Recently Published Documents
A University Hospital Healthcare Workers' High-Risk Contact with Patients Diagnosed with Coronavirus Disease (COVID-19): a Cross-Sectional Evaluation
Clinical Presentations of Brucellosis Over a Four-Year Period at Sultan Qaboos University Hospital and Armed Forces Hospital, Muscat, Oman
Objectives: Brucellosis is a highly contagious zoonotic disease which can have serious health implications for affected humans and livestock. This study aimed to evaluate the clinical presentation, geographical distribution and risk factors of brucellosis cases admitted over a four-year period to two hospitals in Muscat, Oman. Methods: This observational study was conducted from January 2015 to December 2018 at the Sultan Qaboos University Hospital and Armed Forces Hospital in Muscat. All patients with probable or definitive diagnoses of brucellosis according to the diagnostic criteria of the World Health Organization were included. Relevant data were gathered from the patients’ medical records, including results from standard agglutination tests, Brucella enzyme-linked immunosorbent assays, bacterial blood or tissue/aspirate cultures and Brucella polymerase chain reaction tests. Results: A total of 64 patients were diagnosed with brucellosis over the study period. The median age was 31.5 years and 73.4% were male. The majority (95.2%) presented with fever, followed by weight loss (51%), transaminitis (48.4%), peripheral arthritis/arthralgia (15.9%) and back pain (spondylodiscitis/sacroiliitis; 23.4%). Overall, 75.5% reported having consumed raw dairy products, while only 25.9% gave a positive history of animal contact. Conclusion: Patients with brucellosis presented with a wide range of clinical features, the most predominant of which was fever. The majority of patients were residents of or had recently visited Salalah and had consumed raw dairy products. These findings highlight the need for healthcare practitioners to maintain a high index of suspicion for this diagnosis. Moreover, further regulatory measures are necessary to oversee the sale of raw/unpasteurised dairy products. Keywords: Brucellosis; Bacterial Infections; Zoonotic Bacterial Infections; Risk Factors; Epidemiology; Oman.
Biological and Psychosocial Factors, Risk Behaviors, and Perinatal Asphyxia in a University Hospital: Matched Case–Control Study, Cali, Colombia (2012–2014)
Introduction: Perinatal asphyxia is one of the main causes of morbidity and mortality in newborns. It generates high costs, both social and economic, and presents modifiable risk factors.Objective: To determine the biological and psychosocial factors and risk behaviors associated with the development of perinatal asphyxia (Sarnat II-III) in newborns from low socioeconomic status in a tier III university hospital in the city of Cali, Colombia.Materials and Methods: With a case and control design, 216 patients were studied (54 cases/162 controls) (1 case/3 matched controls). The cases were defined as newborns with modified or severe perinatal asphyxia (Sarnat II-III) between 2012 and 2014, with gestational age ≥ 36 weeks, with neurological signs not attributable to other causes, multiorgan compromise, advanced reanimation, and presence of a sentinel event. For the analysis, conditional logistic regression models were developed to evaluate association (OR), considering that the cases and controls had been paired by the birth and gestational age variables.Results: The final model showed that, from the group of biological variables, meconium amniotic fluid was identified as a risk factor (OR 15.28, 95%CI 2.78–83.94). Induction of labor lowered the risk of perinatal asphyxia by 97% (OR 0.03, 95%CI 0.01–0.21), and monitoring of fetal heart rate was associated with lower odds by 99% (OR 0.01, 95%CI 0.00–0.31) of developing perinatal asphyxia in the newborn. Regarding social variables, the lack of social support was identified as a risk factor for the development of perinatal asphyxia (OR 6.44, 95%CI 1.16–35.66); in contrast, secondary education lowered the odds of developing perinatal asphyxia by 85% when compared with pregnant women who only had primary school education (OR 0.15, 95%CI 0.03–0.77).Conclusion: Assessment of biological and psychosocial factors and social support is important in pregnant women to determine the risk of developing perinatal asphyxia in a low-income population.
Profiles of microorganisms isolated from neonates’ blood cultures, incubators, cradles, ventilators, washbasins, and health-workers of Libreville University Hospital Neonatal Service: focus on infection prevention and control measures
Background: Nosocomial infection outbreaks in neonatal services are a serious healthcare concern in both developed and developing countries, but few studies have been conducted in sub-Saharan Africa. Objective: This study explored the etiology of septicemia in neonates and associated patterns of antimicrobial susceptibility in Gabon. Methods: We analyzed cultures from neonates’ blood and swabs from medical personnel and equipment located in the neonatology service. Results: Sixty-eight microorganisms were isolated from the medical personnel and equipment; 46 microorganisms were isolated from neonates’ blood culture. Klebsiella pneumoniae spp pneumoniae was the most common bacteria found in both (30.6% and 26.9%, respectively). All Klebsiella pneumoniae spp pneumonia isolates were resistant to amoxicillin with clavulanic acid, gentamycin resistance ranged from 93% to 100%, and cephalosporin resistance ranged from 33.3% to 47%. Conclusions: Awareness of the etiology, prevalence, and outcome of nosocomial infection is the first and most important step to appropriate interventions
The Riga East University Hospital Stroke Registry—An Analysis of 4915 Consecutive Patients with Acute Stroke
Background and Objectives: A hospital-based stroke registry is a useful tool for systematic analyses of the epidemiology, clinical characteristics, and natural course of stroke. Analyses of stroke registry data can provide information that can be used by health services to improve the quality of care for patients with this disease. Materials and Methods: Data were collected from the Riga East University Hospital (REUH) Stroke Registry in order to evaluate the etiology, risk factors, clinical manifestations, treatment, functional outcomes, and other relevant data for acute stroke during the period 2016–2020. Results: During a five-year period, 4915 patients (3039 females and 1876 males) with acute stroke were registered in the REUH Stroke Registry. The causative factors of stroke were cardioembolism (45.7%), atherosclerosis (29.9%), lacunar stroke (5.3%), stroke of undetermined etiology (1.2%), and stroke of other determined causes (1.2%). The most frequent localizations of intracerebral hemorrhage were subcortical (40.0%), lobar (18.9%), and brainstem (9.3%). The most prevalent risk factors for stroke were hypertension (88.8%), congestive heart failure (71.2%), dyslipidemia (46.7%), and atrial fibrillation (44.2%). In addition, 1018 (20.7%) patients were receiving antiplatelet drugs, 574 (11.7%) were taking statins, and 382 (7.7%) were taking anticoagulants. At discharge, 35.5% of the patients were completely independent (mRS (modified Rankin Scale) score: 0–2), while 49.5% required some form of assistance (mRS score: 3–5). The intrahospital mortality rate was 13.7%, although it was higher in the hemorrhage group (30.9%). Conclusions: Our stroke registry data are comparable to those of other major registries. Analysis of stroke registry data is important for improving stroke care and obtaining additional information for stroke studies.
An open-label phase Ⅰ/Ⅱ a clinical trial of 11β-HSD1 inhibitor for Cushing’s syndrome and autonomous cortisol secretion
Abstract Context 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) inhibitors demonstrate anti-metabolic and anti-sarcopenic effects in Cushing’s syndrome (CS) and autonomous cortisol secretion (ACS) patients. Objective To confirm the efficacy and safety of S-707106 (11β-HSD1 inhibitor) administered to CS and ACS patients. Design A 24-week single-center, open-label, single-arm, dose-escalation, investigator-initiated clinical trial on a database. Setting Kyushu University Hospital, Kurume University Hospital, and related facilities. Patients Sixteen patients with inoperable or recurrent CS and ACS, with mildly impaired glucose tolerance. Intervention Oral administration of 200-mg S-707106 after dinner, daily, for 24 weeks. In patients with insuﬃcient improvement in oral glucose tolerance test results at 12 weeks, an escalated dose of S-707106 (200-mg BID) was administered for the residual 12 weeks. Main Outcome Measures The rate of participants responding to glucose tolerance impairment, defined as those showing a 25% reduction in the area under the curve (AUC) of plasma glucose during the 75 g-oral glucose tolerance test at 24 weeks. Results S-707106 administration could not achieve the primary endpoint of this clinical trial (>20% of responsive participants). AUC glucose decreased by -7.1% (SD, 14.8 [90% CI: -14.8– -1.0], P=0.033) and -2.7% (14.5 [-10.2–3.4], P=0.18) at 12 and 24 weeks, respectively. S-707106 administration decreased AUC glucose significantly in participants with a high body mass index. Body fat percentage decreased by -2.5% (1.7 [-3.3– -1.8], P<0.001), and body muscle percentage increased by 2.4% (1.6 [1.7–3.1], P<0.001). Conclusions S-707106 is an effective insulin sensitizer and anti-sarcopenic and anti-obesity medication for these patients.
Evaluation Of The Discriminative Capacity Of Anthropometric Indicators And Their Predictive Relationship Of Diabetes In Health Workers Of The University Hospital Of Guayaquil - Ecuador
It’s pronounced “EE-lick”: Milo Ellik, veteran, urologist, and inventor of the evacuator that bears his name
Objectives The Ellik Evacuator is a commonly used tool in transurethral endoscopic surgery and a standard of care for the rapid removal from the bladder of resected tumor fragments, prostatic chips, or blood. Little is known, however, about the inventor of the Ellik evacuator, his urologic contributions, and how the evacuator came to be. Methods We contacted surviving descendants of Dr. Milo Ellik, and conducted interviews as part of an oral history project. Original medical equipment and personal belongings, provided by the family of Dr. Ellik, were analysed. Secondary source materials included published urologic articles and unpublished biographic information. Results Milo Ellik was born in Chicago in 1905 but was orphaned and put himself through college. He graduated from the University of Iowa with an MD in 1932 and began residency under Nathan Alcock. Ellik conceived of the evacuator that bears his name as a resident, visiting the glass-blowing facility at the Iowa University Hospital to construct the prototype. He published the results in a 1937 issue of the Journal of Urology but did not obtain a patent which was eventually procured by Bard in 1940. Conclusions Milo Ellik designed a major innovation in transurethral surgery as a resident in urology by constructing the first glass evacuator that bears his name. The Ellik family donated a large quantity of Dr. Ellik’s inventions to the AUA’s Didusch Museum for permanent storage and study.