Tag: pubmed

West Afr J Med. 2022 Apr 29;39(4):388-393.

ABSTRACT

BACKGROUND: Adherence to standard precautions in hospitals is vital to control the spread of hospital-acquired infections (HAIs).

OBJECTIVE: To determine the level of compliance to standard precautionary measures by clinical students and doctors in a Nigerian tertiary hospital to curb spread of infectious diseases, with focus on uptake of Hepatitis B Virus (HBV) vaccine.

METHODS: This study which involved 228 participants used self-administered questionnaire to obtain data on respondents’ biodata, history of exposure to patient’s body fluids (PBF) in the last six months, HBV vaccination status, use and recapping of needles, handwashing, and use of Personal Protective Equipment (PPE). Data analysis was done using SPSS version18; associations were tested with Chi-square statistics, and p<0.05 was considered significant.

RESULTS: Of the 228 respondents, 113(49.6%) were clinical students and 115 (50.4%) doctors with mean age of 27.61±7.48 years. A total of 140 (61.4%) respondents had been exposed to PBF: [89 (63.6%) doctors, 51(36.4%) students]. Age, student/doctor category, and number of years of practice all affected exposure to PBF (p<0.05). Recapping of needles was practiced by 167 (73.2%); hand-washing by 225 (98.7%), and lack of running water was the commonest reason for non-compliance. Also, 218 (95.6%) and 123 (53.9%) wore handgloves and face-masks respectively when attending to patients while 111 (48.7%) received at least a dose of HBV vaccine: [72 (64.9%) doctors, 39 (35.1%) students; p<0.05] but only 60.3% completed their doses.

CONCLUSION: Majority had good hand-washing practice, but only about half wore face-masks while working, and recapping of needles was prominent. Doctors had more occupational exposure to PBF but received more HBV vaccine although many were yet to complete their doses. With COVID-19 added to existing list of HAIs, there is need to scale-up compliance to infection control practices through sustained training programs and better health policies which would also drive vaccine coverage in this population.

PMID:35489043

West Afr J Med. 2022 Apr 29;39(4):369-374.

ABSTRACT

BACKGROUND: Globally, peripartum or puerperal infections account for about one tenth of maternal mortality, most of which occur in low income countries. Therefore, vaginal preparation with an antiseptic prior to a caesarean delivery could be considered an additional measure to prevent subsequent infectious morbidities.

OBJECTIVES: To evaluate vaginal preparation with 0.3% chlorhexidine solution in the prevention of endometritis, surgical site infection and post-operative fever following emergency caesarean section.

METHODS: This prospective randomized controlled trial (RCT) was conducted among 240 participants planned for emergency caesarean sections (CS) at term in the University of Medical Sciences Teaching Hospital Complex, Ondo State, Nigeria. Participants were randomised into either group “A” (study) or “B” (control). The former had vaginal preparation with 0.3% chlorhexidine gluconate immediately after anaesthesia while the latter received normal saline. Participants were followed up post-operatively during which clinical features of puerperal infectious morbidities were observed for each during admission as well as 8th and 14th days after delivery.

RESULTS: The rate and risk of endometritis were significantly lower in the study group compared to the control; 5.0% versus 13.3%, respectively (chi squared =5.004; p=0.042, RR = 0.38; 95% CI = 0.15-0.94; p = 0.042; RRR = 0.62). Post-operative fever and surgical site infection, were also lower in the study group compared to the controls, but the difference was not statistically significant.

CONCLUSION: When compared to placebo, pre-caesarean section vaginal preparation with 0.3% chlorhexidine solution significantly reduced only the rate and risk of post-operative endometritis among infectious morbidities.

PMID:35489037

Int J Cancer. 2022 Apr 30. doi: 10.1002/ijc.34057. Online ahead of print.

ABSTRACT

Skin damage is the most common and most important toxicity during and after radiotherapy. Its assessment and understanding of the factors influencing its occurrence, is a major issue in the management of patients irradiated for an early breast cancer CANTO is a prospective clinical cohort study of 10 150 patients with stage I-III BC treated from 2012-2017 in 26 cancer centers. In this study, we used CANTO-RT, a sub-cohort of CANTO, including 3480 patients who received RT. We are focus on specifical skin toxicities: Erythema, fibrosis, telangiectasia, and cutaneous pigmentation The prevalence of toxicities of interest varied over time, so at M3-6, 41.1% of patients had erythema while 24.8% of patients had fibrosis. At M12 and M36, the prevalence of erythema decreased respectively while fibrosis remains stable. The prevalence of telangiectasia increases from 1% to 7.1% from M3-6 to M36. After adjustments, we showed an association between the occurrence of skin erythema and obesity; the type of surgery; the presence of axillary dissection; the use of taxane-based CT and the 3DvsIMRT irradiation technique. Regarding fibrosis, an association is found, at M3-6, with age at diagnosis, obesity, tobacco, and the use of boost. Only obesity and the type of surgery received by the patient remained statistically significant at M12 and M36. In this study we identified several risk factors for acute and late skin. The use of a boost was mainly related to the occurrence of fibrosis while the use of IMRT-type technique decreased the occurrence of skin erythema.

PMID:35489021 | DOI:10.1002/ijc.34057

Environ Sci Pollut Res Int. 2022 Apr 30. doi: 10.1007/s11356-022-20394-9. Online ahead of print.

ABSTRACT

We investigate the determinants of communicable diseases (CDs) and nexus of financial development, economic development, and renewable energy consumption to address the issues of ecological footprint level, the impacts of communicable diseases (CDs), and economic growth of the OECD countries throughout 2000-2019. The results from FMOLS and DOLS reveal that the levels of financial development, energy consumption, and trade volume significantly contribute to overcoming the death toll occurring due to CDs. As regards the growth function, the level of trade in the economy is significantly associated with economic growth. The findings reveal that the improvements and developments in the financial sectors and trading activities cause a reduction in the infection cases represented by COVID-19. In contrast, economic growth does have a negative but insignificant impact upon COVID-19. We conclude that sound financial development combined with economic and environmental regulations could be strategically helpful to cope with CDs.

PMID:35488993 | DOI:10.1007/s11356-022-20394-9

J Gastrointest Cancer. 2022 Apr 30. doi: 10.1007/s12029-022-00827-x. Online ahead of print.

ABSTRACT

PURPOSE: Worldwide, gastric cancer (GC) is the 5^th cancer with the highest incidence and the 4^th in mortality. To reduce it, one strategy is to diagnose preneoplastic lesions (PNL): atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia (DYS); to form risk groups on which to focus surveillance efforts as are first-degree relatives (FDR). The aim of this study was to determine prevalence of gastric PNL in FDR of patients with GC, and to study association with sex, age, and Helicobacter pylorii (Hp) infection.

METHODS: Cross-sectional study. One hundred and ten FDR, aged between 50 and 65 years, 54.5 female, obtained through convenience sampling, were studied. Biodemographic data survey and upper gastrointestinal endoscopy with histological study were applied according to Sidney protocol, and focal lesions found. Diagnosis of these lesions and condition of mucosa was carried out by applying OLGA and OLGIM systems. Descriptive statistics, estimation of prevalence, odds ratio (OR), and 95% confidence intervals (95CI) were calculated.

RESULTS: Median age of study group was 56.5 years. Prevalence of PNL, AG, IM, and DYS were 86.4%, 82.7%, 54.5%, and 12.7% respectively. Advanced stages of OLGA and OLGIM were verified in 18.0% and 16.3% respectively. No association with sex, age, and Hp infection were found ([OR 3.10; 95CI 1.0; 9.64]; [OR 0.74; 95CI 0.26; 2.14]; [OR 0.58; 95CI 0.12; 2.77]) respectively.

CONCLUSION: FDR of patients with GC have a high prevalence of PNL, which makes them a risk group in which endoscopic surveillance should be applied.

PMID:35488975 | DOI:10.1007/s12029-022-00827-x

Photochem Photobiol Sci. 2022 Apr 30. doi: 10.1007/s43630-022-00225-z. Online ahead of print.

ABSTRACT

The photon upconversion based on triplet-triplet annihilation (TTA) is a mechanism that converts the absorbed low-energy electromagnetic radiation into higher energy photons also at extremely low excitation intensities, but its use in actual technologies is still hindered by the limited availability of efficient annihilator moieties. We present here the results obtained by the synthesis and application of two new fluorinated chromophores based on phenazine and acridine structures, respectively. Both compounds show upconverted emission demonstrating their ability as TTA annihilator. More interesting, the acridine-based chromophore shows an excellent TTA yield that overcomes the one of some of best model systems. By correlating the experimental data and the quantum mechanical modeling of the investigated compound, we propose an alternative efficient pathway for the generation of the upconverted emissive states involving the peculiar high-energy triplet levels of the dye, thus suggesting a new development strategy for TTA annihilators based on the fine tuning of their high-energy excited states properties.

PMID:35488979 | DOI:10.1007/s43630-022-00225-z

J Cancer Educ. 2022 Apr 30. doi: 10.1007/s13187-022-02148-w. Online ahead of print.

ABSTRACT

Shared decision-making (SDM) helps patients weigh risks and benefits of screening approaches. Little is known about SDM visits between patients and healthcare providers in the context of lung cancer screening. This study explored the extent that patients were informed by their provider of the benefits and harms of lung cancer screening and expressed certainty about their screening choice. We conducted a survey with 75 patients from an academic medical center in the Southeastern U.S. Survey items included knowledge of benefits and harms of screening, patients’ value elicitation during SDM visits, and decisional certainty. Patient and provider characteristics were collected through electronic medical records or self-report. Descriptive statistics, Kruskal-Wallis tests, and Pearson correlations between screening knowledge, value elicitation, and decisional conflict were calculated. The sample was predominately non-Hispanic White (73.3%) with no more than high school education (53.4%) and referred by their primary care provider for screening (78.7%). Patients reported that providers almost always discussed benefits of screening (81.3%), but infrequently discussed potential harms (44.0%). On average, patients had low knowledge about screening (score = 3.71 out of 8) and benefits/harms. Decisional conflict was low (score = – 3.12) and weakly related to knowledge (R= – 0.25) or value elicitation (R= – 0.27). Black patients experienced higher decisional conflict than White patients (score = – 2.21 vs – 3.44). Despite knowledge scores being generally low, study patients experienced low decisional conflict regarding their decision to undergo lung cancer screening. Additional work is needed to optimize the quality and consistency of information presented to patients considering screening.

PMID:35488967 | DOI:10.1007/s13187-022-02148-w

J Interv Card Electrophysiol. 2022 Apr 30. doi: 10.1007/s10840-022-01147-7. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the changes of P wave indices in atrial fibrillation (AF) patients after catheter ablation and the association between P wave indices and AF recurrence.

METHODS: PubMed, Embase, and Cochrane Database were searched through September 15th 2021 for studies on the association between P wave indices and AF with catheter ablation. Heterogeneity was estimated using the I² statistic, the random effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) was used to evaluate the predictive value.

RESULTS: Among included fourteen studies with 1674 AF patients, we found significantly decreased P wave dispersion (P_dis) (mean difference [MD]: – 6.5 ms, 95% confidence interval [95% CI]: – 11.81 to – 1.18, P = 0.02) after cryoballoon ablation (CBA) or radiofrequency ablation (RFA), and maximum P wave (P_max) (MD: – 8.57 ms, 95% CI: – 17.03 to – 0.10, P = 0.05) after RFA only, but increased minimum P wave (P_min) (MD: 3.43 ms, 95% CI: 1.07 to 5.79, P < 0.01) after CBA only. P_dis measured before ablation was remarkably higher (MD: 5.79 ms, 95% CI: 2.23 to 9.36, P < 0.01) in patients with recurrence than without; meanwhile, P_max was higher measured both before and after ablation (MD: 6.49 ms, 95% CI: 2.30 to 10.69, P < 0.01 and MD: 11.2 ms, 95% CI: 2.88 to 19.52, P < 0.01). Furthermore, SROC analysis showed acceptable predictive efficiencies of P_dis (AUC = 0.776) and P_max (AUC = 0.759) for AF recurrence.

CONCLUSION: P_dis was significantly decreased after AF catheter ablation. Higher P_dis and P_max may have predictive values for AF recurrence.

PMID:35488962 | DOI:10.1007/s10840-022-01147-7

Oral Maxillofac Surg. 2022 Apr 30. doi: 10.1007/s10006-022-01066-x. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study is to identify which patient-level factors, if any, influence the risk of infection following dog bite wounds to the face.

MATERIALS AND METHODS: This retrospective cohort study was conducted using the Kids’ Inpatient Database (KID). The primary predictor variable was the type of facial injury. The primary outcome variable was the presence of facial infection. SPSS was used to perform statistical analyses and statistical significance was set at a P-value of < 0.05.

RESULTS: Our final sample comprised a total of 4,420 patients who suffered dog bites to the face, of which 1,237 (28.0%) resulted in infection. Open wound (n = 4,176, 94.5%) was the most common facial injury, followed by bone fractures (n = 105, 2.4%). Relative to children 16-20 years old, children who were 0-5 years old were three times more likely to develop an infection (P < 0.01). Finally, open wounds (P < 0.01) were over seven times more likely to get infected relative to fractures.

CONCLUSIONS: Young children, particularly those below the age of five, are vulnerable to dog bite wounds to the face. Open wounds posed the greatest risk of getting infected.

PMID:35488948 | DOI:10.1007/s10006-022-01066-x

Eur Arch Otorhinolaryngol. 2022 Apr 30. doi: 10.1007/s00405-022-07413-8. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to investigate the possible role of raftlin (RFTN) in chronic rhinosinusitis with nasal polyps (CRSwNP). There is no study in the literature investigating the role of RFTN in the pathogenesis of CRSwNP.

METHODS: The present study was designed as a case-control study and conducted between 25.09.2020 and 01.01.2022. CRSwNP and control groups were formed in the study. Serum and tissue samples were taken from each patient in the study and their RFTN levels were measured. While nasal polyps were used for tissue samples in the CRSwNP group, middle meatus mucosa obtained during concha bullosa surgery was used in the control group.

RESULTS: The control group included 31 patients (8 female, 23 male) and the CRSwNP group included 49 patients (14 female, 35 male). The mean age of the control group was 40.42 ± 9.99 years, while the mean age of the CRSwNP group was 43.47 ± 10.19 years. When the groups are compared in terms of gender and age, there were no statistically significant differences (p = 0.78, p = 0.19, respectively). The serum RFTN levels in the control and CRSwNP groups were 7.85 ± 10.87 ng/ml, and 7.02 ± 8.59 ng/ml, respectively (p = 0.45). The tissue RFTN levels in the control group and CRSwNP group were 87.15 ± 69.91 ng/ml, and 66.50 ± 17.10 ng/ml, respectively (p = 0.04, statistically significant).

CONCLUSION: RFTN deficiency in nasal polyp tissue may be one of the reasons for the development of CRSwNP. Further studies are needed to elucidate the role of RFTN in CRSwNP.

PMID:35488906 | DOI:10.1007/s00405-022-07413-8