scholarly journals Initial Drug Regimen for Active Tuberculosis Cases in Montreal, 1995-1998

2001 ◽  
Vol 12 (2) ◽  
pp. 89-92
Author(s):  
Paul Rivest ◽  
Terry N Tannenbaum

OBJECTIVES:To evaluate the proportion of tuberculosis (TB) cases initially treated with the recommended four-drug regimen of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA) and ethambutol (EMB) or streptomycin; and to identify factors associated with the choice of initial therapy.DESIGN:Descriptive analysis of surveillance data obtained by TB case notifications from physicians and microbiology laboratories.SETTING:The island of Montreal (with a population of 1,854,435 people).STUDY POPULATION:All TB cases reported between January 1, 1995 and December 31, 1998.OUTCOME MEASURE:The proportion of TB cases initially treated with a four-drug regimen by sex, age, country of birth, site of disease and year of reporting.MAIN RESULTS:Seven hundred forty-one cases were reported during the study period. Among the 687 analyzed cases, 406 (59.1%) received the recommended initial four-drug regimen (INH-RIF-PZA-EMB), 187 (27.2%) received an INH-RIF-PZA regimen, 61 (8.9%) received an INH-RIF-EMB regimen and 33 (4.8%) received an INH-RIF regimen only. In a logistical regression model, a four-drug regimen was significantly associated with respiratory disease (odds ratio [OR] 4.48; 95% CI 3.15 to 6.39), age younger than 65 years (OR 2.32; 95% CI 1.55 to 3.45), being foreign-born (OR 1.62; 95% CI 1.06 to 2.48) and later year of reporting (OR 1.27; 95% CI 1.09 to 1.47).CONCLUSIONS:The proportion of TB cases initially treated with a four-drug regimen has increased steadily since 1995, reaching 65% in 1998. However, given the rate of INH resistance in Montreal, efforts to promote the use of the initial four-drug regimen must continue.

2021 ◽  
pp. 002203452098296
Author(s):  
H. Fransson ◽  
L. Bjørndal ◽  
F. Frisk ◽  
V.S. Dawson ◽  
K. Landt ◽  
...  

Essentially, root fillings are performed to preserve natural teeth. Over time, however, some root-filled teeth will inevitably be extracted. The aim of this historical prospective cohort study in the adult Swedish population was to identify factors associated with extractions within 5 y of registration of a root filling. The cohort consisted of all those whose root fillings had been reported to the tax-funded Swedish Social Insurance Agency (SSIA) in 2009. Demographic data on the individuals registered with a root filling (sex, age, country of birth, disposable income, educational level, and marital status) were received from Statistics Sweden or the SSIA. Dental care setting, tooth type, and any registration of subsequent restorations within 6 mo were received from the SSIA. Multivariable regression analysis was used, and P < 0.05 was considered statistically significant. In total, 216,764 individuals had been registered with at least 1 root filling. Individuals ( n = 824) without complete data were excluded from the analyses. After 5 y, 9.3% of the root-filled teeth had been registered as extracted. Logistic regression analysis found significant associations for all variables except country of birth, disposable income, and educational level. The highest odds ratios for extractions were associated with the type of restoration: teeth with no registration of any restoration and teeth with a direct restoration combined with a post were 3 times more likely to undergo extraction than teeth restored with an indirect restoration combined with a post and core. Overall, high odds ratios for extractions were associated with any type of composite restoration, including composite fillings and crowns combined with or without any post. In summary, after root filling in the Swedish adult population, several individual- and tooth-specific variables were associated with extraction. The reasons for the extractions remain to be studied further.


Author(s):  
Loes Verdoes ◽  
Floriana S Luppino ◽  
Jacco Wallinga ◽  
Leo G Visser

Abstract Background After an animal-associated injury (AAI) in rabies-endemic regions, post-exposure prophylaxis (PEP) is needed to prevent infection.1,3 PEP consist of rabies vaccinations (RV) and in some cases also additional rabies immune globulins (RIG). Not always PEP medication, and RIG in particular, is accessible. Along with an increased number of exposure notifications among Dutch travelers, this might lead to treatment delay, and thus to increased health risks. Until now, research mainly focused on factors associated with exposition, but none on which factors are associated with PEP delay. This study aimed to identify which general sample characteristics are associated with PEP delay while being abroad. Methods A quantitative retrospective observational study was conducted. The study population consisted of insured Dutch international travelers who actively contacted their medical assistance company (2015-2019) because of an animal-associated injury (AAI) (N = 691). The association between general sample characteristics and delay of different PEP treatments was studied using survival analysis. Results Travelers without PrEP had an increased hazard, and therefore a shorter delay, for receiving their first RV as compared to travelers with PrEP (HR:1.11, 95%CI:1.01-1.22). The travelers needing both RV and RIG had a decreased hazard, and therefore a longer delay, as compared to travelers only needing RV (HR:0.81, 95%CI:0.67-0.96). General sample characteristic associated with RIG administration delay was travel destination. Travelers to Central and South America, East Mediterranean and Europe had a decreased hazard, and therefore a longer delay, for receiving RIG treatments relative to travelers to South East Asia (HR:0.31, 95%CI:0.13-0.70; HR:0.34, 95%CI:0.19-0.61; HR:0.46, 95%CI:0.24-0.89; HR:0.48, 95%CI:0.12-0.81 respectively). Conclusions Our results suggest that the advice for PrEP should be given based travel destination, as these was found to be the main factor for PEP delay, among travelers going to rabies endemic countries.


Author(s):  
Ila R Falcão ◽  
Rita de Cássia Ribeiro-Silva ◽  
Marcia Furquim de Almeida ◽  
Rosemeire L Fiaccone ◽  
Natanael J Silva ◽  
...  

ABSTRACT Background Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. Objectives To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. Methods The study population consisted of women of reproductive age (14–49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. Results Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14–20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35–49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1–3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1–3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). Conclusions In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Cristhiane Almeida Leite ◽  
Marcial Francis Galera ◽  
Mariano Martínez Espinosa ◽  
Paulo Ricardo Teles de Lima ◽  
Vander Fernandes ◽  
...  

Background.Systemic lupus erythematosus (SLE) is a chronic inflammatory, multisystem, and autoimmune disease.Objective.The aim of this study was to describe the prevalence of hyposalivation in SLE patients and evaluate factors associated.Methods.This is a cross-sectional study developed at the Cuiaba University General Hospital (UNIC-HGU), Mato Grosso, Brazil. The study population consisted of female SLE patients treated at this hospital from 06/2010 to 12/2012. Unstimulated salivary flow rates (SFRs) were measured. Descriptive and inferential analyses were performed in all cases using a significance levelP<0.05.Results.The results showed that 79% of patients with systemic lupus erythematosus suffered from hyposalivation and that the disease activity and age in years were the factors that resulted in statistically significant differences.Conclusion.The activity of the disease, age >27 years, and the drugs used were factors associated with hyposalivation, resulting in a statistically significant decrease in saliva production.


2013 ◽  
Vol 21 (3) ◽  
pp. 679-686 ◽  
Author(s):  
Ana Belén Fernández-Cervilla ◽  
Ana Isabel Piris-Dorado ◽  
Maria Esperança Cabrer-Vives ◽  
Ana Barquero-González

OBJECTIVE: Describe the current situation of complementary therapies in nursing education in schools and nursing schools in Spain. METHOD: Descriptive study. Study population all faculties andschools ascribed to Spain. Data collection through observation sheet. Analysis units Curricula. Variables (credits, course type, location, type of therapy). Descriptive analysis of relative and absolute data using Excel spreadsheet. RESULTS: Most of the faculties and schoolsofnursingscrutinized the subject of Complementary Therapies has disappeared and those that aparace is an optional subject. CONCLUSION: Complementary Therapies training in Spain is deficient because it is not collected as a core subject and / or obligatory. The absence of Complementary Therapies in the curriculum, questions such as their value in training, conceptualization which teachers, the impact on quality of care, training of teachers responsible for teaching the subject, as well as the number of credits and the course being in the degree of Grado.


Author(s):  
Cintia da Silva Marconato ◽  
Ana Carolina de Souza Magnago ◽  
Tânia Solange Bosi de Souza Magnago ◽  
Graziele de Lima Dalmolin ◽  
Rafaela Andolhe ◽  
...  

Abstract OBJECTIVE Investigating the prevalence and factors associated with minor psychiatric disorders (MPDs) in Hospital housekeeping workers. METHOD A cross-sectional study carried out in 2013 with workers from the cleaning service of a public university hospital in Rio Grande do Sul, Brazil. Data were collected through a form containing sociodemographic, occupational, habits and health variables. The Self-Reporting Questionnaire-20 was used in order to evaluate MPDs. RESULTS The study population consisted of 161 workers. The overall prevalence of suspected MPD was 29.3%. The chances of suspected MPDs were higher in workers with Effort-Reward Imbalance, those who did not have time or who occasionally had time for leisure activities, and those taking medications. CONCLUSION The prevalence of MPDs was similar to that found in the literature for health workers. Therefore, we consider it important to include these workers in institutional programs for continuing health education.


2018 ◽  
Vol 31 (6) ◽  
pp. 303
Author(s):  
Rita Filipe ◽  
Pedro Aguiar

Introduction: A dental voucher was created to facilitate the access to oral health care, however the use of these vouchers, by students aged 7, 10 and 13 with dental caries from state schools within the geodemographic area covered by the Community Health Center Group of Western Lisbon and Oeiras, had a low uptake (23%, school year 2014/2015) The aim of this study was to examine the factors associated with this non-use.Material and Methods: A case-control study was carried out involving 270 students (135 cases and 135 controls) from 35 state schools who agreed to participate in the study. A descriptive analysis of the reasons for non-adhesion to the voucher, and a study associating the variables and the use/non-use of the dental vouchers using bivariate and multivariate statistical analysis was made adopting a significance of 0.05.Results: The main reasons for non-use (n = 135) were the use of private dentists outside the dental voucher scheme (23.7%) and forgetting to use the vouchers or exceeding the expiry date (21.5%). The main factor associated with the non-use was students having a private dentist (OR adjusted 2.004, p = 0.012; IC 95%: 1.176 – 3.413) and the main factor associated with the use was having information of dentists accepting dental vouchers (OR adjusted 0.096, p = < 0.001; IC 95%: 0.047 – 0.198).Discussion: Our findings highlight the need to improve the accessibility to dental vouchers.Conclusion: It is hoped that the identification of these factors will contribute in the planning of strategies and activities to improve the use of dental vouchers.


2022 ◽  
Vol 35 (13) ◽  
Author(s):  
Francisco Duarte ◽  
Nuno Rua ◽  
David Gomes ◽  
Vasco Ricoca Peixoto ◽  
Daniela Azevedo ◽  
...  

Introduction: Pre-exposure prophylaxis (PrEP) has gained relevance as a method of prevention for HIV in certain people and settings. Following the publication of the guideline on PrEP prescribing in Portugal, we aimed to assess the knowledge of Portuguese Medical Students about PrEP.Material and Methods: An online survey was sent to Medical students of Portuguese Medical Schools. We conducted a descriptive analysis of the results and an analytic cross-sectional study to identify factors associated with “knowing about PrEP”, “having had one class about PrEP” and “identifying eligible groups correctly”.Results: Of the 796 students that responded to the survey, 64.6% were aware of what PrEP is. Of these, 34.44% acquired this knowledge during their training. Out of the total amount of respondents, 4.77% could identify correctly and completely the eligible groups for PrEP. As the training years went by, the probability of being aware of PrEP, having had one class about PrEP, and identifying the eligible groups correctly, increased. Of the sixth-year students, 43.48% had had one class about PrEP and among the students that were aware of PrEP, 28% identified what the eligible groups were. After adjusting for the school year, we found differences between Medical Schools regarding the outcomes. The association between the different ways of learning about PrEP and the ability to correctly identify eligible groups for PrEP was not statistically significant.Conclusion: The differences between Medical Schools could be harmonized through changes in the medical curricula that would allow this topic to be addressed more often.


2017 ◽  
Vol 3 (1) ◽  
pp. 53
Author(s):  
Retno Wulandari ◽  
Euis Salbiah ◽  
M.YGG Seran

The purpose of this study  is to know the Road Safety Partnership Action Program Police Goes To School at SMAN 6 and SMK Pembangunan in Bogor City.The theory used in this research is by using policy evaluation from William N. Dunn which stating that to measure the success of an evaluation of the program can be measured through six variables: effectiveness, efficiency, adequacy, equity, responsiveness, and appropriateness. The method used is descriptive analysis using quantitative approach. Data analysis technique used is by using the calculation of Weight Mean Score (WMS). Data collection techniques used are literature studies and field studies. The study population are 1,857 students from two schools. While the sampling technique used is proportionate stratified random sampling (stratified proportional). The samples using Yamane formula thus obtained sample are 180 respondents.The results of Program Evaluation Research Road Safety Partnership Action Police Goes To School in SMA 6 and SMK Pembangunan Bogor City obtained a score of 3.64 (in scale of 5) which, according to the interpretation of the criteria that are in “good” categories, although it is still the number of violations that occurred among students. This happens due to the lack of awareness of students in traffic, do not care about the safety and ignore the socialization conducted by the police about the ethics of a good drive to support traffic safety and reduce the number of traffic violations or accidents. Efforts are being made to address the problem is by imposing preventive methods (prevention) and applying repressive methods (in applying force). Keywords: Evaluation, Program, Violation


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S106-S106
Author(s):  
Karthika Srikumar ◽  
Richard Walsh ◽  
Donnchadh Walsh ◽  
Sonn Patel ◽  
Sheila O'Sullivan

AimsPsychiatric polypharmacy refers to the prescription of two or more psychotropic medications to any one patient. This definition is purely quantitative and does not take into account whether such a prescription is detrimental, or unnecessary. In many cases, polypharmacy has been implemented in challenging illnesses, and some studies have shown that it can improve overall outcomes for certain patients. Evidence suggests that the prevalence of psychotropic polypharmacy is increasing, despite advances in psychosocial interventions. The aim of this study was to assess the current prevalence of polypharmacy among patients being treated by a community mental health team (CMHT), and the patient factors associated with its use.MethodWe performed a cross-sectional study of all patients registered with a CMHT in a mixed urban/rural area on a single date. Case records were examined to determine the most recently prescribed drug regimen for each patient. Clinical chart diagnoses were recorded and each one independently verified by the team consultant using ICD-10. A number other sociodemographic variables were recorded. Using Microsoft Excel, we analysed the medications prescribed as well as rates and levels of polypharmacy based on multiple different patient characteristics.ResultOf the 245 patients, the mean age was 56.3 and 51.2% (n = 126) were female. Psychotropic polypharmacy was seen in 62% (n = 152) of patients. 33% (n = 82) of patients were on two psychotropic medications, and of this subset, a combination of one antipsychotic and one antidepressant was the most common drug regimen, seen in 16.7% (n = 41) of all patients. Polypharmacy was more prevalent in females, with 68% (n = 85) being on two or more psychotropics, in comparison to 58% of male patients. In relation to age, patients aged between 51 to 65 years had the highest prevalence of polypharmacy, at a rate of 71% (n = 49). Among all primary diagnoses, polypharmacy was most common in patients with affective disorders, with 80% (n = 40) of this patient cohort on two or more medications. Second to this was psychotic disorders, with polypharmacy seen in 65% (n = 62) of this group.ConclusionWe found that psychotropic polypharmacy is highly prevalent in psychiatric patients being treated in a community setting. Certain demographics and patient factors, such as age, gender and psychiatric diagnosis influenced the rate of polypharmacy and certain drug combinations were more commonly prescribed than others.


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