scholarly journals Delirium in neurological practice

2021 ◽  
Vol 17 (4) ◽  
pp. 86-92
Author(s):  
O.Ye. Dubenko ◽  
V.V. Nikonov
Keyword(s):  
Risk Factors ◽  
Neurological Diseases ◽  
Cognitive Activity ◽  
Emotional Disturbances ◽  
Transient Condition ◽  
Consciousness Disturbance ◽  
Wide Range ◽  
Other Substances ◽  
Acute Changes ◽  
Tract Infections

Delirium is an acute, usually reversible, fluctuating impairment of the level of consciousness, attention, and cognitive activity resulted from impaired brain metabolism due to a wide range of various neurological and non-neurological diseases, the effects of drugs and other substances. The main manifestations of delirium are acute changes in consciousness, disturbance of attention, perception, often with the development of hallucinations, emotion, sleep-wake cycle, psychomotor and autonomic activity. Delirium is divided into hypoactive and hyperactive subtypes depending on the severity of psychomotor and emotional disturbances. Patients with acute stroke are also often susceptible to episodes of delirium at the risk factors such as age, pre-existing cognitive impairment, pneumonia, urinary tract infections, and right hemispheric stroke. The pathophysiology of delirium has been less known, but there is evidence of the role of cholinergic deficiency. Delirium is a transient condition, but it needs treatment to prevent the development of complications since it is usually associated with poor functional outcomes, longer hospitalization and higher mortality. The strategy for the treatment of patients with delirium should be directed to early identification of its symptoms, elimination of modifiable risk factors and metabolic causes. In patients with severe symptoms of agitation and hallucinations, short-term prescription of antipsychotics for their relief is possible.

scholarly journals Urinary Tract Infections among Bladder Outlet Obstruction Patients in Accra, Ghana: Aetiology, Antibiotic Resistance, and Risk Factors

Diseases ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 65
Author(s):  
Karikari Asafo-Adjei ◽  
James Mensah ◽  
Appiah-Korang Labi ◽  
Nicholas Dayie ◽  
Eric Donkor
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Bacterial Isolates ◽  
Microbiological Methods ◽  
Wide Range ◽  
Tract Infections ◽  
Urine Specimens

The aim of this study was to investigate urinary tract infections among patients with Bladder Outlet Obstruction (BOO) at the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana, including the prevalence, risk factors, aetiological agents and their antibiogram. Urine specimens were collected from 188 male patients presenting with BOO and cultured for bacteria. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antimicrobial agents using the Kirby Bauer method. Demographic information and the clinical history of study participants were also recorded. The prevalence of urinary tract infection among the BOO patients was 76.6% and the main risk factor identified was catheterization (p < 0.0001). A wide range of bacterial organisms was isolated from urine specimens and they were predominantly, Enterobacteriaceae; Escherichia coli was the most frequent cause of bacteriuria (33.3%), followed by Klebsiella (17.3%). Bacterial isolates were most resistant to Augmentin (97.8%) followed by tetracycline (85.8%), nalidixic acid (82.8%) and ciprofloxacin (75%) while 93.6% were multi-drug resistant. The highest susceptibility was observed with amikacin, which had a resistance prevalence of 4.4% resistance. These findings have important implications in the treatment of urinary tract infections among the BOO patients in Ghana.

Risk Factors in Diabetes and Pregnant Women with Urinary Tract Infections Compared to Younger Aged Female.

2018 ◽  
Vol 1 (3) ◽  
pp. 26-38
Author(s):  
Abdulghani Mohamed Alsamarai ◽  
Shler Ali Khorshed
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Female Student ◽  
Mean Value ◽  
Infected Female ◽  
Significant Difference ◽  
Tract Infections

Background: Urinary tract infection is common with health impact in women and characterised by failure to treatment and recurrent episodes. Aim: This study was conducted to determine the risk factors for the development of urinary tract infection in diabetic and pregnant women in comparison to student female. Materials and methods: A prospective cross-sectional study conducted during the period from 1st of June 2015 to the end of January 2016. The population included in the study are 563 women, of them 425 were outpatients, and 138 were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples collected and cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: In diabetic women, there were no significant difference in mean age and BMI values between culture positive and culture negative groups. However, pus cell mean scale was significantly higher [P=0.000] in women with urinary tract infection [1.76±1.25] than in those with negative culture [0.69±1.00]. In pregnant women, BMI mean value was significantly [P=0.013] lower in pregnant women with UTI [26.14] as compared to those without infection [26.99]. Pus cell scale mean value was significantly [P=0.000] higher in pregnant women with UTI [1.55] than women with negative UTI [0.85]. While there was no significant difference in mean age between UTI positive and negative pregnant women. In female student, there was a significant difference between UTI infected and non-infected in mean age [P=0.041] and pus cell scale [P=0.000]. However, BMI was not significantly different between infected and non-infected female student. Other risk factors association are variables in the 3 groups when analysed using X2, while AUC and OR show different trends of association between risk factors and UTI. Conclusion: BMI, pus cell scale, child number, delivery method, operation history and hospital setting were significantly associated with culture positivity in the 3 studied groups as determined by AUC. While OR confirmed association with pus sale scale in the 3 groups.

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

The development of information interaction as a key element of state risk management and health protection

2020 ◽  
pp. 68-76
Author(s):  
S. Voronkova
Keyword(s):  
Risk Factors ◽  
Health Promotion ◽  
Information System ◽  
Information Interaction ◽  
New Information ◽  
Wide Range ◽  
Working Age ◽  
The Russian Federation ◽  
Working Age Population ◽  
Types Of Information

The article discusses ways to obtain information about risk factors and the health status of the population. The article describes a new information system «labor Medicine», which allows to organize the collection of a wide range of data for further analysis and application in the activities of various Executive authorities, public organizations, foundations, legal entities and citizens. It is proposed to improve this system by expanding the types of information collected, creating a passport for health promotion organizations, as well as integration with systems that are being implemented in the Russian Federation for managing the health of the working-age population in the context of state policy in the field of Informatization.

scholarly journals Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Victor Garcia-Bustos ◽  
Ana Isabel Renau Escrig ◽  
Cristina Campo López ◽  
Rosario Alonso Estellés ◽  
Koen Jerusalem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Multidrug Resistance ◽  
Urinary Tract ◽  
Prospective Cohort ◽  
Bacterial Infections ◽  
Cohort Analysis ◽  
Term Care ◽  
Hospitalised Patients ◽  
Tract Infections

AbstractUrinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine independent risk factors for multidrug resistance and its outcome implications. A single-centre observational prospective cohort analysis of 163 adult patients hospitalized for suspected symptomatic UTI in the Departments of Internal Medicine, Infectious Diseases and Short-Stay Medical Unit of a tertiary hospital was conducted. Most patients currently admitted to hospital for UTI are elderly and usually present high comorbidity and severe dependence. More than 55% met sepsis criteria but presented with atypical symptoms. Usual risk factors for multidrug resistant pathogens were frequent. Almost one out of five patients had been hospitalized in the 90 days prior to the current admission and over 40% of patients had been treated with antibiotic in the previous 90 days. Infection by MDR bacteria was independently associated with the previous stay in nursing homes or long-term care facilities (LTCF) (OR 5.8, 95% CI 1.17–29.00), permanent bladder catheter (OR 3.55, 95% CI 1.00–12.50) and urinary incontinence (OR 2.63, 95% CI 1.04–6.68). The degree of dependence and comorbidity, female sex, obesity, and bacteraemia were independent predictors of longer hospital stay. The epidemiology and presentation of UTIs requiring hospitalisation is changing over time. Attention should be paid to improve management of urinary incontinence, judicious catheterisation, and antibiotic therapy.

scholarly journals Identifying Risk Factors for Lower Reproductive Tract Infections among Women Using Reusable Absorbents in Odisha, India

2021 ◽  
Vol 18 (9) ◽  
pp. 4778
Author(s):  
Padmalaya Das ◽  
Danielle Lisnek ◽  
Krushna Chandra Sahoo ◽  
Shalini Sinha ◽  
JyotiRanjan Mohanty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Reproductive Tract ◽  
Laboratory Diagnosis ◽  
Poverty Line ◽  
Reproductive Age ◽  
Reproductive Tract Infections ◽  
Menstrual Hygiene ◽  
Socio Demographic Factors ◽  
Tract Infections ◽  
Study Laboratory

A large proportion of women in Odisha, India, use reusable absorbents to manage their menstruation. Yet, the risk factors for lower reproductive tract infections (RTIs) related to menstrual hygiene management (MHM) have not been studied among reusable absorbent users. Women of reproductive age attending one of two hospitals from two different cities in Odisha during two separate study intervals were recruited for the study. Laboratory diagnosis of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) were conducted. A questionnaire was used to collect information on MHM practices, water, sanitation, and socio-demographic factors. Among the 509 women who used reusable absorbents, 71.7% were diagnosed with at least one infection. After adjusting for confounders, women with BV were more likely to identify as being a housewife (aOR: 1.8 (1.1–2.9)). Frequent absorbent changing was protective against BV (aOR: 0.5 (0.3–0.8)), whereas frequent body washing increased the odds of BV (aOR: 1.5 (1.0–2.2)). Women with VVC were more likely to be older (aOR: 1.6 (1.0–2.5)), live below the poverty line (aOR: 1.5 (1.1–2.2)), have a non-private household latrine (aOR: 2.2 (1.3–4.0)), dry their absorbents inside the house (aOR: 3.7 (2.5–4.5)), and store absorbents in the latrine area (aOR: 2.0 (1.3–2.9)). Washing absorbents outside the house was protective against VVC (aOR: 0.7 (0.4–1.0)). This study highlights the importance of improving MHM practices among reusable absorbent users to prevent lower RTIs among women reusing menstrual materials in Odisha.

scholarly journals Frequency of myelin oligodendrocyte glycoprotein antibodies in a large cohort of neurological patients

2021 ◽  
Vol 7 (2) ◽  
pp. 205521732110227
Author(s):  
Friederike Held ◽  
Sudhakar Reddy Kalluri ◽  
Achim Berthele ◽  
Ana-Katharina Klein ◽  
Markus Reindl ◽  
...  
Keyword(s):  
Time Course ◽  
Neurological Diseases ◽  
External Validation ◽  
Diagnostic Value ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Large Cohort ◽  
Wide Range ◽  
Neurological Patients ◽  
A Cell ◽  
Nosological Entity

Background Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is recognized as a distinct nosological entity. IgG antibodies against MOG (MOG-Ab) overlap with neuromyelitis optica spectrum disorders (NMOSD) phenotype in adults. However, an increasing number of clinical phenotypes have been reported to be associated with MOG-Ab. Objective To investigate the seroprevalence of MOG-Ab under consideration of demographics, disease entities and time course in a large cohort of unselected neurological patients. Methods Blood samples of 2.107 consecutive adult neurologic patients admitted to our department between 2016-2017 were tested for MOG-Ab using a cell-based assay. MOG-Ab persistence was analyzed in follow-up samples. External validation was performed in two independent laboratories. Results We found MOG-Ab in 25 of 2.107 (1.2%) patients. High antibody ratios were mostly associated with NMOSD and MOG-AD phenotype (5/25). Low ratios occurred in a wide range of neurological diseases, predominantly in other demyelinating CNS diseases (5/25) and stroke (6/25). MOG-Ab persistence over time was not confined to NMOSD and MOG-AD phenotype. Conclusion The present study demonstrates the occurrence of MOG-Ab in a wide range of neurological diseases. Only high MOG-Ab ratios were associated with a defined clinical phenotype, but low MOG-Ab ratios were not. The diagnostic value of low MOG-Ab is thus highly limited.

scholarly journals Robust Step Detection from Different Waist-Worn Sensor Positions: Implications for Clinical Studies

2020 ◽  
Vol 4 (1) ◽  
pp. 50-58
Author(s):  
Matthias  Tietsch ◽  
Amir Muaremi ◽  
Ieuan Clay ◽  
Felix Kluge ◽  
Holger Hoefling ◽  
...  
Keyword(s):  
Clinical Study ◽  
Clinical Studies ◽  
Neurological Diseases ◽  
Human Gait ◽  
Robust Solution ◽  
Step Detection ◽  
Study Protocols ◽  
Study Results ◽  
Wide Range ◽  
The Impact

Analyzing human gait with inertial sensors provides valuable insights into a wide range of health impairments, including many musculoskeletal and neurological diseases. A representative and reliable assessment of gait requires continuous monitoring over long periods and ideally takes place in the subjects’ habitual environment (real-world). An inconsistent sensor wearing position can affect gait characterization and influence clinical study results, thus clinical study protocols are typically highly proscriptive, instructing all participants to wear the sensor in a uniform manner. This restrictive approach improves data quality but reduces overall adherence. In this work, we analyze the impact of altering the sensor wearing position around the waist on sensor signal and step detection. We demonstrate that an asymmetrically worn sensor leads to additional odd-harmonic frequency components in the frequency spectrum. We propose a robust solution for step detection based on autocorrelation to overcome sensor position variation (sensitivity = 0.99, precision = 0.99). The proposed solution reduces the impact of inconsistent sensor positioning on gait characterization in clinical studies, thus providing more flexibility to protocol implementation and more freedom to participants to wear the sensor in the position most comfortable to them. This work is a first step towards truly position-agnostic gait assessment in clinical settings.

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