The incidence of congenital heart disease in Azerbaijan: prospective epidemiological study

Background The incidence of Congenital Heart Disease (CHD) in Azerbaijan has never been calculated with a prospective study, using Echo-2D as a study method Aim First prospective epidemiology study calculating incidence and types of CHD in Baku, Azerbaijan. Population-method From June 2016 to August 2018, 2570 term neonates were screened in 2 major maternity units. The screening was randomized to equal females/males with no known previous obstetric alert regarding CHD. Scanning was done by two teams of pediatric cardiologists in echo-2D. Each team was ‘blinded’ to the findings of each other. All scans were recorded, and a third senior physician reevaluated them. Results From 2570 term neonates of the general population we detected 47 CHD’s. From them, 17 were c-CHD and 5, s-CHD. 25 were simple or moderate complex non-cyanotic CHD. The estimated incidence was 1.828%. 17/47 (36.2%) were cyanotic. The incidence of simple CHD was 25/47(53.2%). Analysis of the specific anatomy is presented in table 1. Conclusions This first-ever prospective epidemiology study in Azerbaijan involving a cohort equal to 1.65% of the annual living births of the country, estimated a high incidence. This is among the highest reported globally. The amount of critical & cyanotic CHD was 46.8% and 36.2% respectable. These high numbers are possibly related to an isolated population and conjugated marriage customs of the country. This represents a public population health burden.

Behçet’s syndrome in children and young people in the United Kingdom & Republic of Ireland: a prospective epidemiological study

Objectives To define the incidence and prevalence of Behçet’s syndrome (BS) in children and young people (CYP) up to the age of 16 years in the United Kingdom (UK) and Republic of Ireland (ROI). Methods A prospective epidemiological study was undertaken with the support of the British Paediatric Surveillance Unit (BPSU) and the British Society of Paediatric Dermatologists (BSPD). Consultants reported anonymised cases of BS seen. A follow-up study at one year examined progression of disease and treatment. Results Over a two-year period, 56 cases met International Criteria for Behçet’s Disease. For children under 16 years of age, the two-year period prevalence estimate was 4.2 per million (95% CI 3.2–5.4) and the incidence was 0.96 per million person years (95% CI 0.66–1.41). Mucocutaneous disease was the most common phenotype (56/100%), with ocular (10/56; 17.9%), neurological (2/56; 3.6%) and vascular involvement (3/56; 5.4%) being less common. Median age at onset was 6.34 years and at diagnosis was 11.72 years. There were slightly more female than male children reported (32/56; 55.6%). The majority of cases (85.7%) were white Caucasian. Apart from genital ulcers, which were more common in females, there were no significant differences in frequency of manifestations between male or females, nor between ethnicities. Over 83% of cases had three or more non-primary care healthcare professionals involved in their care. Conclusion BS is extremely rare in CYP in the UK and ROI and most have mucocutaneous disease. Healthcare needs are complex, and coordinated care is key.

RISK FACTORS IN PATIENTS WITH BISPHOSPHONATE - ASSOCIATED OSTEONECROSIS OF THE JAWS

Purpose: To investigate patient diagnosed with BAONJ in order to identify the presence of risk factors. Material/Methods: A prospective epidemiological study of 112 patients diagnosed with Bisphosphonate-associated Osteonecrosis of the jaw in 2016 and 2017 was conducted in the Clinic of maxillo-facial surgery of UMHAT "St. George", Plovdiv, Bulgaria, based on anamnesis, clinical examination, hospital documentation, and imaging studies. SPSS Statistics v.24 was used for statistical analysis, at a significance level p<0.05. Results: Of the patients, 77.89% had a primary oncological diagnosis of breast or prostate cancer; the average duration of bisphosphonate therapy up to the time of the study is 4.5 years; the most common co-morbidities were hypertension (72.73%), anemia (40.00%) and diabetes (23.67%); 65.18% of patients smoke or are former smokers; the time till first oral complaints after initiation of BP treatment was usually 2 years (31.25%, n = 35) and 3 years (24.11%, n = 27) (p> 0.05).; the last dental manipulation before the onset of symptoms was tooth extraction (52.68%), followed by removable dentures (21.42%). Conclusions: The investigation of identified in the literature risk factors with their occurrence in the studied population shows a correlation with the data of leading researchers.

Association between overall fruit and vegetable intake, and fruit and vegetable sub-types and blood pressure: the PRIME study (Prospective Epidemiological Study of Myocardial Infarction)

Increased fruit and vegetable (FV) intake is associated with reduced blood pressure (BP). However, it is not clear whether the effect of FV on BP depends on the type of FV consumed. Furthermore, there is limited research regarding the comparative effect of juices or whole FV on BP. Baseline data from a prospective cohort study of 10 660 men aged 50–59 years examined not only the cross-sectional association between total FV intake but also specific types of FV and BP in France and Northern Ireland. BP was measured, and dietary intake assessed using FFQ. After adjusting for confounders, both systolic BP (SBP) and diastolic BP (DBP) were significantly inversely associated with total fruit, vegetable and fruit juice intake; however, when examined according to fruit or vegetable sub-type (citrus fruit, other fruit, fruit juices, cooked vegetables and raw vegetables), only the other fruit and raw vegetable categories were consistently associated with reduced SBP and DBP. In relation to the risk of hypertension based on SBP >140 mmHg, the OR for total fruit, vegetable and fruit juice intake (per fourth) was 0·95 (95 % CI 0·91, 1·00), with the same estimates being 0·98 (95 % CI 0·94, 1·02) for citrus fruit (per fourth), 1·02 (95 % CI 0·98, 1·06) for fruit juice (per fourth), 0·93 (95 % CI 0·89, 0·98) for other fruit (per fourth), 1·05 (95 % CI 0·99, 1·10) for cooked vegetable (per fourth) and 0·86 (95 % CI 0·80, 0·91) for raw vegetable intakes (per fourth). Similar results were obtained for DBP. In conclusion, a high overall intake of fruit, vegetables and fruit juice was inversely associated with SBP, DBP and risk of hypertension, but this differed by FV sub-type, suggesting that the strength of the association between FV sub-types and BP might be related to the type consumed, or to processing or cooking-related factors.

MONITORING OF PERIPHERAL VENOUS CATHETERIZATION AT THE SURGICAL HOSPITAL

Introduction. Peripheral venous catheters are widely used in medical practice to provide continuous venous access for therapeutic and diagnostic purposes. Peripheral vascular catheterization can be accompanied by infectious complications, including catheter-related bloodstream infections. An effective system of epidemiological surveillance and infection control of catheter-related bloodstream infections has not been developed at the state level in Ukraine; there is no proper monitoring for administration site and no registration of complications associated with the vascular catheterization. The purpose of this work was to assess the validity and propriety of the use of peripheral venous catheters in patients who receive inpatient treatment. Materials and methods: Between October 2019 and April 2020, 93 adult patients who were peripheral venous catheterized in a surgical hospital in Kharkiv were included in a prospective epidemiological study. The author's observation card was used for data collection for each patient daily. The catheter site was observed daily, and the following symptoms were entered into the card: flushed skin, swelling, discharge, and pain at the administration site at rest and on palpation. Interpretation of symptoms was conducted using the visual infusion phlebitis scale by A. Jackson. Statistical processing of data was carried out using descriptive statistics methods. To identify the relationship between the nominative values, Pearson's criterion χ2 was determined with P < 0.01. Research results: 51 women (54.8%) and 42 men (45.2%) aged 18 to 84 were enrolled. In total, patients spent 619 bed-days in the hospital, of which the proportion of days with vascular catheters equaled 90.8% (n = 562). The main indication for the catheterization procedure was multicomponent therapy or the use of incompatible medications (98.9% / n = 92). In total, 148 peripheral venous catheters were inserted in these patients. The number of vascular catheters per patient ranged 1 to 3. According to the data of daily monitoring of the administration site, the signs of inflammation were observed in 65.5% of cases (n = 97). The incidence of signs of inflammation at the administration site with the first catheterization was significantly higher (χ2 = 25.2804; p < 0.00001) than that with the second or third catheterization. The signs of local inflammation, which were more common in patients with vascular catheters, included flushed skin in the area of the catheter site (65.5% / n = 97), complaints of pain on palpation in the area of the catheter site (60.8% / n = 90) and swelling in the area of the catheter site (57.4% / n = 85). It was found that for more than half of the cases (55.4% / n = 82), the patients had symptoms of middle-stage phlebitis. It was also revealed that the most common reason for the removal of a peripheral venous catheter (n = 148) in the studied hospital were signs of local inflammation at the catheter site (61.5% / n = 91). However, in 16.9% of cases (n = 25), the occurrence of at least two signs of local inflammation at the catheter site, which indicated the initial stage of phlebitis and required to rearrange the catheter, was not the reason for immediate catheter removal. Conclusions: Health care workers make mistakes when working with peripheral venous catheters; in particular, there is no timely replacement of vascular catheters in the event of signs of infusion phlebitis. To reduce the risk of infectious complications of vascular catheterization at a health facility, the indications for insertion and removal of peripheral venous catheters and central venous catheters should be clearly defined, and standard operating procedures for ensuring vascular access and algorithms for managing patients with vascular catheters should be developed and implemented. Keywords intravascular catheter, prospective epidemiological study, assessment of the catheter insertion site, infusion phlebitis, catheter-related bloodstream infections, infection control.