The Association between Social Integration, Coping Mechanisms and Anxiety in Patients with Non-Communicable Diseases

Recently, mental health issue and chronic physical condition are substantially linked and this comorbidity is likely to increase.Patient focusing in the self-care activities is an important component in the mechanism of coping with chronic disease with a significant impact on clinical and psychological outcomes. In this context, the current study is conducted to assess the impact of self-care and social integration mechanisms on anxiety levels among patients with chronic non-communicable diseases.This observational study of cross-sectional design was performed in the pathology service of Fier city hospital, in Albania during August-September 2020. To assess the level of anxiety, we used the scale of 7 items of General Anxiety Disorder (GAD-7) with a score of ≥10 indicating GAD. Subscales of the Health Education Impact Questionnaire (heiQ) were used in order to evaluate social integration and self-care mechanism. The data were entered into the statistical program SPSS, version 23. The regression analysis is performedto examine the relationship between variables. The findings revealed that 56% of participants had GAD, 47% of participants were unable to self-monitor the disease, while 89% of them didnot performe any type of physical activity. The scale of anxiety was significantly associated with variables of Self–monitoring (p=0.000<0.05; OR=0.10) and Social integration (p=0.000<0.05; OR=21.4). These findings address the need to support peoplewho struggle with chronic non-communicable diseases developing adaptive ways to deal with their chronic condition and improve their lifestyle for better overall health.

Caudal epidural blockades for chronic pain in the lower back in working age

Introduction. Chronic back pain syndrome, which significantly restricts a person’s daily activity, can cause the formation of depressive states and is a significantly more difficult task for treatment compared to acute pain.Aim. To evaluate the efficacy and safety of caudal epidural catheterization (CEC) and local therapy with anesthetics and glucocorticoids for chronic nonspecific discogenic and chronic radicular low back pain (LBP) in young and middle-aged patients.Materials and methods. 42 patients aged from 29 to 59 years, who in the neurosurgical department of the Vologda City Hospital No. 1 in 2017–2019 underwent an operation to install a caudal epidural catheter and prolonged injection therapy of local anesthetics and glucocorticosteroids for chronic nonspecific discogenic and chronic radicular LBP.Results. There were no purulent-septic complications, hematomas of the spinal canal. In the group of patients with radicular syndrome the average values of LBP according to VAS were as follows: before CEC – 78.5 mm; 5 days after CEC – 24.1 mm; 6 months after CEC – 19.6 mm; after 12 months – 17.9 mm. In the group of patients with nonspecific discogenic LBP the average pain estimates for VAS were as follows: before CEC – 78.1 mm; 5 days after CEC – 21.7 mm; 6 months after CEC – 20.9 mm; after 12 months – 23.4 mm.Сonclusion. Our experience indicates a high long-term efficacy and safety of treatment with caudal epidural catheterization and local prolonged therapy with anesthetics and glucocorticoids for chronic radicular and chronic nonspecific discogenic pain in the lower back in young and middle-aged patients selected on the basis of a special system of criteria.

Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry

Background The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. Methods This retrospective study, carried out over a three-year follow-up period (2014–2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years. Results From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS. Conclusion The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.

The lineage of coronavirus SARS-CoV-2 of Russian origin: Genetic characteristics and correlations with clinical parameters and severity of coronavirus infection

The identification of new SARS-CoV-2 and human protein and gene targets, which may be markers of the severity and outcome of the disease, are extremely important during the COVID-19 pandemic. The goal of this study was to carry out genetic analysis of SARS-CoV-2 RNA samples to elucidate correlations of genetic parameters (SNPs) with clinical data and severity of COVID-19 infection.Material and Methods. The study included viral RNA samples isolated from 56 patients with COVID-19 infection who received treatment at the City Hospital No. 40 of St. Petersburg from 04/18/2020 to 04/18/2021. Patients underwent physical examination with the assessments of hemodynamic and respiratory parameters, clinical risk according to National Early Warning Score (NEWS), computed tomography (CT) of the chest, and laboratory studies including clinical blood analysis, assessment of ferritin, C-reactive protein (CRP), interleukin-6 (IL-6), lactate dehydrogenase (LDH), D-dimer, creatinine, and glucose levels. All patients tested positive for SARS-CoV-2 RNA by polymerase chain reaction (PCR). Single nucleotide polymorphisms (SNPs) in viral RNA were identified through the creation of cDNA libraries by targeted sequencing (MiSeq Illumina). Bioinformatic analysis of viral samples was performed using the viralrecon v2 pipeline with the further annotation via Pangolin and Nextlade. Sampled genomes were visualized using the Integrative Genomics Viewer (IGV) software. Statistical data processing (descriptive statistics and graphical analysis of data relationships from diff erent tables) was performed using a GraphPad device on the Prism 8.01 platform.Results. A comparative analysis of SNP frequencies in the virus genome in samples from deceased and discharged patients was carried out. The SNPs associated with risk of death (OR > 1), neutral SNPs (OR = 1), and protective SNPs (OR < 1) were identifi ed. Patient samples were infected with 14 lines of SARS-CoV-2, fi ve of which (B.1.1.129, B.1.1.407, B.1.1.373, B.1.1.397, and B.1.1.152) were of Russian origin. The SNPs in the samples infected with the strains of non-Russian origin were associated with an increased risk of mortality (OR = 2.267, 95% confi dence interval 0.1594-8.653) compared to the SNPs in the samples obtained from the group of patients infected with the strains of Russian origin. Positive correlations were identifi ed between the average SNP number, nonsynonymous SNPs, and S-protein SNPs with the degree of respiratory failure, total NEWS score, CT-based form of disease, duration of treatment with mechanical ventilation, disease outcome, levels of LDH, glucose, D-dimer, and ferritin, and RNA amount in the PCR test. S-protein SNPs negatively correlated with the leukocyte and neutrophil counts.

The IoT and registration of MRI brain diagnosis based on genetic algorithm and convolutional neural network

The technology <span>of the multimodal brain image registration is the key method for accurate and rapid diagnosis and treatment of brain diseases. For achieving high-resolution image registration, a fast sub pixel registration algorithm is used based on single-step discrete wavelet transform (DWT) combined with phase convolution neural network (CNN) to classify the registration of brain tumors. In this work apply the genetic algorithm and CNN clasifcation in registration of magnetic resonance imaging (MRI) image. This approach follows eight steps, reading the source of MRI brain image and loading the reference image, enhencment all MRI images by bilateral filter, transforming DWT image by applying the DWT2, evaluating (fitness function) each MRI image by using entropy, applying the genetic algorithm, by selecting the two images based on rollout wheel and crossover of the two images, the CNN classify the result of subtraction to normal or abnormal, “in the eighth one,” the Arduino and global system for mobile (GSM) 8080 are applied to send the message to patient. The proposed model is tested on MRI Medical City Hospital in Baghdad database consist 550 normal and 350 abnormal and split to 80% training and 20 testing, the proposed model result achieves the 98.8% </span>accuracy.

Clinical Characteristics and Severity Profile of COVID-19 Patient with Hypertension in Palu, Central Sulawesi

Corona virus infection (COVID-19) is still an unsolved problem in Indonesia until this year. Apart from Java, other islands, including Sulawesi, were also badly affected. The very high mortality rate in Central Sulawesi (3.36%) poses a challenge for health workers; therefore, they should be well informed and with up-to-date information about correct therapeutic decisions. One of the most common comorbidities that often occurs with the severity and mortality of COVID-19 is hypertension. This study aims to determine the clinical characteristics and severity profile and their relationship with the mortality rate of COVID-19 patients with hypertension in Palu, Central Sulawesi. A total of 185 data on COVID-19 patients undergoing treatment at the Palu City Hospital during 2021 and meeting the criteria were recruited as research samples. Patients were divided into two categories, hypertensive (43%) and non-hypertensive (57%). The results showed that the age group, comorbid diabetes mellitus, cardiovascular, blood pressure, and blood glucose levels showed a significant relationship between the two groups (p < 0.05). The median length of stay was 12 days, with conditions leading to discharge (83%) and death (17%); patients who died were hospitalized in moderate and severe clinical conditions. Age group, liver function, and kidney function were positively correlated with severity and mortality. However, hypertension did not show a significant relationship with the severity and mortality of COVID-19 patients.

Analisis Kebutuhan Debit Air Di Gedung C RSUD Kota Bukittinggi

In the Bukittinggi City Hospital building which has 6 floors, there is a water pump and a reservoir used to supply clean water for daily needs. Based on the reality in the field where there is no secondary data to determine the type of pump and reservoir. The purpose of this analysis is to obtain clean water discharge requirements, obtain the type of pump and ensure that the reservoir used for building C RSUD Kota Bukittinggi is in accordance with the type of pipe and reservoir installed in building C, floor 6. By using field studies and interviews and applying the formulas related to pump calculations. In determining the type of pump to be used in the building, it includes the required water discharge, determining the capacity of the components to be used such as pipe diameter, water tank capacity on the ground floor and roof of the building and the total head on the pipe. Based on the calculation results, the required water discharge is 0.08333 m 3 /min, the upper reservoir has a capacity of 150,000 liters, the bottom reservoir is 5,000 liters and the Hot that occurs is 18.429 m. Then the required pump specifications are 40 x 32B2 -51.5 Grundfos CM 10-3. The pump specifications are not much different from those that have been applied in the field.

Five-year Surveillance of Antimicrobial Resistance Changes and Epidemiological Characteristics in Pseudomonas aeruginosa: A Retrospective Study in a Chinese City Hospital

Background: In recent years, the widespread use of antibiotics has resulted in increased rates of antibiotic resistance (ABR). Pseudomonas aeruginosa is one of the most important opportunistic pathogens causing hospital-acquired infections. Pseudomonas aeruginosa has continuously increased resistance to commonly used clinical antimicrobial drugs, bringing great difficulties to clinical treatment. Objectives: This retrospective study investigated the epidemiological characteristics of P. aeruginosa and changes in ABR over a 5-year period at a hospital in Shandong Province, China. Methods: Pseudomonas aeruginosa strains were collected from 2015 to 2019. The antimicrobial susceptibility testing employed the Kirby-Bauer disk diffusion method and the broth microdilution method (VITEK-2 compact system), according to the guidelines by the Clinical and Laboratory Standards Institute. Data were analyzed using WHONET 5.6 and SPSS V. 21.0 software. Results: A total of 3,324 P. aeruginosa strains were isolated from clinical specimens (604, 631, 700, 595, and 794 strains from 2015 to 2019, respectively). The highest P. aeruginosa detection rates were from respiratory tract specimens (72.54%). The highest resistance was seen in aztreonam, followed by ciprofloxacin, levofloxacin, and imipenem. The isolation rates for carbapenem-resistant P. aeruginosa (CRPA) and multidrug-resistant P. aeruginosa (MDRPA) ranged from 15.21 - 18.38% and 17.31 - 27.31%, respectively. Also, the isolation rates for extensively drug-resistant P. aeruginosa (XDRPA) ranged from 1.86 - 3.52%. Conclusions: The main sources of the P. aeruginosa isolates were older adult patients with chronic respiratory diseases. The isolation rates for CRPA, MDRPA, and XDRPA strains decreased over the 5-year period. However, the drug resistance situation remains a serious concern. Hence, continued infection control and antimicrobial stewardship and basic and clinical research on bacterial resistance are essential.

Clotting of Hemodialysis Access in Patients with COVID-19 in an Inner-City Hospital

<b><i>Background:</i></b> An increased incidence of thrombotic complications in patients with coronavirus disease 2019 (COVID-19) has been reported. Severe acute kidney injury (AKI) is one of the major clinical manifestations of COVID-19 with the need for renal replacement therapy. It was observed that hemodialysis (HD) accesses tended to thrombose more often in the COVID-19 population than in non-COVID-19 patients. We hypothesize that the hypercoagulable state of COVID-19 is associated with higher incidence of access clotting. <b><i>Method:</i></b> In this retrospective single-centered study at Kings County Hospital in New York City, 1,075 patients with COVID-19 were screened, and 174 patients who received HD from January 3, 2021 to May 15, 2020 were enrolled to examine the risk factors of dialysis access clotting in patients with COVID-19. <b><i>Results:</i></b> Of the 174 patients, 109 (63%) were COVID-19 positive. 39 (22.6%) patients had dialysis access clotting at least once during their hospitalization, and they had significantly higher body mass index (BMI) (<i>p</i> = 0.001), higher rates of COVID-19 (<i>p</i> = 0.015), AKI (<i>p</i> &#x3c; 0.001), higher platelet counts (<i>p</i> = 0.029), higher lactate dehydrogenase levels (<i>p</i> = 0.009), and lower albumin levels (<i>p</i> = 0.001) than those without access malfunctions. Low albumin levels (<i>p</i> = 0.008), AKI (<i>p</i> = 0.008), and high BMI (<i>p</i> = 0.018) were risk factors associated with HD access clotting among COVID-19 patients. <b><i>Conclusion:</i></b> Patients with COVID-19 who receive HD for AKI with high BMI are at a higher risk of clotting their HD access.