Paediatric tuberculosis in Singapore: a retrospective review

BackgroundTuberculosis (TB) is a major cause of mortality and morbidity in the world. Each case represents ongoing transmission and has a significant public health burden. We aim to examine the clinical profile of paediatric TB and compare pulmonary TB (PTB) with extrapulmonary TB (EPTB) in Singapore.MethodsA retrospective study of patients admitted to KK Women’s and Children’s Hospital, Singapore from January 2008 to September 2017 with active TB was undertaken. The clinical characteristics and outcomes of patients with PTB and EPTB were compared.ResultsSeventy-five patients were diagnosed as having active TB (49 (65%) with PTB and 26 (35%) with EPTB). Patients with EPTB were more likely than those with PTB to be younger (median age 5.1 (IQR 1.2–10.2) years vs 10.1 (IQR 3.5–13.5) years), immunodeficient (35% vs 6%), with a lower haemoglobin count (median 11.2 (IQR 10.2–11.9) g/dL vs 12.0 (IQR 10.5–13.9) g/dL), lower recovery rate (27% vs 57%) and required longer duration of treatment (median 12 (IQR 9–12) months vs 6 (IQR 6–9) months). Common clinical presentations of both PTB and EPTB were significant fever (27%), cough (33%) and weight loss (32%). Overall mortality was 8% with septic shock responsible for three of the six deaths.ConclusionEPTB is more common in the younger age group and is associated with a lower recovery rate.

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Unmapped exome reads implicate a role for Anelloviridae in childhood HIV-1 long-term non-progression

npj Genomic Medicine ◽

10.1038/s41525-021-00185-w ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Savannah Mwesigwa ◽

◽

Lesedi Williams ◽

Gaone Retshabile ◽

Eric Katagirya ◽

...

Keyword(s):

Hiv Infection ◽

Diversity Index ◽

Strong Association ◽

Community Diversity ◽

Added Value ◽

Sequencing Platform ◽

Public Health Burden ◽

Survival Status ◽

Significant Public Health

AbstractHuman immunodeficiency virus (HIV) infection remains a significant public health burden globally. The role of viral co-infection in the rate of progression of HIV infection has been suggested but not empirically tested, particularly among children. We extracted and classified 42 viral species from whole-exome sequencing (WES) data of 813 HIV-infected children in Botswana and Uganda categorised as either long-term non-progressors (LTNPs) or rapid progressors (RPs). The Ugandan participants had a higher viral community diversity index compared to Batswana (p = 4.6 × 10−13), and viral sequences were more frequently detected among LTNPs than RPs (24% vs 16%; p = 0.008; OR, 1.9; 95% CI, 1.6–2.3), with Anelloviridae showing strong association with LTNP status (p = 3 × 10−4; q = 0.004, OR, 3.99; 95% CI, 1.74–10.25). This trend was still evident when stratified by country, sex, and sequencing platform, and after a logistic regression analysis adjusting for age, sex, country, and the sequencing platform (p = 0.02; q = 0.03; OR, 7.3; 95% CI, 1.6–40.5). Torque teno virus (TTV), which made up 95% of the Anelloviridae reads, has been associated with reduced immune activation. We identify an association between viral co-infection and prolonged AIDs-free survival status that may have utility as a biomarker of LTNP and could provide mechanistic insights to HIV progression in children, demonstrating the added value of interrogating off-target WES reads in cohort studies.

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Antioxidant Therapy in Inflammatory Bowel Diseases

Antioxidants ◽

10.3390/antiox10030412 ◽

2021 ◽

Vol 10 (3) ◽

pp. 412

Author(s):

Katarzyna Dziąbowska-Grabias ◽

Małgorzata Sztanke ◽

Przemysław Zając ◽

Michał Celejewski ◽

Katarzyna Kurek ◽

...

Keyword(s):

Inflammatory Bowel Diseases ◽

Nitrosative Stress ◽

Treatment Options ◽

Chemical Compounds ◽

Continuous Increase ◽

Public Health Burden ◽

Bowel Diseases ◽

Significant Public Health ◽

Inflammatory Bowel

Inflammatory bowel diseases (IBD) are a group of chronic, incurable diseases of the digestive tract, the etiology of which remains unclear to this day. IBD result in significant repercussions on the quality of patients’ life. There is a continuous increase in the incidence and prevalence of IBD worldwide, and it is becoming a significant public health burden. Pharmaceuticals commonly used in IBD management, for example, mesalamine, sulfasalazine, corticosteroids, and others, expose patients to diverse, potentially detrimental side effects and frequently do not provide sufficient disease control. The chronic inflammation underlies the etiology of IBD and closely associates with oxidative/nitrosative stress and a vast generation of reactive oxygen/nitrogen species. Relative to this, several substances with antioxidant and anti-inflammatory properties are now intensively researched as possible adjunctive or independent treatment options in IBD. Representatives of several different groups, including natural and chemical compounds will be characterized in this dissertation.

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Bovine tuberculosis in Rwanda: Prevalence and economic impact evaluation by meat inspection at Société des Abattoirs de Nyabugogo-Nyabugogo Abattoir, Kigali

Journal of the South African Veterinary Association ◽

10.4102/jsava.v85i1.1062 ◽

2014 ◽

Vol 85 (1) ◽

Cited By ~ 4

Author(s):

Gervais Habarugira ◽

Joseph Rukelibuga ◽

Mark O. Nanyingi ◽

Borden Mushonga

Keyword(s):

Economic Impact ◽

Bovine Tuberculosis ◽

Meat Inspection ◽

Control Measures ◽

Meat Industry ◽

Biochemical Tests ◽

Tissue Samples ◽

Public Health Burden ◽

Significant Public Health ◽

Lowenstein Jensen

Despite the significant public health burden of bovine tuberculosis (bTB) in Rwanda, the prevalence of bTB is poorly documented. This study was conducted to estimate the prevalence of bTB in cattle using gross examination of granulomatous lesions, to identify mycobacteria species in suspected samples, and to evaluate the economic impact of meat condemnation based on bTB-like lesions in the meat industry in Rwanda. Routine meat inspection was conducted at Société des Abattoirs de Nyabugogo (SABAN)-Nyabugogo Abattoir. Tissue samples including 31 lymph nodes, 3 lungs and 2 livers were obtained from cattle of different ages with gross tuberculous lesions. Mycobacterium bovis was identified using microscopy with Kinyoun staining and isolation of mycobacterial species in culture on Löwenstein–Jensen and Colestos media, further identified using biochemical tests. Our findings, based on culture and postmortem results, show that the prevalence of bTB is 0.5%(0.587*148/16753), with an overall gross tuberculous lesion prevalence of 0.9% (148/16753). The presence of lesions were higher in cattle aged 2 years and older (1.6% vs. 0.6%, p < 0.05) and higher in females than in males (1.4% vs. 0.6%, p < 0.05). Of the 36 samples tested, 26 (72.2%) were positive by microscopic examination with Kinyoun staining while M. bovis was culture-confirmed in 21 (58.7%) cases. Bovine tuberculosis caused condemnation of 1683.5 kg of meat, resulting in an estimated loss of $4810. Our findings indicate that the prevalence of bTB in Rwanda is significant, and that bTB is a major cause of meat condemnation requiring continued implementation of surveillance and control measures. Furthermore, the results from this study also show important variations in sensitivity of the different tests that were used to determine the prevalence of bTB in cattle in Rwanda.

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Indian agriculture, air pollution, and public health in the age of COVID

10.31220/osf.io/qhwau ◽

2020 ◽

Author(s):

Andrew J McDonald ◽

Balwinder-Singh ◽

M.L. Jat ◽

Peter Craufurd ◽

Jon Hellin ◽

...

Keyword(s):

Public Health ◽

Air Pollution ◽

Crop Residues ◽

Health Conditions ◽

Public Health Burden ◽

Pollution Levels ◽

Indian Agriculture ◽

Significant Public Health ◽

Agricultural Burning ◽

Northwest India

Emerging evidence supports the intuitive link between chronic health conditions associated with air pollution and the vulnerability of individuals and communities to COVID-19. Poor air quality already imposes a highly significant public health burden in Northwest India, with pollution levels spiking to hazardous levels in November and early December when rice crop residues are burned. The urgency of curtailing the COVID-19 pandemic and mitigating a potential resurgence later in the year provides even more justification for accelerating efforts to dramatically reduce open agricultural burning in India.

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Risk Factors for Chronic Kidney Disease

Kidney Protection ◽

10.1093/med/9780190611620.003.0004 ◽

2019 ◽

pp. 29-38

Author(s):

Hania Kassem ◽

Bernard G. Jaar

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Kidney Stones ◽

Developed Countries ◽

Modifiable Risk Factors ◽

Public Health Burden ◽

Obstructive Sleep ◽

Significant Public Health ◽

Common Risk Factors

Chronic kidney disease (CKD) represents a significant public health burden worldwide and several risk factors have been identified over the years; these have been well-described in the medical literature. Common risk factors such as diabetes mellitus and hypertension will be described in other chapters. While this chapter will focus mainly on CKD risk factors observed in developed countries, several of these are also observed in developing countries. It is now well-established that some risk factors are modifiable while others are non-modifiable. In this chapter, we will explore several of these non-modifiable risk factors in more detail, such as age, gender, race, family history, and low birth weight. But we will also discuss some of the modifiable risk factors such as kidney stones, obstructive sleep apnea, smoking, drugs (excluding NSAIDs), diet, obesity, metabolic syndrome, and hyperuricemia. We will provide a balanced and up to date review of the evidence linking these risk factors with CKD.

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P86 Treatment modalities in peripheral facial nerve palsy in children and adolescents

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-esdppp.124 ◽

2019 ◽

Vol 104 (6) ◽

pp. e53.1-e53

Author(s):

J Samardzic ◽

B Kukolj ◽

M Jovanovic ◽

O Djuric ◽

J Jancic

Keyword(s):

Recovery Rate ◽

Combined Therapy ◽

Recovery Period ◽

Treatment Modalities ◽

P Value ◽

Physical Treatment ◽

Therapeutic Modalities ◽

Peripheral Facial Palsy ◽

Younger Age ◽

Peripheral Facial Nerve Palsy

BackgroundBell´s palsy is the most common type of peripheral facial palsy in pediatrics. Recent studies strongly support the combined therapy with corticosteroids (CS), antiviral drugs and vitamins B. Our study aims to assess the effectiveness of proposed therapeutic modalities, including the relation between the patients‘ recovery and their age, etiological factors and applied treatment.MethodsThe retrospective analysis involved 88 patients (52 females/36 males), between 18 months and 18 years old; the average age was 11.7 years. Data was obtained from the documentation of patients hospitalized at the Clinic of Neurology and Psychiatry for Children and Youth in Belgrade, from 2000 to 2017. House Brackmann´s scale was used for the assessment of disease course and outcome. Pearson´s χ2 test, Friedman´s test and general linear model were applied for statistical data processing.ResultsThe majority of patients were treated with combined CS/vitamins (42.0%) and CS/antiviral/vitamins (17.0%), whereas CS only received 22.7% of patients, all with an appropriate physical treatment. The group of idiopathic paralysis makes 62.5%, while the incidence of symptomatic paralysis is 37.5%; however, the recovery rate between these groups has not been shown (p=0.309). Patients received CS therapy were divided into 4 groups: CS only, CS+antiviral, CS+vitamins B, and CS+antiviral+vitamins B. The statistically significant recovery was registered in each group (p< 0.001); however, no difference was found between the groups in term of recovery rate (p=865). For the assessment of recovery period in relation to the age, the obtained p value was 0.054, a borderline level, suggesting a faster recovery of children at younger age.ConclusionThe acute one-sided mimic musculature weakness is mostly idiopathic. The effectiveness of the CS therapy was strongly supported, suggesting CS as a core treatment for the Bell´s palsy. It has been shown the faster recovery of children at younger age.Disclosure(s)Nothing to disclose

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Changes in socioeconomic mortality inequalities at adult and old ages in Lithuania, 2001–05 to 2011–15

European Journal of Public Health ◽

10.1093/eurpub/ckz088 ◽

2019 ◽

Vol 29 (5) ◽

pp. 971-973 ◽

Cited By ~ 4

Author(s):

Domantas Jasilionis ◽

Vladislava Stankūnienė ◽

Marė Baublytė

Keyword(s):

Public Health ◽

Older Adults ◽

Economic Activity ◽

Mortality Decline ◽

Public Health Burden ◽

Relative Mortality ◽

Health Burden ◽

Overall Mortality

Abstract This article provides evidence about changes in mortality inequalities by education and economic activity status among adults aged 30–64 and older adults aged 65 and over in Lithuania between 2001–05 and 2011–15. The study shows that the overall mortality decline in Lithuania was not homogeneous across socio-economic groups. The inequitable progress resulted in a widening in absolute and relative mortality inequalities among older adults and notable increases in relative mortality inequalities among adults aged 30–64. The total public health burden of mortality inequalities remained very pronounced or even increased further.

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Flow-Induced Wall Pressure Under Average Resting Hemodynamic Conditions for Patient-Specific Abdominal Aortic Aneurysms

Advances in Bioengineering ◽

10.1115/imece2002-32326 ◽

2002 ◽

Author(s):

Ender A. Finol ◽

Shoreh Hajiloo ◽

Keyvan Keyhani ◽

David A. Vorp ◽

Cristina H. Amon

Keyword(s):

Imaging Techniques ◽

Abdominal Aortic Aneurysms ◽

Aneurysm Rupture ◽

Aortic Aneurysms ◽

Patient Specific ◽

Mortality And Morbidity ◽

Abdominal Aortic ◽

Lethal Event ◽

Overall Mortality

Abdominal Aortic Aneurysms (AAAs) are characterized by a continuous dilation of the infrarenal segment of the abdominal aorta. Despite significant improvements in surgical procedures and imaging techniques, the mortality and morbidity rates associated with untreated ruptured AAAs are still outrageously high. AAA disease is a health risk of significant importance since this kind of aneurysm is mostly asymptomatic until its rupture, which is frequently a lethal event with an overall mortality rate in the 80% to 90% range. From a purely biomechanical viewpoint, aneurysm rupture is a phenomenon that occurs when the mechanical stress acting on the dilating inner wall exceeds its failure strength. Since the internal mechanical forces are maintained by the dynamic action of blood flowing in the aorta, the quantification of the hemodynamics of AAAs is essential for the characterization of their biomechanical environment.

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Colorectal Cancer in Iran: Molecular Epidemiology and Screening Strategies

Journal of Cancer Epidemiology ◽

10.1155/2015/643020 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 31

Author(s):

Roya Dolatkhah ◽

Mohammad Hossein Somi ◽

Mortaza Jabbarpour Bonyadi ◽

Iraj Asvadi Kermani ◽

Faris Farassati ◽

...

Keyword(s):

Colorectal Cancer ◽

Molecular Genetic ◽

Epidemiologic Study ◽

Medical Subject Headings ◽

Public Health Burden ◽

Screening Programs ◽

Younger Age ◽

Screening Strategies ◽

History Of ◽

Epidemiologic Features

Purpose. The increasing incidence of colorectal cancer (CRC) in the past three decades in Iran has made it a major public health burden. This study aimed to report its epidemiologic features, molecular genetic aspects, survival, heredity, and screening pattern in Iran.Methods. A comprehensive literature review was conducted to identify the relevant published articles. We used medical subject headings, including colorectal cancer, molecular genetics,KRASandBRAFmutations, screening, survival, epidemiologic study, and Iran.Results. Age standardized incidence rate of Iranian CRCs was 11.6 and 10.5 for men and women, respectively. Overall five-year survival rate was 41%, and the proportion of CRC among the younger age group was higher than that of western countries. Depending on ethnicity, geographical region, dietary, and genetic predisposition, mutation genes were considerably diverse and distinct among CRCs across Iran. The high occurrence of CRC in records of relatives of CRC patients showed that family history of CRC was more common among young CRCs.Conclusion. Appropriate screening strategies for CRC which is amenable to early detection through screening, especially in relatives of CRCs, should be considered as the first step in CRC screening programs.

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The effect of cyclosporin A on the course ofParagonimus miyazakiiinfection in rats

Journal of Helminthology ◽

10.1017/s0022149x00011615 ◽

1988 ◽

Vol 62 (3) ◽

pp. 251-256 ◽

Cited By ~ 10

Author(s):

Yoshihisa Hashiguchi ◽

Yoshisuke Okamura

Keyword(s):

Cyclosporin A ◽

Post Infection ◽

Recovery Rate ◽

Cyst Formation ◽

Fungal Metabolite ◽

Host Parasite Relationship ◽

Parasite Relationship ◽

Host Parasite ◽

Time Of Administration ◽

Lower Recovery

ABSTRACTThe effect of the immunomodulatory fungal metabolite cyclosporin A (CyA) on the course ofParagonimus miyazakiiinfection in rats was studied. Administration of CyA 15 to 19 days post-infection resulted in a significantly lower recovery rate of worms and cyst formation in the host's lungs than in controls. Administration of CyA − 1 to + 3 days post-infection enhanced the growth and maturation ofP. miyazakii, expressed as weight of worms and the number of worms with eggs in uteri with respect to control values. This study shows that administration of CyA to rats affects the host-parasite relationship, depending on the time of administration of the drug.

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