scholarly journals 1322A pilot study of faecal sample collection from prospective cohort study participants

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Fiona Bruinsma ◽  
Graham Giles ◽  
Brigid Lynch ◽  
Theresa Whalen ◽  
Helen Tsimiklis ◽  
...  

Abstract Background Faecal specimens offer a relatively accessible means of assessing the gut microbial community. We conducted a pilot study to compare the feasibility of different protocols for self-collection of faecal specimens from Australian Breakthrough Cancer (ABC) Study participants. Methods Pilot study participants were randomly selected from ABC Study participants who had not yet been invited to participate in follow-up. All pilot study participants were asked to provide a faecal sample using FOBT cards and complete a ‘day of sample’ questionnaire. Participants were randomised to 1 of 4 groups defined by combination of (i) a request (or not) to also provide a faecal sample using a tube containing 2.5ml of 95% ethanol and (ii) a request (or not) to complete a food frequency questionnaire. Results 1,136 ABC Study participants were invited to participate in the pilot study. Of the 56% that opted in, 88% returned the requested sample. Very few participants (5%) actively opted out. Overall, 49% of invited participants returned a sample. There was no statistically significant difference between the groups in the percentage of participants who completed the pilot study. Conclusions The pilot study demonstrated the feasibility of self-collection of faecal samples. Increasing the time commitment and complexity (through provision of an additional sample suspended in ethanol and a FFQ) did not reduce the likelihood of successful completion. Key messages The findings demonstrate the feasibility of collecting faecal samples both on an FOBT card and in a tube containing ethanol, and a lengthy FFQ, within a prospective cohort study.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tinglong Yang ◽  
Xueying Yang ◽  
Linghua Li ◽  
Huifang Xu ◽  
Lirui Fan ◽  
...  

Abstract Background We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. Methods A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). Results Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p < 0.001). A significant difference of mean score was detected in each HBM construct between pre- and post-scaleup groups (p < 0.05). After adjusting for significant background variables, among all participants, only the self-efficacy [adjusted HR (HRa) = 1.23, 95% CI 1.06 to 1.43, p = 0.006], has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa = 0.71 to 1.83, p < 0.05), while in post-scaleup group, no significant difference was found in each construct (p > 0.05). Conclusions The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.


2014 ◽  
Vol 38 (3) ◽  
pp. 197-200 ◽  
Author(s):  
S Ruiz-Rodriguez ◽  
V Lacavex-Aguilar ◽  
M Pierdant-Perez ◽  
P Mandeville ◽  
M Santos-Diaz ◽  
...  

Objective: To investigate the possible association between maternal S. mutans levels and those of the infant during the period between birth and 5 months and evaluate possible risk factors in the S mutans colonization. Study Design: A prospective cohort study was carried out comprising 62 infants and their mothers, selected at the time of childbirth. For each infant, a sample swab was taken at 0, 15, 30, 90, and 150 days postpartum; on the same days, a sample was obtained from the mothers. TYCSB medium was employed for identifying the microorganism, which was later confirmed by Gram staining, the catalase activity test, and the API strep test. Results: The final total sample consisted of 60 infants, from which S. mutans was detected in only 2 (3%) at the 150th day of oral sample collection. Of the sample of 60 mothers, 54 exhibited colonization levels. Conclusions: In the studied sample pairs up to 150 days, it was not possible to demonstrate the presence of a direct relationship between maternal S. mutans oral levels.


2012 ◽  
Vol 15 (2) ◽  
pp. 332 ◽  
Author(s):  
Paulo Roque Obreli-Neto ◽  
Alessandro Nobili ◽  
Divaldo Pereira De Lyra Júnior ◽  
Diogo Pilger ◽  
Camilo Molino Guidoni ◽  
...  

Purpose. The primary objective of this study was to investigate the incidence of drug-drug interactions (DDIs) related to adverse drug reactions (ADRs) in elderly outpatients who attended public primary healthcare units in a southeastern region of Brazil. The secondary objective was to investigate the possible predictors of DDI-related ADRs. Methods. A prospective cohort study was conducted between November 1, 2010, and November 31, 2011, in the primary public healthcare system in the Ourinhos micro-region in Brazil. Patients who were at least 60 years old, with at least one potential DDI, were eligible for inclusion in the study. Eligible patients were assessed by clinical pharmacists for DDI-related ADRs for 4 months. The causality of DDI-related ADRs was assessed independently by four clinicians using three decisional algorithms. The incidence of DDI-related ADRs during the study period was calculated. Logistic regression analysis was used to study DDI-related ADR predictors. Results. A total of 433 patients completed the study. The incidence of DDI-related ADRs was 6.5%. A multivariate analysis indicated that the adjusted odds ratios (ORs) rose from 0.91 (95% confidence interval [CI] = 0.75-1.12, p = 0.06) in patients aged 65-69 years to 4.40 (95% CI = 3.00-6.12, p < 0.01) in patients aged 80 years or older. Patients who presented two to three diagnosed diseases presented lower adjusted ORs (OR = 0.93 [95% CI = 0.68-1.18, p = 0.08]) than patients who presented six or more diseases (OR = 1.12 [95% CI = 1.02-2.01, p < 0.01]). Elderly patients who took five or more drugs had a significantly higher risk of DDI-related ADRs (OR = 2.72 [95% CI = 1.92-3.12, p < 0.01]) than patients who took three to four drugs (OR = 0.93 [95% CI = 0.74-1.11, p = 0.06]). No significant difference was found with regard to sex (OR = 1.08 [95% CI 0.48-2.02, p = 0.44]). Conclusion. The incidence of DDI-related ADRs in elderly outpatients was significant, and most of the events presented important clinical consequences. Because clinicians still have difficulty managing this problem, highlighting the factors that increase the risk of DDI-related ADRs is essential. Polypharmacy was found to be a significant predictor of DDI-related ADRs in our sample. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.


Author(s):  
A. Kasthuri ◽  
K. Mohana Krishnan ◽  
S. K. Amsavathani

Background: The objectives of the study were to study the epidemiological correlates of ART Naïve HIV cases; to study the incidence of co–infections among them; to find the incidence of onset of diabetes among them. Concomitant infection of hepatitis B virus, hepatitis C virus viruses leads to higher frequency of carrier state and severe manifestations of the disease in HIV patients. There is general agreement that the traditional risk factors for DM (increasing age, minority race, obesity) are still responsible for most of the increased risk in the HIV infected population.Methods: This study was designed as a prospective cohort study and was done at the Meenakshi Medical College & Research institute, an academic and Tertiary medical centre in Kanchipuram, Tamil Nadu, South India. The study duration was from June 2004 to June 2010. SPSS 13 was used in the calculation of chi-square and percentages.Results: Among 207 participants, mean age is 36.04 and the SD is 10.895. There is significant difference between the incidence of viral co-infections like hepatitis B and hepatitis C (p<0.001). There is significant difference between the incidence of onset of diabetes (p<0.001). The HbsAg and HCV co infection was comparatively lower than the urban population. Among the 50 HIV reactive, non diabetic patients without risk factors, only one found to be Diabetic and another found to be Pre diabetic after 6 months follow-up.Conclusions: The cost of treatment escalates, when PLHA is co-infected either with viral infections or diabetes, and also their quality of life becomes poor. So, monitoring of CD4 and CD8 should be done as a routine and screening and early treatment should be made mandatory. 


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Leake Gebrargs ◽  
Bereket Gebremeskel ◽  
Bacha Aberra ◽  
Assefa Hika ◽  
Yusuf Yimer ◽  
...  

Background. Hypotension and bradycardia are the most common complications associated with spinal anesthesia and more common in patients with a history of hypertension. Regular use of antihypertensive medications can prevent these complications. The occurrence of hypotension under spinal anesthesia among controlled hypertensive and normotensive patients with age 40 years and above is still debated. The objective of the study was to compare blood pressure and heart rate changes following spinal anesthesia between controlled hypertensive and normotensive patients undergoing surgery below the umbilicus at Black lion hospital, Addis Ababa, Ethiopia, 2020. Method. A hospital-based prospective cohort study was conducted. A total of 110 elective patients with controlled hypertension (55) and normotensive (55) patients who underwent surgery with spinal anesthesia at black lion hospital during the study period were included. The sample was selected using a systematic random sampling technique. Continuous data of independent and dependent variables were analyzed using an independent sample t-test for normally distributed and Mann–Whitney U-test for nonnormally distributed between the study groups. Categorical variables between the study groups were analyzed using the chi-square test. Descriptive data were displayed using tables and figures. For continuous and categorical variables, a p value <0.05 was considered statistically significant. Results. The incidence of hypotension in the controlled hypertension group (23.6%) was higher than the normotensive group (7.3%) with p value of 0.018. The occurrence of bradycardia was seen to be 12.7% in each group with a p value >0.05. There was a statistically significant difference in the mean systolic blood pressure, mean arterial pressure, mean heart rate, and vasopressor consumption at the measurement time interval between controlled hypertension and normotensive groups. Conclusion. Under spinal anesthesia, patients with controlled hypertension are more likely to develop hypotension than normotensive patients, but on the occurrence of bradycardia, there was no statistically significant difference between the two groups.


Author(s):  
Ulrika M. Wallgren ◽  
Jan Sjölin ◽  
Hans Järnbert-Pettersson ◽  
Lisa Kurland

Abstract Background There is little evidence of which sepsis screening tool to use in the ambulance setting. The primary aim of the current study was to compare the performance of NEWS2 (National Early Warning score 2) and RETTS (Rapid Emergency Triage and Treatment System) with respect to identification of sepsis among ambulance patients with clinically suspected infection. The secondary aim was to compare the performance of the novel Predict Sepsis screening tools with that of NEWS2, RETTS and clinical judgment. Methods Prospective cohort study of 323 adult ambulance patients with clinically suspected infection, transported to hospitals in Stockholm, during 2017/2018. The sensitivity, specificity, and AUC (Area Under the receiver operating Curve) were calculated and compared by using McNemar´s test and DeLong’s test. Results The prevalence of sepsis in the current study population was 44.6% (144 of 323 patients). No significant difference in AUC was demonstrated between NEWS2 ≥ 5 and RETTS ≥ orange. NEWS2 ≥ 7 demonstrated a significantly greater AUC than RETTS red. The Predict Sepsis screening tools ≥ 2 demonstrated the highest sensitivity (range 0.87–0.91), along with RETTS ≥ orange (0.83), but the lowest specificity (range 0.39–0.49). The AUC of NEWS2 (0.73) and the Predict Sepsis screening tools (range 0.75–0.77) was similar. Conclusions The results indicate that NEWS2 could be the better alternative for sepsis identification in the ambulance, as compared to RETTS. The Predict Sepsis screening tools demonstrated a high sensitivity and AUCs similar to that of NEWS2. However, these results need to be interpreted with caution as the Predict Sepsis screening tools require external validation. Trial registration: ClinicalTrials.gov, NCT03249597. Registered 15 August 2017—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03249597.


2019 ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  

Abstract Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: A prospective cohort study was carried out, and only women who underwent cesarean deliveries under spinal anesthesia were included. Postoperative patient-controlled intravenous analgesia was performed for all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen, and the pump was programmed as 2.0 mL/h background infusion, and loading dose of 1 mL with a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using visual analogue scale, and inadequate analgesia was defined as visual analogue scale ≥40 during the postoperative 48 hours. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: From January to May 2017, a total of 168 patients (67 primipara and 101 multipara) were included. The relative risk for multipara to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primipara. In patients under 30 years old, inadequate analgesia on visceral pain in the multipara was higher than that on the primipara (RR, 3.56 [1.05 to 12.04], P=0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). No difference was found in PCIA consumption between two groups. (111.1 ± 36.0mL vs. 110.9 ± 37.3mL, P=0.979) Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (62.2%vs.37.7%, P=0.011). Conclusions: Multipara who underwent first repeat cesarean section have lower risk to experience inadequate analgesia on incision pain during the first 48 hours after surgery compared to primipara. While multipara under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain.


2021 ◽  
Author(s):  
Sonia Qureshi ◽  
Nosheen Nasir ◽  
Naveed Haroon Rashid ◽  
Naveed Ahmed ◽  
Zoya Haq ◽  
...  

AbstractIntroductionA significant number of patients continue to recover from COVID-19; however, little is known about the lung function capacity among survivors. We aim to determine the long-term impact on lung function capacity in patients who have survived moderate or severe COVID-19 disease in a resource-poor setting.Methods and analysisThis prospective cohort study will include patients aged 15 years and above and have reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID 19 (nasopharyngeal or oropharyngeal). Patients with a pre-existing diagnosis of obstructive or interstitial lung disease, lung fibrosis and cancers, connective tissue disorders, autoimmune conditions affecting the lungs, underlying heart disease, history of syncope and refuse to participate will be excluded. Pulmonary function will be assessed using spirometry and diffusion lung capacity for carbon monoxide (DLCO) at three- and six-months interval. A chest X-ray at three and six-month follow-up and CT-chest will be performed if clinically indicated after consultation with the study pulmonologist or Infectious Disease (ID) physician. Echocardiogram (ECHO) to look for pulmonary hypertension at the three months visit and repeated at six months if any abnormality is identified initially. Data analysis will be performed using standard statistical software.Ethics and disseminationThe proposal was reviewed and approved by ethics review committee (ERC) of the institution (ERC reference number 2020-4735-11311). Informed consent will be obtained from each study participant. The results will be disseminated among study participants, institutional, provincial and national level through seminars and presentations. Moreover, the scientific findings will be published in high-impact peer-reviewed medical journals.Strengths and Limitations of this study-The study has the potential to develop context-specific evidence on the long-term impact on lung function among COVID-19 survivors-Findings will play key role in understanding the impact of the disease on vital functions and help devise rehabilitative strategies to best overcome the effects of disease-This is a single-center, study recruiting only a limited number of COVID-19 survivors-The study participants may loss-to-follow up due to uncertain conditions and disease reemergence


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022720 ◽  
Author(s):  
Olivier Colin ◽  
Julien Labreuche ◽  
Julie Deguil ◽  
Anne-Marie Mendyk ◽  
Valérie Deken ◽  
...  

ObjectivesWe tested the hypothesis that stroke outcomes in patients with preadmission use of benzodiazepine are worse.MethodIn a prospective cohort study, we recruited patients with acute ischaemic stroke. Mortality, functional outcomes and cognition were evaluated at 8 and 90 days after stroke.Results370 patients were included. 62 (18.5%) of the 336 remaining patients were treated with benzodiazepines when stroke occurred, and they did not receive any other psychotropic drug. The mortality rate was higher in benzodiazepines users than non-users at day 8 (2.2% vs 8.1%, p=0.034) and day 90 (8.1% vs 25.9%, p=0.0001). After controlling for baseline differences using propensity-score matching, only the difference in mortality rate at day 90 was of borderline of significance, with a matched OR of 3.93 (95% CI, 0.91 to 16.98). In propensity-score-adjusted cohort, this difference remained significant with a similar treatment effect size (adjusted OR, 3.50; 95% CI, 1.57 to 7.76). A higher rate of poor functional outcome at day 8 and day 90 defined bymodified Rankin scale (mRS) ≥2 or by theBarthel index (BI) <95 was found in benzodiazepines users. In propensity-score-adjusted cohort, only the difference in mRS≥2 at day 90 remained significant (adjusted OR, 1.89; 95% CI, 1.02 to 3.48). In survivors at day 8 and at day 90, there was no significant difference in cognitive evaluation.ConclusionOur study has shown that preadmission use of benzodiazepines could be associated with increased post-stroke mortality at 90 days. These findings do not support a putative neuroprotective effect of γ-aminobutyric acidAreceptors agonists and should alert clinicians of their potential risks.Trial registration numberNCT00763217.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  

Abstract Background The differences in post-operative pain are unclear between the primiparas who underwent a primary cesarean section and multiparas who underwent their first repeat cesarean section. The study aimed to explore the possible differences in postoperative pain between primiparas and multiparas. Methods A prospective cohort study was performed only including women who underwent cesarean deliveries under spinal anesthesia. Postoperative patient-controlled intravenous analgesia (PCIA) was administered to all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen; the pump was programmed as 2.0 mL/h background infusion with a loading dose of 1 mL and a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using the visual analogue scale, and inadequate analgesia was defined as a visual analogue scale score ≥ 40 during 48 h post-operation. Additionally, the patients’ pain statuses in postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results From January to May 2017, a total of 168 patients (67 primiparas and 101 multiparas) were included. The relative risk for multiparas to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primiparas. In patients aged < 30 years, inadequate analgesia on visceral pain was higher in multiparas than in primiparas (RR, 3.56 [1.05 to 12.04], P = 0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multiparas and primiparas (33.7% vs. 40.2%, P = 0.381). No difference was found in PCIA use between the two groups (111.1 ± 36.0 mL vs. 110.9 ± 37.3 mL, P = 0.979). In addition, a significantly higher incidence of pain was noted 4 weeks post-surgery in primiparas than that in multiparas (62.2% vs. 37.7%, P = 0.011). Conclusion Multiparas who underwent their first repeat cesarean section have a lower for inadequate analgesia on incision pain during the first 48 h after surgery than primiparas. Multiparas aged under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain. Trail Registration ClinicalTrial.gov: NCT03009955, Date registered: December 30, 2016.


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