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Author(s):  
Ashlan J. Kunz Coyne ◽  
Anthony M. Casapao ◽  
Carmen Isache ◽  
James Morales ◽  
Yvette S. McCarter ◽  
...  

Our study supports the additional benefit of molecular rapid diagnostic test in combination with timely antimicrobial stewardship program (ASP) intervention on shortening the time to both optimal and effective antimicrobial therapy in patients with extended-spectrum beta-lactamase (ESBL)- or carbapenemase-producing Escherichia coli and Klebsiella pneumoniae bloodstream infections, compared to conventional microbiological methods and ASP. Gram-negative infections are associated with significant morbidity and mortality, often resulting in life-threatening organ dysfunction.


PPAR Research ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-28
Author(s):  
Mahdi Ftouh ◽  
Nesrine Kalboussi ◽  
Nabil Abid ◽  
Souad Sfar ◽  
Nathalie Mignet ◽  
...  

According to the Center for Disease Control and Prevention (CDC), the coronavirus disease 2019, a respiratory viral illness linked to significant morbidity, mortality, production loss, and severe economic depression, was the third-largest cause of death in 2020. Respiratory viruses such as influenza, respiratory syncytial virus, SARS-CoV-2, and adenovirus, are among the most common causes of respiratory illness in humans, spreading as pandemics or epidemics throughout all continents. Nanotechnologies are particles in the nanometer range made from various compositions. They can be lipid-based, polymer-based, protein-based, or inorganic in nature, but they are all bioinspired and virus-like. In this review, we aimed to present a short review of the different nanoparticles currently studied, in particular those which led to publications in the field of respiratory viruses. We evaluated those which could be beneficial for respiratory disease-based viruses; those which already have contributed, such as lipid nanoparticles in the context of COVID-19; and those which will contribute in the future either as vaccines or antiviral drug delivery systems. We present a short assessment based on a critical selection of evidence indicating nanotechnology’s promise in the prevention and treatment of respiratory infections.


2021 ◽  
Vol 84 (1) ◽  
Author(s):  
R.T. Alexander ◽  
D.G. Fuster ◽  
H. Dimke

Nephrolithiasis is a worldwide problem with increasing prevalence, enormous costs, and significant morbidity. Calcium-containing kidney stones are by far the most common kidney stones encountered in clinical practice. Consequently, hypercalciuria is the greatest risk factor for kidney stone formation. Hypercalciuria can result from enhanced intestinal absorption, increased bone resorption, or altered renal tubular transport. Kidney stone formation is complex and driven by high concentrations of calcium-oxalate or calcium-phosphate in the urine. After discussing the mechanism mediating renal calcium salt precipitation, we review recent discoveries in renal tubular calcium transport from the proximal tubule, thick ascending limb, and distal convolution. Furthermore, we address how calcium is absorbed from the intestine and mobilized from bone. The effect of acidosis on bone calcium resorption and urinary calcium excretion is also considered. Although recent discoveries provide insight into these processes, much remains to be understood in order to provide improved therapies for hypercalciuria and prevent kidney stone formation. Expected final online publication date for the Annual Review of Physiology, Volume 84 is February 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.


Author(s):  
Godfred Otchere ◽  
Emmanuel Dwomoh ◽  
Emmanuel Kumah ◽  
Samuel Egyakwa Ankomah ◽  
Adam Fusheini ◽  
...  

BACKGROUND: Hepatitis B virus (HBV) infection is a serious global public health problem, with significant morbidity and mortality from acute and chronic complications. Increasing awareness and improving knowledge of HBV helps reduce the risk of the disease. Although many studies have been conducted on HBV in Ghana, few have focused on examining knowledge, attitude and preventive practices among adolescents towards the disease. OBJECTIVE: The objective of this study was to assess HBV knowledge, attitude and practice (KAP) among adolescents in high schools in the Asante Mampong Municipality in the Ashanti Region of Ghana. METHODS: A descriptive cross-sectional study was conducted among 398 adolescents from six senior high schools within the Asante Mampong Municipality. Data was collected using a 30-item structured questionnaire. Each item had two response options: “Yes” and “No”. A scoring system was generated and respondents were given a score on each item answered. A positive response to an item was scored 1 point and a negative response was scored 0. Scores were then summed up and averaged to give the mean knowledge, attitude and practice scores. RESULTS: The majority of the respondents were male (60%), between 15 and 17 years (45%), Christian (93%) and in their first year of study. The adolescents had basic knowledge, positive attitude, and poor practices towards HBV. There was no significant relationship between the demographic variables of the respondents and KAP mean scores. CONCLUSION: There is the need to introduce health education and awareness programs in schools within the Asante Mampong Municipality to improve students’ level of knowledge of HBV. Countrywide studies examining KAP towards HBV infection among adolescents are also warranted.


Author(s):  
Sunil K. S. Bhadouriya ◽  
Shaili Priyamvada ◽  
Hukam Singh

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo.  Vertigo and balance disorders are among the most common symptoms experienced in patients who visit ENT outpatient department.  BPPV is a common vestibular disorder leading to significant morbidity and psychosocial impact. Residual dizziness is a common condition that manifests as persistent disabling imbalance after successful repositioning maneuvers for BPPV.</p><p class="abstract"><strong>Methods: </strong>In this study we analysed and compared the effectiveness of Cawthorne Cooksey Exercise with Brandt Daroff Exercise to treat residual dizziness after successful Epley’s maneuver for posterior canal benign paroxysmal positional vertigo. A total of 30 subjects with residual dizziness after successful Epley’s maneuver for posterior canal BPPV were included in our study, 10 were male and 20 were female. The Group A received the Cawthorne Cooksey exercise post Epley’s maneuver and Group B received the Brandt Daroff exercise post Epley’s maneuver. </p><p class="abstract"><strong>Results:</strong> We conclude that both the groups have significant improvement in their symptoms and balance. This was indicated by the results.  Despite the significant results within the groups, there was no significant difference between the groups, means both exercises showed almost equal improvement in their respective group.</p><p><strong>Conclusions: </strong>This<strong> </strong>study concludes that both Cawthorne Cooksey exercise and Brandt Daroff exercise are helpful in treating residual dizziness after successful Epley’s maneuver in posterior canal BPPV patients. These exercises are safe and able to reduce subjective symptoms and imbalance hence, any of these can be recommended for treating post Epley’s residual dizziness in patients with posterior canal BPPV.  </p>


Author(s):  
Nithya Venkataramani ◽  
Sonali Muralidhar ◽  
Ravi Sachidananda

<p class="abstract">Necrotising fasciitis of the periorbital region is a rare condition where there is destruction of the periorbital soft tissue with potential of rapid spread causing significant morbidity and mortality. It is generally seen in immuno suppressed individuals following trivial trauma. Here we present a case of periorbital necrotising fasciitis in a young immonocompetent lady with emphasis on early identification and aggressive treatment to prevent loss of vision and mortality.</p>


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1086
Author(s):  
Kiran Kishor Nakarmi ◽  
Bishnu Deep Pathak ◽  
Dhan Shrestha ◽  
Pravash Budhathoki ◽  
Shankar Man Rai

Background: Scald burns result from exposure to high-temperature fluids and are more common in the pediatric age group. They occur mainly by two mechanisms: (i) spill and (ii) immersion (hot cauldron) burns. These two patterns differ in clinical characteristics and outcomes. Scalds cause significant morbidity and mortality in children. The objective of this study was to compare accidental spill burns and hot cauldron burns in a hospital setting. Methods: An analytical cross-sectional study was conducted by reviewing the secondary data of scald cases admitted during the years 2019 and 2020 in a burn-dedicated tertiary care center. Total population sampling was adopted. Data analysis was done partly using SPSS, version-23, and Stata-15. Mann Whitney U-test and Chi-square/Fisher's exact test were done appropriately to find associations between different variables. Regression analysis was performed taking mortality events as the outcome of interest. Results: Out of 108 scald cases, 43 (39.8%) had hot cauldron burns and 65 (60.2%) had accidental spill burns. Overall mortality was 16 (14.8%), out of which hot cauldron burns and accidental spill burns comprised 12 (75.0%) and 4 (25.0%), respectively. Multinomial logistic regression analysis showed the type of scald, age, and Baux score found to be associated with mortality. Every one-year increment in age had a 29% lower odds of occurrence of mortality event (adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.50-0.99, p=0.042). Likewise, every one-point increment in Baux score was associated with 19% higher odds of mortality (adjusted OR, 1.190; 95% CI, 1.08-1.32; p<0.001). Conclusions: Accidental spill burns were more common but mortality was significantly higher for hot cauldron burns. The majority of burn injuries occurred inside the kitchen emphasizing appropriate parental precautions. The risk of mortality was significantly higher in burn events occurring outside the house, and burns involving back, buttocks, perineum, and lower extremities.


2021 ◽  
Vol 17 (10) ◽  
pp. e1009959
Author(s):  
Anna L. Gregory ◽  
Daniel A. Pensinger ◽  
Andrew J. Hryckowian

Clostridioides difficile is an opportunistic diarrheal pathogen responsible for significant morbidity and mortality worldwide. A disrupted (dysbiotic) gut microbiome, commonly engendered by antibiotic treatment, is the primary risk factor for C. difficile infection, highlighting that C. difficile–microbiome interactions are critical for determining the fitness of this pathogen. Here, we review short chain fatty acids (SCFAs): a major class of metabolites present in the gut, their production by the gut microbiome, and their impacts on the biology of the host and of C. difficile. We use these observations to illustrate a conceptual model whereby C. difficile senses and responds to SCFAs as a marker of a healthy gut and tunes its virulence accordingly in order to maintain dysbiosis. Future work to learn the molecular mechanisms and genetic circuitry underlying the relationships between C. difficile and SCFAs will help to identify precision approaches, distinct from antibiotics and fecal transplant, for mitigating disease caused by C. difficile and will inform similar investigations into other gastrointestinal pathogens.


2021 ◽  
Vol 11 (21) ◽  
pp. 9813
Author(s):  
Farah M. Alkhafaji ◽  
Ghaidaa A. Khalid ◽  
Ali Al-Naji ◽  
Basheer M. Hussein ◽  
Javaan Chahl

Cardiac arrest (CA) in infants is an issue worldwide, which causes significant morbidity and mortality rates. Cardiopulmonary resuscitation (CPR) is a technique performed in case of CA to save victims' lives. However, CPR is often not performed effectively, even when delivered by qualified rescuers. Therefore, international guidelines have proposed applying a CPR feedback device to achieve high-quality application of CPR to enhance survival rates. Currently, no feedback device is available to guide learners through infant CPR performance in contrast to a number of adult CPR feedback devices. This study presents a real-time feedback system to improve infant CPR performance by medical staff and laypersons using a commercial CPR infant manikin. The proposed system uses an IR sensor to compare CPR performance obtained with no feedback and with a real-time feedback system. Performance was validated by analysis of the CPR parameters actually delivered against the recommended target parameters. Results show that the real-time feedback system significantly improves the quality of chest compression parameters. The two-thumb compression technique is the achievable and appropriate mechanism applied to infant subjects for delivering high-quality CPR. Under the social distancing constraints imposed by the SARS-CoV-2 pandemic, the results from the training device were sent to a CPR training center and provided each participant with CPR proficiency.


Women ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 192-203
Author(s):  
Susan J. Rees ◽  
Ruth Wells ◽  
Mohammed Mohsin ◽  
Nawal Nadar ◽  
Batool Moussa ◽  
...  

Intimate Partner Violence (IPV) is a major public health issue, including during pregnancy where it poses a serious risk to the woman’s health. Influenza-Like Illness (ILI) also causes significant morbidity for women during pregnancy. It may be possible that ILI in pregnancy is associated with IPV, and that depression and trauma history play a role in the connection. 524 Australia-born women and 578 refugee-background women. Baseline participants were randomly recruited and interviewed from antenatal clinics between January 2015 and March 2016, and they were reinterviewed six months post-partum. Bivariate and path analysis were used to assess links between IPV, depression and ILI. One in 10 women (10%; 111 out of 1102) reported ILI during their pregnancy period and this rate was significantly (p < 0.001) higher for women born in conflict-affected countries (13%; 76 out of 578) as compared to Australian-born women (7%; 35 out of 524). In both groups, Time 1 traumatic events, IPV and depression symptoms were significantly associated with ILI at Time 2. A significant association between IPV at Time 1 and ILI at Time 2 was fully mediated by depression symptoms at Time 1 (Beta = 0.36 p < 0.001). A significant direct path was shown from depression symptoms to ILI (Beta = 0.26, p < 0.001). Regardless of migration history, pregnant women who have experienced IPV and depression are more likely to report influenza-like symptoms in pregnancy. This may suggest that trauma and depression negatively affect immunity, although it could also indicate a connection between depressive symptoms and physical experiences of ILI.


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