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2.
Rev Med Liege ; 79(5-6): 282-284, 2024 Jun.
Artículo en Francés | MEDLINE | ID: mdl-38869112

RESUMEN

It's easy to imagine using medicines to treat or even cure an illness. For most people, however, the idea of taking one or more medicines to prevent or delay the onset of an illness or its complications seems less obvious. However, there is indeed a place for using medicines in the field of prevention. Knowing the definition of a medicine means you can immediately understand the role it can play in the field of prevention. What's more, the use of medicines should be based not only on evidence-based medicine, but also on an approach that integrates a collegial discussion with the patient, which will make it possible to discuss the expected benefits of such an approach, as well as explaining any possible side-effects. Only in this way can we expect better compliance of a person still without a disease. This article briefly summarizes the role that medicines can play in a prevention strategy.


L'usage des médicaments se conçoit aisément pour traiter, voire guérir, une maladie. Dans l'esprit de la population, envisager de prendre un ou des médicaments pour éviter ou retarder l'apparition d'une maladie ou les complications liées à celle-ci semble moins évident. Pourtant, il existe bien une place pour l'usage de médicaments dans le domaine de la prévention. Bien connaître la définition d'un médicament permet de comprendre d'emblée la place que celui-ci peut occuper dans le domaine de la prévention. Cependant, l'utilisation des médicaments devra se baser, non seulement sur la médecine basée sur les preuves, mais aussi en intégrant cette approche dans une discussion collégiale avec le patient. Ce dialogue permettra d'aborder les bénéfices attendus d'une telle approche, mais aussi d'expliquer les éventuelles manifestations indésirables (effets secondaires). Ce n'est que par cette méthode que l'on sera en droit d'attendre une meilleure observance de la part d'une personne non encore malade. Cet article résume brièvement la place que peuvent avoir les médicaments dans une stratégie de prévention.


Asunto(s)
Preparaciones Farmacéuticas , Prevención Primaria , Humanos
3.
Front Public Health ; 12: 1399672, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38887242

RESUMEN

Objectives: The aim of this study is to estimate the excess mortality burden of influenza virus infection in China from 2012 to 2021, with a concurrent analysis of its associated disease manifestations. Methods: Laboratory surveillance data on influenza, relevant population demographics, and mortality records, including cause of death data in China, spanning the years 2012 to 2021, were incorporated into a comprehensive analysis. A negative binomial regression model was utilized to calculate the excess mortality rate associated with influenza, taking into consideration factors such as year, subtype, and cause of death. Results: There was no evidence to indicate a correlation between malignant neoplasms and any subtype of influenza, despite the examination of the effect of influenza on the mortality burden of eight diseases. A total of 327,520 samples testing positive for influenza virus were isolated between 2012 and 2021, with a significant decrease in the positivity rate observed during the periods of 2012-2013 and 2019-2020. China experienced an average annual influenza-associated excess deaths of 201721.78 and an average annual excess mortality rate of 14.53 per 100,000 people during the research period. Among the causes of mortality that were examined, respiratory and circulatory diseases (R&C) accounted for the most significant proportion (58.50%). Fatalities attributed to respiratory and circulatory diseases exhibited discernible temporal patterns, whereas deaths attributable to other causes were dispersed over the course of the year. Conclusion: Theoretically, the contribution of these disease types to excess influenza-related fatalities can serve as a foundation for early warning and targeted influenza surveillance. Additionally, it is possible to assess the costs of prevention and control measures and the public health repercussions of epidemics with greater precision.


Asunto(s)
Causas de Muerte , Gripe Humana , Humanos , Gripe Humana/mortalidad , Gripe Humana/epidemiología , China/epidemiología , Adulto , Persona de Mediana Edad , Masculino , Femenino , Preescolar , Adolescente , Niño , Lactante , Anciano , Adulto Joven , Vigilancia de la Población
4.
Prev Med ; 185: 108033, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38851401

RESUMEN

OBJECTIVE: The pathogenic mechanisms of syphilis and the host defense mechanisms against syphilis remain poorly understood. Exploration of the susceptibility factors of syphilis may provide crucial clues for unraveling its underlying mechanisms. METHODS: A two-sample Mendelian Randomization framework was utilized, and the inverse-variance weighted method was used as the main analysis. All data was sourced from Genome-wide association studies datasets from 2015 to 2022 in Europe, and all participants were of European descent. Only summary-level statistics were used. Sensitivity analyses were conducted to evaluate the heterogeneity and pleiotropy of the datasets. RESULTS: Our study established 18 exposure factors (12 risk factors and 6 protective factors) for syphilis susceptibility. Twelve factors encompassing body mass index, waist circumference, darker natural skin, cooked vegetable intake, processed meat intake, diabetes mellitus, glucose regulation disorders, gout, autoimmune diseases, rheumatoid arthritis, diverticulitis, and longer menstrual cycles were found to increase susceptibility to syphilis. In contrast, 6 factors including easier skin tanning, blonde natural hair color, irritability, higher neuroticism scores, extended sleep duration, and delayed age at first sexual intercourse were connected to a reduced risk of syphilis infection (all P < 0.05). CONCLUSIONS: This study identified 18 influencing factors of syphilis susceptibility. These findings offered novel insights for further probing into the underlying pathogenic mechanisms of syphilis and underscored the importance of multifaceted prevention strategies against syphilis.


Asunto(s)
Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Sífilis , Humanos , Sífilis/epidemiología , Factores de Riesgo , Europa (Continente)/epidemiología , Femenino , Masculino
5.
Cancer Med ; 13(12): e7372, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38923216

RESUMEN

BACKGROUND: Chimeric antigen receptor T (CAR-T) cell therapy has emerged as a potent treatment for relapsed or refractory multiple myeloma, demonstrating significant clinical efficacy. Despite these advances, treatment-related toxicities, particularly infections, pose a significant challenge to patient safety. METHODS: This review synthesizes current knowledge on the mechanisms underlying post-CAR-T therapy infections, focusing on the interplay between immune dysfunction, host factors, and treatment-induced toxicity. It provides a comprehensive analysis of the temporal and individual variability in infection characteristics and the confounding clinical presentation of cytokine release syndrome. RESULTS: The review identifies that patients receiving CAR-T cells are at increased risk of concurrent infections due to the heterogeneity in infection characteristics across different time periods, individuals, and patient groups. It highlights the diagnostic and therapeutic complexities introduced by the overlapping symptoms of infection and cytokine release syndrome. CONCLUSION: To enhance the infection control post-CAR-T therapy, this review proposes preventive strategies tailored to the early and long-term management of patients. It underscores the need for a nuanced understanding of infection mechanisms and the importance of personalized prevention plans to improve clinical outcomes in multiple myeloma treatment.


Asunto(s)
Inmunoterapia Adoptiva , Mieloma Múltiple , Humanos , Mieloma Múltiple/terapia , Mieloma Múltiple/inmunología , Inmunoterapia Adoptiva/efectos adversos , Inmunoterapia Adoptiva/métodos , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/prevención & control , Receptores Quiméricos de Antígenos/inmunología , Infecciones/etiología , Factores de Riesgo
6.
Infect Dis Rep ; 16(3): 491-498, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-38920893

RESUMEN

RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy. Fifty-two RSV-positive patients were identified from the 2014-2015 to the 2022-2023 seasons. RSV type B was found in 71.2% of cases. The median age was 78 years (IQR: 72-84) and 40.4% of the subjects had at least one comorbidity; 5.8% needed intensive care. The use of combined rapid tests for SARS-CoV-2/influenza/RSV identification in primary care settings may contribute to an improved definition of the burden of RSV in the elderly. The implementation of an anti-RSV vaccination strategy in the elderly population would reduce direct and indirect infection costs. More robust epidemiological data in Italy are needed for targeted preventive strategies.

7.
China CDC Wkly ; 6(14): 277-281, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38634102

RESUMEN

What is already known about this topic?: The mortality rate and disease burden associated with falls among the elderly in China are on the rise. Interventions can play a crucial role in preventing and managing falls. What is added by this report?: The application of the "5E" injury prevention strategy led to a decrease in both the occurrence of falls and the likelihood of subsequent falls. Regular physical activity and maintaining a positive outlook were identified as protective measures against falls, while sleep issues and hearing impairment were found to increase the risk of falling. What are the implications for public health practice?: The group-based comprehensive intervention strategy is crucial as it offers an innovative intervention model and empirical evidence for decreasing fall rates among elderly individuals living in rural areas.

9.
JMIR Form Res ; 8: e46195, 2024 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-38446536

RESUMEN

BACKGROUND: In 2017, the Quebec government assigned the Association québécoise de prévention du suicide (AQPS) to develop a digital suicide prevention strategy (DSPS). The AQPS responded by creating a centralized website that provides information on suicide and mental health, identifies at-risk individuals on the internet, and offers direct crisis intervention support via chat and text. OBJECTIVE: This study aims to evaluate the effectiveness of suicide.ca, Quebec's DSPS platform. METHODS: This study used a cross-sectional descriptive design. The study population comprised internet users from Quebec, Canada, who visited the suicide.ca platform between October 2020 and October 2021. Various data sources, such as Google Analytics, Firebase Console, and Customer Relation Management data, were analyzed to document the use of the platform. To understand the profile of suicide.ca users, frequency analyses were conducted using data from the self-assessment module questionnaires, the intervention service's triage questionnaire, and the counselors' intervention reports. The effectiveness of the platform's promotional activities on social media was assessed by examining traffic peaks. Google Analytics was used to evaluate the effectiveness of AQPS' strategy for identifying at-risk internet users. The impact of the intervention service was evaluated through an analysis of counselors' intervention reports and postintervention survey results. RESULTS: The platform received traffic from a diverse range of sources, with promotional efforts on social media directly contributing to the increased traffic. The requirement of a user account posed a barrier to the use of the mobile app, and a triage question that involved personal information led to a substantial number of dropouts during the intervention service triage. AdWords campaigns and fact sheets addressing suicide risk factors played a crucial role in driving traffic to the platform. With regard to the profile of suicide.ca users, the findings revealed that the platform engaged individuals with diverse levels of suicidal risk. Notably, users of the chat service displayed a higher suicide risk than those who used the self-assessment module. Crisis chat counselors reported a positive impact on approximately half of the contacts, and overall, intervention service users expressed satisfaction with the support they received. CONCLUSIONS: A centralized digital platform can be used to implement a DSPS, effectively reaching the general population, individuals with risk factors for suicide, and those facing suicidal issues.

10.
BMC Urol ; 24(1): 52, 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38443863

RESUMEN

BACKGROUND: The forgotten ureteral stents (FUS) is one of the late complications of stent placement. This systematic review summarized different aspects of FUS and focused on the problems and solutions related to FUS. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. PubMed® and Embase® were searched from inception until October 1st, 2022. Eligible studies were those defining FUS as a stent unintentionally left in situ longer than at least 2 months. RESULTS: Total 147 studies with 1292 patients were finally included. The mean indwelling time of FUS was 33.5 months (range from 3 months to 32 years). The most common initial cause for stent placement was adjunct treatment to urolithiasis (79.2%). The major forgetting reasons were patient-related (83.9%), which included poor compliance, lapse in memory, and misconceptions about the necessity of timely removal. Primary presenting complaints were flank pain (37.3%), lower urinary tract symptoms (33.3%), and hematuria (22.8%). Encrustation (80.8%) and urinary tract infections (40.2%) were the most common complications detected in patients with FUS. Computed tomography evolving as a preferred imaging test (76.1%) was indispensable for evaluating encrustation, migration, fracture and other complicated situations in patients with FUS. Besides, evaluation of kidney function and infection status was also of great importance. Multiple and multimodal procedures (59.0%) were often necessitated to achieve the stent-free status, and were mostly endoscopic procedures. Cystoscope was most commonly used (64.8%). Retrograde ureteroscopy (43.4%) and antegrade stent removal (31.6%) were often used when dealing with more complicated situations. Extracorporeal shockwave lithotripsy (30.4%) was often used as adjunctive to other endoscopic procedures, but it sometimes failed. The decision regarding the choice of treatment is based on the volume and site of encrustation, the direction of migration, the site of fracture, kidney function and other urinary comorbidities. CONCLUSIONS: FUS not only pose hazard to patients' health, but also impose a huge economic burden on medical care. Thorough preoperative evaluation is fundamental to developing the treatment strategy. The management of FUS should be individualized using different treatment modalities with their advantages to minimize patients' morbidities. Prevention is better than cure. Strengthening health education and setting a tracking program are of great importance to the prevention of FUS.


Asunto(s)
Cuerpos Extraños , Fracturas Óseas , Litotricia , Stents , Urolitiasis , Humanos , Cistoscopios , Hematuria , Ureteroscopía , Stents/efectos adversos
11.
Nutrients ; 16(3)2024 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-38337657

RESUMEN

This study aimed to assess the prevalence of dry eye syndrome among Korean women aged 40 and above and explore the correlation between the syndrome and daily dietary nutrient intake. We analyzed data from 92,888 female participants (mean age: 63.35 ± 8.86 years) from the 8th Korea National Health and Nutrition Examination Survey (KNHANES 2019). Dietary intake was evaluated using a personalized 24 h recall method for 21 nutrients, including macronutrients, macro- and micro-minerals, and both water- and fat-soluble vitamins. Associations between nutrient intake and dry eye syndrome were determined using odds ratios from multivariate logistic regression. We found a 7.7% prevalence of dry eye syndrome in the population studied. Intake of dietary fiber (adjusted OR: 0.72), protein (adjusted OR: 0.84), omega-3 fatty acids (adjusted OR: 0.90), water (adjusted OR: 0.76), calcium (adjusted OR: 0.82), phosphate (adjusted OR: 0.87), potassium (adjusted OR: 0.88), magnesium (adjusted OR: 0.87), vitamin A (adjusted OR: 0.78), vitamin C (adjusted OR: 0.73), and vitamin E (adjusted OR: 0.86) was inversely associated with dry eye syndrome prevalence (p < 0.0001 for all). Conversely, a higher intake of carbohydrates (adjusted OR: 1.23), sugar (adjusted OR: 1.30), fat (adjusted OR: 1.25), cholesterol (adjusted OR: 1.32), sodium (adjusted OR: 1.18), iron (adjusted OR: 1.28), and zinc (adjusted OR: 1.26) correlated with an increased risk (p < 0.0001 for all). No significant associations were found between the prevalence of dry eye syndrome and the intake of omega-6 fatty acids and vitamin D. Our study identified significant associations between specific dietary nutrients and the risk of dry eye syndrome among Korean women aged 40 and above. These findings suggest that dietary choices could influence the likelihood of developing dry eye syndrome, indicating a potential role for dietary intervention in its management. However, it is important to note that these observations are preliminary, and further research is necessary to confirm these relationships and explore their implications for dietary recommendations in dry eye syndrome prevention and management.


Asunto(s)
Dieta , Síndromes de Ojo Seco , Humanos , Femenino , Persona de Mediana Edad , Anciano , Encuestas Nutricionales , Prevalencia , Dieta/efectos adversos , Vitaminas , Síndromes de Ojo Seco/epidemiología , Síndromes de Ojo Seco/etiología , República de Corea/epidemiología , Agua
12.
Infect Drug Resist ; 17: 187-206, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38283111

RESUMEN

Background: COVID-19, a severe respiratory illness, is caused by the SARS-CoV-2 virus. The pandemic has devastated public health, economies, and social structures worldwide. In Ethiopia, the government and health authorities have implemented various COVID-19 prevention strategies to contain the spread of the virus. This study aims to investigates the factors influencing the implementation and effectiveness of COVID-19 prevention strategies in Jigjiga Town, Ethiopia. Methods: A community-based cross-sectional study was conducted from April 2022 to December 2022, involving 593 participants in Jigjiga town. Multi-stage sampling techniques were used, and data was collected using a structured questionnaire covering demographic characteristics, socioeconomic status, attitude, knowledge, prevention practices, misconceptions, and COVID-19 prevention strategies. A multivariate model was developed to control for confounding, using variables suitable for multivariate logistic regression analysis with p-values less than 0.25. A variable is considered significant in multivariable logistic regression analysis if its p-value is less than 0.05. Results: The study found that only 12.2% of participants used COVID-19 prevention strategies. Those with a bachelor's degree or higher had a strong association with prevention strategies (AOR: 20.08, 95% CI: 2.13-188.85). Participants informed about COVID-19 prevention were 6.886 times more likely to use strategies (95% CI: 2.975-15.938). People who received the COVID-19 vaccine were 1.14 times more likely to engage in reasonable preventive measures compared to those who did not get vaccinated. Conclusion: The study reveals low COVID-19 prevention practices among participants, with only 12.2% utilizing preventive strategies. The covariate, the kinds of information received on COVID-19 prevention mechanisms, participants with a favorable attitude toward COVID-19, educational level, mask-wearing, social distancing, vaccination, hand hygiene, public health communication, and household income were significantly associated with COVID-19 prevention strategies. The COVID-19 vaccination promotes preventive practices, reduces infection risk, protects against severe illness, and decreases community spread.

13.
Pediatr Surg Int ; 40(1): 32, 2024 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-38196049

RESUMEN

Necrotizing enterocolitis (NEC) is one of the diseases in neonates, with a high morbidity and mortality rate, especially in preterm infants. This review aimed to briefly introduce the latest epidemiology, susceptibility factors, and clinical diagnosis and presentation of NEC. We also organized new prevention strategies by risk factors according to different pathogeneses and then discussed new treatment methods based on Bell's staging and complications, and the classification of mild to high severity based on clinical and imaging manifestations. Such a generalization will help clinicians and researchers to gain a deeper understanding of the disease and to conduct more targeted classification, grading prevention, and exploration. We focused on prevention and treatment of the early and suspected stages of NEC, including the discovery of novel biomarkers and drugs to control disease progression. At the same time, we discussed its clinical application, future development, and shortcomings.


Asunto(s)
Enterocolitis Necrotizante , Enfermedades Fetales , Enfermedades del Recién Nacido , Lactante , Femenino , Recién Nacido , Humanos , Enterocolitis Necrotizante/diagnóstico , Enterocolitis Necrotizante/prevención & control , Recien Nacido Prematuro , Progresión de la Enfermedad
14.
BMC Pulm Med ; 24(1): 15, 2024 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-38178024

RESUMEN

BACKGROUND: IPF is a complex lung disease whose aetiology is not fully understood, but diet may have an impact on its development and progression. Therefore, we investigated the potential causal connection between dietary intake and IPF through TSMR to offer insights for early disease prevention recommendations. METHODS: The study incorporated 29 dietary exposure factors, oily fish intake, bacon intake, processed meat intake, poultry intake, beef intake, pork intake, lamb/mutton intake, non-oily fish intake, fresh fruit intake, cooked vegetable intake, baked bean intake, fresh tomato intake, tinned tomato intake, salad/raw vegetable intake, Fresh fruit intake, coffee intake, tea intake, water intake, red wine intake, average weekly beer plus cider intake, alcoholic drinks per week, cereal intake, bread intake, whole-wheat intake, whole-wheat cereal intake, cheese intake, yogurt intake, salt added to food and whole egg intake. The study explored the causal link between diet and IPF using TSMR analysis, predominantly the IVW method, and performed sensitivity analyses to validate the results. RESULT: The study revealed that consuming oily fish, yogurt, and dried fruits had a protective effect against IPF, whereas the consumption of alcoholic beverages and beef was linked to an increased risk of IPF. CONCLUSION: In this MR study, it was discovered that the consumption of oily fish, yogurt, and dried fruits exhibited a protective effect against IPF, whereas the intake of alcoholic beverages and beef was associated with an elevated risk of IPF. These findings underscore the significance of making informed and timely dietary decisions in IPF prevention.


Asunto(s)
Dieta , Fibrosis Pulmonar Idiopática , Análisis de la Aleatorización Mendeliana , Ingestión de Alimentos , Frutas , Estudio de Asociación del Genoma Completo , Fibrosis Pulmonar Idiopática/genética , Verduras , Humanos
15.
Acta Diabetol ; 61(2): 139-149, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37936027

RESUMEN

AIMS: The association between gestational diabetes mellitus (GDM) and common carotid artery (CCA) intima-media thickness (IMT) is still controversial. This systematic review and meta-analysis was performed to assess the correlation between GDM and CCA-IMT in and after pregnancy. METHODS: PubMed and EMBASE databases were systematically reviewed on April 2023. Studies measuring CCA-IMT in both pregnant women with GDM and women with previous history of GDM (pGDM) vs. healthy controls were included. The subtotal and overall standardized mean differences (SMDs) of CCA-IMT were calculated using the random-effect model. RESULTS: Nineteen studies with a total of 302 GDM and 861 pGDM women were analyzed. The average value of CCA-IMT measured in GDM/pGDM (0.59 ± 0.12 mm) was slightly increased in comparison to the accepted reference limits of IMT according to age classes. Substantial heterogeneity was detected for the studies involving both GDM and pGDM women, with an overall statistic I2 of 86.0% (p < 0.001). Large SMDs were obtained for the studies conducted on both GDM and pGDM women, with an overall SMD of 0.89 (95%CI 0.63-1.15, p < 0.001). Egger's test for a regression intercept gave a p-value of 0.37, indicating no publication bias. On meta-regression analysis, all potential confounders (number of patients, age at pregnancy, body mass index, measuring time, follow-up duration and GDM criteria) were not significantly associated with effect modification. CONCLUSIONS: GDM in and after pregnancy is independently associated with subclinical atherosclerosis. The association between GDM and carotid remodeling is potentially mediated by the longstanding underlying risk.


Asunto(s)
Aterosclerosis , Diabetes Gestacional , Humanos , Femenino , Embarazo , Grosor Intima-Media Carotídeo , Aterosclerosis/etiología , Arterias Carótidas , Factores de Riesgo
16.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1031538

RESUMEN

ObjectiveTo investigate the clinical features and high risk of very preterm infants with late-onset bacterial sepsis,so as to propose feasible prevention and treatment suggestions. MethodsTotally 94 very preterm infants with late-onset bacterial sepsis from the Neonatology Department of Women’s Hospital of Jiangnan University were recruited from February, 2012 to January, 2024. Their clinical data, including the perinatal situation, clinical symptoms, pathogens, risk factors and treatment, were collected and analyzed. ResultsThe incidence rate of very preterm infants with late-onset bacterial sepsis were 8.40 for 100 live birth babies. The major pathogens of the infections among these very premature infants included gram-positive bacteria (71.1%). Logistic regression analysis showed that long term(≥7 d)use of antibiotics, invasive mechanical ventilation, indwelling central venous catheter(≥7 d), and vaginal delivery were high risk factors of very preterm infants with late-onset bacterial sepsis, the relative risk (OR) values were 2.787, 4.243, 3.033 and 2.174, respectively. ConclusionThe gram-positive bacteria are the main pathogens of late-onset bacterial sepsis in very preterm infants. Long term(≥7 d)use of antibiotics, invasive mechanical ventilation, indwelling central venous catheter(≥7 d)and vaginal delivery are high risk factors of very preterm infants with late-onset bacterial sepsis. The incidence of late-onset bacterial sepsis in very preterm infants can be reduced by strengthening perinatal management, shortening the time of antibiotic application and reducing invasive operations.

17.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1039496

RESUMEN

【Objective】 To analyze the application of serological test results in the diagnosis and treatment of anti-M-induced hemolytic disease of the fetus and newborn(HDFN), and to explore HDFN prevention strategies. 【Methods】 The serological test results of 12 cases of HDFN caused by anti-M diagnosed in our laboratory from January 2017 to December 2023 were retrospectively analyzed, including blood group identification of mothers and children, serum total bilirubin/hemoglobin/antibody titer test, and three hemolysis tests in newborns. Clinical data of the children and mothers were collected, including pregnancy history, blood transfusion history, prenatal antibody testing, history of intrauterine blood transfusion and gestational week of delivery, and the prognosis of the children was followed up. 【Results】 All 12 cases of fetal neonatal hemolytic disease due to anti-M were RhD+ MN phenotype newborn born to RhD+ NN mother, with maternal- fetal incompatiblility in MN blood groups. In the ABO blood group system, ABO incompatibility between mother and child accounted for 41.7%(5/12).None of the mothers had a history of blood transfusion, and the median titer of the test at 4℃ was 32, and the median titer at 37℃ was 4. The mothers of 3 cases had a history of multiple intrauterine blood transfusions, with an incidence of 25%(3/12). One case had an abnormal first pregnancy, with an incidence of 8.3%(1/12), and seven cases had an abnormal pregnancy with a miscarriage, with an incidence of abnormal pregnancy and birth history of 58.3%(7/12). There were 6 cases of premature labor, with an incidence of 50%(6/12). The mothers in three cases underwent regular obstetric examination and the specificity of the antibodies was determined, accounting for 25%(3/12). Twelve children had free antibodies with a median titer of 6 at 4℃ and 2 at 37℃. Two children had anti-M antibodies that were not reactive at 37℃, with a negative rate of 16.7%(2/12). The positive rate of DAT and elution test was respectively 8.3%(1/12) and 16.7%(2/12) in the children. The median minimum hemoglobin value was 75 g/L, and all 12 children received blood transfusions. The median peak total bilirubin value was 157.5 μmol/L, and none of them reached the threshold for blood exchange. The rate of delayed anemia was 16.7%(2/12), the postnatal mortality rate was 8.3%(1/12), and 11 children was free of growth and neurodevelopmental delay in prognosis. 【Conclusion】 Anti-M can cause severe HDFN, which can also occur in primigravida. The intensity of antibody titer does not correlate with the severity of the disease, and it is prone to cause delayed anemia, which should be monitored regularly according to the serological characteristics of anti-M and clinical symptoms, and should be treated timely.

18.
Cureus ; 15(11): e48595, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38084174

RESUMEN

BACKGROUND: Patients with autoimmune rheumatic diseases (ARDs) taking JAK inhibitors may have an increased risk of cardiovascular events, especially if they have other health conditions. Identifying high-risk patients can inform targeted preventive care. This study assessed the value of age and deprivation decile in predicting cardiovascular events in patients on JAK inhibitors for ARDs. OBJECTIVE: To assess the predictive value of age and deprivation decile in identifying patients at risk of cardiovascular events while on JAK inhibitor therapy for ARDs. METHODS: This cross-sectional cohort study enrolled 309 patients with ARDs (mean age 59.3 years, 77% female) treated with JAK inhibitors at a UK teaching hospital. Baseline characteristics, including age, gender, ethnicity, and comorbidities, were collected. Cardiovascular events (myocardial infarctions, strokes, and cardiovascular-related deaths) that occurred while on JAK inhibitor therapy were identified retrospectively. Deprivation indices were calculated using socioeconomic factors. RESULTS: Multivariate logistic regression analysis, adjusting for potential confounders, showed that a model combining age and deprivation decile was statistically significant (p = 0.031) in predicting cardiovascular events. Neither age nor deprivation decile alone was statistically significant. Older patients had an odds ratio of 1.06 (95% CI: 1.00-1.13) for increased risk of cardiovascular events. The logistic regression model as a whole was statistically significant (Chi2(14) = 24.04, p = 0.031, n = 309). The AUC of the ROC curve was 0.837. CONCLUSION: Age and deprivation decile can effectively predict cardiovascular events in patients on JAK inhibitor therapy for ARDs. Incorporating these predictive tools into routine clinical practice can help identify patients who warrant intensified cardiovascular risk management.

19.
BMC Health Serv Res ; 23(1): 1164, 2023 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-37885009

RESUMEN

BACKGROUND: Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses' specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects. METHODS: Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training. RESULTS: The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05). CONCLUSIONS: The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses' WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.


Asunto(s)
Violencia Laboral , Humanos , Adaptación Psicológica , Agresión , Encuestas y Cuestionarios , Hospitales , Lugar de Trabajo/psicología
20.
Pathogens ; 12(9)2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37764926

RESUMEN

Human respiratory syncytial virus (hRSV) is a significant cause of respiratory tract infections, particularly in young children and older adults. In this review, we aimed to comprehensively summarize what is known about the immune response to hRSV infection. We described the innate and adaptive immune components involved, including the recognition of RSV, the inflammatory response, the role of natural killer (NK) cells, antigen presentation, T cell response, and antibody production. Understanding the complex immune response to hRSV infection is crucial for developing effective interventions against this significant respiratory pathogen. Further investigations into the immune memory generated by hRSV infection and the development of strategies to enhance immune responses may hold promise for the prevention and management of hRSV-associated diseases.

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