Risk and other factors associated with toxoplasmosis and toxocariasis in pregnant women from southern Brazil

2016 ◽  
Vol 91 (5) ◽  
pp. 534-538 ◽  
Author(s):  
P.C. Santos ◽  
P.L. Telmo ◽  
L.M. Lehmann ◽  
G.T. Mattos ◽  
G.B. Klafke ◽  
...  

AbstractToxoplasmosis causes complications during pregnancy that have serious effects on fetal development. Thus far, toxocariasis has been reported to spread only via vertical transmission. Nonetheless, the population of pregnant women is also exposed to this infection. Co-infection with both Toxoplasma gondii and Toxocara spp. has been reported in children, but there are no reports of co-infection in the population of pregnant women. The aim of this study was to determine the prevalence of co-infection with T. gondii and Toxocara spp. in pregnant women at a university hospital in southern Brazil, and to identify the risk factors associated with infection by both parasites. Two hundred pregnant women were tested for the presence of anti-T. gondii and anti-Toxocara spp. antibodies and were asked to complete an epidemiological questionnaire. In this study, the co-infection rate observed in the total population of pregnant women was 8%. In addition, women with a positive result for a serology test for Toxocara spp. were at increased risk of infection by T. gondii (P = 0.019). Co-infection with both parasites in pregnant women was associated with low birth weights in neonates. The similar modes of transmission of both parasites could explain the co-infection. Only a few previous studies have investigated this phenomenon. The findings of the present study emphasize the importance of serological diagnosis during prenatal care and further research in this area to identify risk factors associated with this co-infection, and the possible implications of this co-infection during pregnancy and on the health of newborns.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S576-S577
Author(s):  
Thomas Holowka ◽  
Harry Cheung ◽  
Maricar F Malinis ◽  
Sarah Perreault ◽  
Iris Isufi ◽  
...  

Abstract Background Ibrutinib is a tyrosine kinase inhibitor used to treat hematologic malignancies that may increase the risk of serious infection including invasive fungal infections (IFI). In a study of 378 patients with hematologic malignancy on ibrutinib, serious infection and IFI occurred in 11% and 4% respectively (Varughese et al. Clin Infect Dis). The primary aims of our study were to determine the incidence of serious infection and associated risk factors in patients on ibrutinib. Methods We performed a retrospective analysis of patients with hematologic malignancy prescribed ibrutinib for ≥ 1 week at Yale New Haven Hospital from 2014 to 2019 to identify serious infections defined as those requiring inpatient management. We collected demographic, clinical and oncologic data. Chi-squared tests were used to determine factors associated with an increased risk of infection. Results A total of 254 patients received ibrutinib including 156 with CLL, 89 with NHL and 9 with other leukemias. Among these, 21 underwent HSCT, 9 complicated by GVHD. There were 51 (20%) patients with serious infections including 45 (17.7%) bacterial, 9 (3.5%) viral and 5 (2%) IFI (1 pulmonary cryptococcosis, 4 pulmonary aspergillosis). Anti-mold prophylaxis was prescribed to 7 (2.8%) patients, none of whom developed IFI. Risk factors associated with serious infection included ECOG score ≥ 2 (OR 4.6, p < 0.001), concurrent steroid use (≥ 10 mg prednisone daily for ≥ 2 weeks; OR 3.0, p < 0.001), neutropenia (OR 3.6, p < 0.01), lymphopenia (OR 2.4, p < 0.05) and maximum ibrutinib dose of 560 mg (OR 2, p < 0.05). There was a dose dependent increase in infections based on number of chemotherapy regimens prior to ibrutinib initiation: 14.3% with 0, 19.7% with 1-2 and 28.7% with ≥ 3 prior treatments. Conclusion The incidence of serious infection in hematologic patients on ibrutinib was higher than previously reported (20% versus 11%) but the rate of IFI was lower (2% versus 4%). High ECOG score, leukopenia, steroids, and higher ibrutinib doses were associated with an increased risk for serious infection. Targeted antimicrobial prophylaxis should be considered for patients on ibrutinib with these risk factors. Improving functional status may also reduce the risk of infection in patients on ibrutinib. Disclosures All Authors: No reported disclosures


2007 ◽  
Vol 9 (5) ◽  
pp. 392-396 ◽  
Author(s):  
Luisa Rambozzi ◽  
Arianna Menzano ◽  
Alessandro Mannelli ◽  
Simona Romano ◽  
Maria Cristina Isaia

An epidemiological study was carried out to identify factors associated with the risk of cryptosporidian infection in cats. Faecal samples from 200 domestic cats were collected in the small animal clinic at the Faculty of Veterinary Medicine in Turin (north-west Italy). The faecal samples were analysed for the presence of Cryptosporidium species oocysts using a centrifugation concentration floatation method. For each cat, age, sex, breed, indoor/outdoor status, diet, diarrhoea and presence of other enteric parasites were analysed for association with Cryptosporidium species infection. Cryptosporidia oocysts were identified in 49 cats (24.5%) aged from 2 months to 18 years. Statistical analysis revealed that four variables are significantly associated with an increased risk of infection: less than 1 year of age ( χ2=6.5, P=0.01), feeding home-cooked diet ( χ2=6.92, P<0.01), presence of diarrhoea ( χ2=4.34, P<0.037), and presence of other enteric parasites ( χ2=10.31, P<0.01). No statistical differences were found for sex ( χ2=1.56, P=0.21), breed ( χ2=0.78, P=0.38) and outdoor/indoor status ( χ2=1.49, P=0.22). Cryptosporidium species was the parasite most frequently detected in the cats surveyed.


2021 ◽  
Vol 2 (1) ◽  
pp. 57-70
Author(s):  
Hussein Noureldine ◽  
Georges Chedid ◽  
Jad Gerges Harb ◽  
Wared Nour-Eldine ◽  
Mariam Nour Eldine ◽  
...  

The different presentations, comorbidities, and outcomes of COVID-19 highlight the importance of early identification and proper triage of patients. High-risk patients can be divided into patients with common comorbidities and patients with special categories. Common comorbidities include, but are not limited to, Cardiovascular Disease (CVD), Diabetes Mellitus (DM), immunosuppression, underlying respiratory disease, and obesity. Certain categories of COVID-19 patients are also at increased risk, including neonates and pregnant women.  In the present article, we delineate the reported risk factors for acquisition of infection, and for increased severity of the clinical disease. We also comparatively analyze those risk factors associated with COVID-19 and with the antecedent human acute respiratory syndrome-causing viruses, SARS-CoV-1 and MERS-CoV. We hypothesize that the structural similarities of the three viruses predict a similarity in the profile of high-risk patients. Several pathophysiological patterns have been detected to support this theory.


PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0131058 ◽  
Author(s):  
Paula Costa Santos ◽  
Lis Maurente Lehmann ◽  
Carolina Lorenzi ◽  
Carolina Hirsch ◽  
Paula Lima Telmo ◽  
...  

2015 ◽  
Vol 6;18 (6;11) ◽  
pp. 593-598
Author(s):  
Duck Mi Yoon

Background: Insomnia is highly prevalent among people with chronic pain conditions. Because insomnia has been shown to worsen pain, mood, and physical functioning, it could negatively impact the clinical outcomes of patients with chronic pain. Objective: To determine the risk factors associated with clinical insomnia in chronic neck pain (CNP) patients. Study Design: Retrospective analysis. Setting: Outpatient department for interventional pain management at a university hospital. Methods: Data from 218 CNP patients were analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ≥ 15). Patient demographics and pain-related factors were evaluated with logistic regression analysis to identify risk factors of clinical insomnia in CNP. Results: In total, 53.7% of patients reported mild to severe insomnia after neck pain development; 22.9% of patients met the criteria for clinically significant insomnia (ISI score ≥ 15). In multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain, and a high level of depression were strongly associated with clinical insomnia in patients with CNP. Among these factors, a greater level of depression was the strongest predictor of clinical insomnia, with the highest odds ratio of 3.689 (95% CI 1.570 – 8.667). Limitations: This study was conducted in a single clinical setting including a selected study population with a homogeneous racial background. The ISI does not include several sleep-related variables, the roles of which are unknown in determining insomnia severity. Conclusions: Insomnia should be addressed as an indispensable part of pain management in CNP patients with these risk factors, especially depression. Key words: Chronic neck pain, insomnia, risk factors, pain severity, neuropathic pain, musculoskeletal pain, depression


2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Hassan Hassan Nassar ◽  
Ali Ali ◽  
Sherin Shazly ◽  
Ahmed Mansour

2021 ◽  
Vol 11 (3) ◽  
pp. 484-493
Author(s):  
Jukapun Yoodee ◽  
Aumkhae Sookprasert ◽  
Phitjira Sanguanboonyaphong ◽  
Suthan Chanthawong ◽  
Manit Seateaw ◽  
...  

Anthracycline-based regimens with or without anti-human epidermal growth factor receptor (HER) 2 agents such as trastuzumab are effective in breast cancer treatment. Nevertheless, heart failure (HF) has become a significant side effect of these regimens. This study aimed to investigate the incidence and factors associated with HF in breast cancer patients treated with anthracyclines with or without trastuzumab. A retrospective cohort study was performed in patients with breast cancer who were treated with anthracyclines with or without trastuzumab between 1 January 2014 and 31 December 2018. The primary outcome was the incidence of HF. The secondary outcome was the risk factors associated with HF by using the univariable and multivariable cox-proportional hazard model. A total of 475 breast cancer patients were enrolled with a median follow-up time of 2.88 years (interquartile range (IQR), 1.59–3.93). The incidence of HF was 3.2%, corresponding to an incidence rate of 11.1 per 1000 person-years. The increased risk of HF was seen in patients receiving a combination of anthracycline and trastuzumab therapy, patients treated with radiotherapy or palliative-intent chemotherapy, and baseline left ventricular ejection fraction <65%, respectively. There were no statistically significant differences in other risk factors for HF, such as age, cardiovascular comorbidities, and cumulative doxorubicin dose. In conclusion, the incidence of HF was consistently high in patients receiving combination anthracyclines trastuzumab regimens. A reduced baseline left ventricular ejection fraction, radiotherapy, and palliative-intent chemotherapy were associated with an increased risk of HF. Intensive cardiac monitoring in breast cancer patients with an increased risk of HF should be advised to prevent undesired cardiac outcomes.


Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.


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