 220 (40.91%) in females (P&gt;0.05). The seroprevalence of T. gondii infection was high in all age groups, especially in younger and older cancer patients (aged from 1-10 and &gt;80 years old), (50.00%) in each; while the lower seroprevalence (25.81%) was detected in cancer patients aged 21 to 30 years old, but the differences were not significant (P&gt; 0.05). Moreover, the seroprevalence of toxoplasmosis was higher in individuals treated with chemotherapy (43.07%) than those not used chemotherapy (39.60%), with no significant difference (P&gt;0.05). T. gondii infection remains a major threat to cancer patients, and it needs proper screening, diagnosis and treatment.

Effect of Severity of Depression and Perceived Social Support on Suicidal Ideation among Patients Hospitalized with Substance Use Disorder

Objective: The aim of this study was to investigate the effects of perceived social support and depression on suicidal ideation in inpatients receiving substance abuse disorder treatment.&#x0D; Method: A total of 110 inpatients in an Alcohol and Drug Treatment Center were included in the study. A sociodemographic and clinical information form, Beck Depression Inventory, Suicidal Ideation Scale, and Multidimensional Perceived Social Support Scale were administered to all patients.&#x0D; Results: No significant correlation was identified between total social support score and suicidal ideation, whereas a weak negative but statistically significant correlation was found between social support from family and suicidal ideation scores (r=-0.231; p=0.016). The mean value of suicidal ideation was 2.22 in the non-depressed groupand 10.13 in the severely depressed group. We also found thatpatients whowere exempted from military service and those who had attempted suicide before had statistically significantly higher scores on the suicidal ideation scale.&#x0D; Conclusion: In patients diagnosed with substance use disorder, various factors may increase the risk of suicidal behavior. In particular, patients with insufficient social support, depressive symptoms, unable to carry out their military service and those who have attempted suicide before should be closely followed for suicidal ideation.

Anti-SARS-CoV-2 Nucleocapsid Antibody Positivity Three Years after COVID-19.

The accurate identification of individuals without prior infection with severe acute respiratory syndrome coronavirus 2 is pivotal for seroepidemiological studies and vaccine trials. Owing to widespread vaccination against coronavirus disease 2019 (COVID-19), the anti-nucleocapsid antibody continues to serve as a valuable marker for individuals without a history of COVID-19. This study aimed to comprehensively assess anti-nucleocapsid antibody positivity using diverse commercial and in-house immunoassays among individuals who contracted COVID-19 more than three years earlier. We enrolled 44 participants with laboratory-confirmed COVID-19 between January and May 2020 from the Seoul National University Hospital and its community treatment centers. The results showed anti-nucleocapsid antibody positivity ranging from 45.5% to 87.9%, depending on the immunoassay. This study highlights the importance of considering the limited anti-nucleocapsid antibody positivity in individuals, with a history of distant COVID-19, in seroepidemiological or vaccine research.

Students’ perceptions of fairness and accuracy in clinical practice evaluation

Objectives: This study aims to investigate dental students' perceptions regarding the evaluation of clinical practice and to explore the factors influencing these perceptions.Methods: An online survey was conducted targeting third and fourth-year dental students from 11 nationwide dental schools. The survey focused on their perceptions of the accuracy and fairness of two clinical practices: 1) clinical clerkship in specialty clinics, and 2) direct patient care in pre-doctoral treatment centers. Additionally, the effects of different clerkship models (disciplinary block, longitudinal integrated), evaluation units (individual subject, integrated subject), and grading systems (grading, pass/fail) were assessed.Results: The overall perception of fairness and accuracy in clinical practice evaluation was found to be low. Students in disciplinary block clinical practice settings reported lower perceptions of evaluation accuracy and fairness compared to those in longitudinal integrated or mixed schedule types. Furthermore, the grading system influenced the perception of fairness and accuracy in the evaluation of clinical practices. Regarding direct patient care in pre-doctoral treatment centers, the evaluation units significantly impacted students' perceptions, although the grading system did not. Groups with grading systems showed lower perceptions compared to those with pass/fail or mixed evaluation systems.Conclusion: The study reveals that dental students perceive clinical practice evaluations as generally unfair and inaccurate, particularly within disciplinary block schedules. To improve future dental education, adopting longitudinal integrated schedules could be considered to enhance the perceived fairness and accuracy of clinical practice evaluations.

Sputum culture conversion and its predictors among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia.

Evidence of time to culture conversion is used to predict the time of cure from the disease and the overall drug-resistant tuberculosis (TB) treatment duration. Even though evidence about sputum culture conversion is enormous in TB treatment, no study has yet been done in our areas, where cases are common. The study aimed to assess the time to sputum conversion and its predictors among drug-resistant TB patients from October 2013 to September 2021 in eastern Ethiopia. A retrospective cohort study was conducted in eastern Ethiopia among 273 drug-resistant TB patients who were treated from October 2013 to September 2021 at Dire Dawa City and Harari regional treatment centres. The Kaplan-Meier method was used to estimate the median time of sputum culture conversion. Cox proportional hazards regression was employed to detect the predictors of sputum culture conversion. An adjusted hazard ratio (aHR) with 95% confidence interval (CI) was used to determine the strength and significance of the association. Of the 273 drug-resistant TB patients, the sputum culture of 216 (79.12%) patients became negative in a median time of 3months (interquartile range 2-7). The time to sputum culture conversion was negatively associated with underweight (aHR 0.65 [95% CI 0.49 to 0.90]) and poor adherence (aHR 0.41 [95% CI 0.24 to 0.69]). The time to sputum culture conversion was also positively associated with patients resistant to two or more drugs (aHR 1.58 [95% CI 1.07 to 2.32]) and patients receiving a short treatment regimen (aHR 2.24 [95% CI 1.10 to 2.55]). A shorter culture conversion rate was observed compared with the median time recommended by the World Health Organization. Being underweight, poor adherence to treatment, resistance to two or more drugs and receiving a short treatment regimen were found to be predictors of time to sputum culture conversion. Implementing nutrition assessment, counselling and support of drug adherence may improve sputum culture conversion.

High Aluminum content in the aquifer of Camaçari industrial pole, state of Bahia, Brazil: Correlation with natural and anthropogenic environmental factors using multivariable analysis

&lt;p class="MsoNormal"&gt;This work used multivariable analysis to correlate groundwater high aluminum content in the area of the Liquid Effluent Treatment Center—CETREL of the Camaçari Industrial Pole, with natural environmental factors: geology, hydrogeology, precipitation, soil and vegetation; and anthropic: equipments of treatment and disposal of industrial waste from CETREL. This company made available data from 99 monitoring wells, period 2006–2016, with aluminum content above (0.2mg/L) the limit established by the Ministry of Health Ordinance Nº 888, 5 April 2021. Previous studies have indicated that there is no correlation of aluminum in groundwater of the Camaçari Industrial Pole with other metallic contaminants; also, that aluminum in the studied region is disseminated in the geological matrix, clayey soils, and poor and leached Cerrado soils. The Kruskal-Wallis test indicated significant correlation of high aluminum content with the treatment/disposal areas, geology, soil and vegetation; and no correlation with precipitation and hydrogeology. The four environmental factors indicating the highest average aluminum content (±C&lt;sub&gt;95%&lt;/sub&gt;), in descending order, are: Clayey Soils, Organic Sludge Farm I, Marizal Formation, and Herbaceous-Subshrub Vegetation. The multivariable analysis indicated that, the most influential factors on the high aluminum content in groundwater of the CETREL region, are all ultimately associated with the leaching of aluminum present in the solid matrix. As CETREL processes are not correlated with aluminum residues, the results were an important information for the company environmental managers.&lt;/p&gt;

High Aluminum content in the aquifer of Camaçari industrial pole, state of Bahia, Brazil: Correlation with natural and anthropogenic environmental factors using multivariable analysis

&lt;p class="MsoNormal"&gt;This work used multivariable analysis to correlate groundwater high aluminum content in the area of the Liquid Effluent Treatment Center—CETREL of the Camaçari Industrial Pole, with natural environmental factors: geology, hydrogeology, precipitation, soil and vegetation; and anthropic: equipments of treatment and disposal of industrial waste from CETREL. This company made available data from 99 monitoring wells, period 2006–2016, with aluminum content above (0.2mg/L) the limit established by the Ministry of Health Ordinance Nº 888, 5 April 2021. Previous studies have indicated that there is no correlation of aluminum in groundwater of the Camaçari Industrial Pole with other metallic contaminants; also, that aluminum in the studied region is disseminated in the geological matrix, clayey soils, and poor and leached Cerrado soils. The Kruskal-Wallis test indicated significant correlation of high aluminum content with the treatment/disposal areas, geology, soil and vegetation; and no correlation with precipitation and hydrogeology. The four environmental factors indicating the highest average aluminum content (±C&lt;sub&gt;95%&lt;/sub&gt;), in descending order, are: Clayey Soils, Organic Sludge Farm I, Marizal Formation, and Herbaceous-Subshrub Vegetation. The multivariable analysis indicated that, the most influential factors on the high aluminum content in groundwater of the CETREL region, are all ultimately associated with the leaching of aluminum present in the solid matrix. As CETREL processes are not correlated with aluminum residues, the results were an important information for the company environmental managers.&lt;/p&gt;

The relationship between spousal violence, maternal functioning, depression, and anxiety among Iranian postpartum mothers: a prospective study

BackgroundViolence against women is a critical public health issue that adversely affects physical and mental health, contributing to injuries, chronic conditions, and mental health disorders. This study addresses the gap in understanding the relationship between spousal violence with maternal functioning and mental health in postpartum mothers.MethodsThis Prospective study was conducted on 316 postpartum women who gave birth in Al-Zahra and Taleghani Educational Treatment Centers in Tabriz, Iran, from June 2023 to October 2023. Participants were selected using convenience sampling and followed up for 6–8 weeks. The data were collected using the Revised Conflict Tactics Scale (CTS2), the Edinburgh Postnatal Depression Scale (EPDS), the Postpartum Specific Anxiety Scale (PSAS), and the Barkin Index of Maternal Functioning (BIMF). A general linear model, adjusted for individual, social, and obstetric variables, was used to determine the relationship between domestic violence, maternal functioning, depression and anxiety.ResultsMost women (84%) experienced one or more types of intimate partner violence (IPV), including psychological, physical, or sexual abuse. About one-third (32.9%) reported psychological abuse, 21.2% physical violence, 49.4% sexual coercion, and 6.3% reported injuries. The adjusted general linear model showed that the mean depression score was lower in individuals without any experience of violence compared to those who had experienced any violence (β: -1.75; 95% CI: -3.40 to -0.10; p = 0.038). The mean depression score was significantly higher in homemakers compared to employed individuals (β = 3.53; 95% CI = 1.22 to 5.84, p = 0.003). The mean maternal functioning score was significantly higher in those who had not experienced mild physical violence compared to those who had (β = 2.94; 95% CI = 0.34 to 5.55, p = 0.027). The mean anxiety score was lower in individuals with high income (β: -3.38; 95% CI: -5.73 to -1.04; p = 0.005) and moderate income (β: -2.21; 95% CI: -4.35 to -0.07; p = 0.043) compared to those with low income.ConclusionThe findings reveal a high prevalence of violence, particularly sexual coercion, significantly affecting maternal functioning and mental health. Socioeconomic factors also play a crucial role in postpartum mental health. These results highlight the urgent need for enhanced prevention efforts and targeted interventions that consider the socio-economic context and specific forms of violence.

Impaction-Based Exhaled Breath Sampling for Substance Monitoring: A Prospective Pilot Study (DrugXhale).

For decades, intake monitoring of drugs using urine as the matrix of choice is the gold standard in drug treatment centers. A properly conducted urine drug test can identify recent use of prescribed, non-prescribed and illicit drugs. However, issues like adulteration, substitution and privacy issues have driven the search for alternative matrices. This prospective pilot study evaluates the use of an impaction-based breath sampling device, Breath Explor®, as an alternative to traditional urine-based drug monitoring. Breath samples were analyzed using a validated 32-component liquid chromatography-tandem mass spectrometry (LC-MSMS) method. Recovery data represent the efficiency of extracting the analytes from the breath devices. Both automated and manual processing of the Breath Explor® devices showed mean recovery rates ranging from 39.5% to 55.4% for the 32 analytes. Despite the small number of subjects, breath analysis proved to be a convenient and easy-to-use methodology. An overall kappa-values of 0.5 indicated a moderate level of agreement with urine analysis, underscoring its potential as a complementary diagnostic tool. All participants tested positive in their breath sample for methadone (70% methadone and 100% EDDP), while a significant portion (90%) tested positive for 6-monoacetylmorphine (6-MAM). This innovative approach offers several advantages, including non-invasiveness, reduced risk of adulteration, and the ability to perfom repeated automated sampling and confirmation testing. These findings suggest that breath-based substance monitoring could complement or even replace traditional urine-based methods in clinical practice.

Prevalence of anxio-depressive disorders, insomnia and self-esteem in a Moroccan population addicted to cannabis and/or alcohol: a cross-sectional study

ABSTRACT Background Addiction to cannabis and alcohol is a global public health concern, linked to significant mental health impairments such as anxiety, depression, insomnia, and low self-esteem. This study, conducted in Marrakech’s addiction treatment centers, aims to assess the prevalence of mental health disorders, insomnia, and self-esteem among individuals seeking treatment for alcohol and/or cannabis addiction. Methods This cross-sectional study was conducted from January 1 2023 to January 1 2024. Depression, anxiety, insomnia, and self-esteem were assessed using the HADS, ISI, and Rosenberg scale. Results Anxiety prevalence for cannabis, alcohol, and both substances was 57.9%, 55.2%, and 59.2%, respectively. Depression prevalence was 71.7% (cannabis), 73.1% (alcohol), and 75% (both substances). Sub-clinical insomnia (mild) prevalence for the three groups was 65.4%, 71.6%, and 77.6%. Low self-esteem was observed at 59.1%, 64.2%, and 60.5% for cannabis, alcohol, and both substances, respectively. No significant association has been found between the type of product consumed (cannabis, alcohol, cannabis and alcohol) and anxiety, depression, insomnia and self-esteem. Conclusions These findings highlight prevalent mental health disorders in cannabis and alcohol addiction, underscoring the need for comprehensive, multidisciplinary treatments, including regular mental health screenings, quarterly follow-ups, and family involvement in group therapies at Moroccan addiction centers.