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Objective Interleukin-1 (IL-1) is a pro-inflammatory cytokine which may be related to urolithiasis. Genetic polymorphisms of the interleukin-1β (IL-1β) have been proposed as markers for urolithiasis in some areas. Due to the high incidence of urolithiasis in Uighur children (Xinjiang, China) and existence of ethnic difference, our aim is to explore the potential of IL-1 gene polymorphisms and urolithiasis among these children. Methods Genomic DNA extracted from peripheral blood of 115 patients and 98 controls were used for genotype polymorphisms analyses. IL-1 receptor antagonist gene (IL-1RN) variable numbers of a tandem repeat (VNTR) gene polymorphisms were analyzed by PCR method. PCR-based restriction analysis was done for the IL-1β (−511) and IL-1β (+3954) gene polymorphisms by endonucleases Ava I and Taq I, respectively. The genotype distribution, allele frequencies, carriage rate and haplotype frequencies were statistically analyzed. Results No significant differences were observed in genotypic frequencies between pediatric urolithiasis patients and control group for IL-1RN gene (χ2 = 1.906, p = 0.605), IL-1β (−511) gene (χ2 = 0.105, p = 0.949), or IL-1β (+3954) gene (χ2 = 3.635, p = 0.169). There were yet no significant differences of the allele frequencies of IL-1RN VNTR gene (p = 0.779), IL-1β (-511) gene (p = 0.941), and IL-1β (+3954) gene (p = 0.418) in the case and control groups, as well as the carriage rate and haplotype of them (all p > 0.05). Conclusions The associations between IL-1RN VNTR, IL-1β (-511) and IL-1β (+3954) genes polymorphisms and urolithiasis were not significant in Uighur children. The results need to be confirmed in studies with larger population sample size, as well as in other ethnic groups.

Objective After percutaneous endoscopic lumbar discectomy (PELD), most patients with lumbar disc herniation (LDH) experience relief from the typical symptoms of low back and leg pain. However, for a small number of patients, these symptoms are relieved immediately after surgery but aggravated soon after, and then relieved after short‐term full rest or conservative treatment. The aim of the study was to demonstrate this short‐term recurrent phenomenon, termed rebound pain. Methods A retrospective study was conducted on 144 patients who underwent single‐segment PELD from May 2017 to June 2020. Postoperative patients were divided into a rebound pain group and a non‐rebound pain group. For the former group, general information, symptom characteristics and visual analogue score (VAS) changes in rebound pain were summarized. For both groups, postoperative efficacy was evaluated by recent VAS of low back and leg pain in the remission stage, the Oswestry disability index (ODI) and the modified MacNab criteria at the last follow‐up. Logistic regression analysis was used to identify predictors for rebound pain. Results The VAS and ODI exhibited significant improvements at the last follow‐up of average 15.4 months (P 45 days was found as a protective factor for rebound pain (p = 0.031). Conclusion Although rebound pain with multiple characteristics and a short duration had no significant effect on long‐term postoperative efficacy, its high incidence often caused unnecessary concern in both patients and doctors. As a result, careful differentiation of rebound pain from other postoperative complications is needed., For patients with lumbar disc herniation, most received relief from low back and leg pain after percutaneous endoscopic lumbar discectomy (PELD). However, 10.4% of patients had short‐term pain recurrence after PELD, termed rebound pain, which could be alleviated by adequate rest and conservative treatment.

Background Women are among the susceptible groups to Coronavirus disease-19 (COVID-19) in Ardabil, north-west of Iran, despite the current global status. The underlying causes of high incidence and fatality rate of women in Ardabil are not fully understood. Hence, this study aimed to investigate the healthy behaviours in women of Ardabil and its relationship with COVID-19 mortality. Methods We conducted a case–control study to compare the adherence to health protocols and behaviours with respect to COVID-19 between the infected (261 patients) and healthy (515 persons) women. Health protocols and behaviours such as using mask, gloves, disinfectants, history of travelling and contacting, and attending various gatherings and places during the COVID-19 pandemic along with demographic variables were defined as independent variables, and COVID-19 death rate was defined as the dependent variable. Multivariable logistic regression methods were used to explore the risk factors associated with COVID-19 mortality. Results Chi-square and Fisher tests showed significant differences between infected and healthy women in terms of history of contact and traveling (p p p p = 0.038). Multivariable logistic regression disclosed that the age group over 80 years: 8.97 times (95% CI 2.27–29.85), women with underlying chronic diseases: 4.14 times (95% CI 1.61–10.64), and obese women: 3.01 times (95% CI 1.04–6.03) were more likely to die from COVID-19 than other women. Conclusion Considering the high incidence and mortality rate in Ardabil women due to COVID-19 and the corresponding health behavioural factors, special emphasis should be given to the increase of women awareness on the importance of healthy behaviours, diet, and life-style.

Background This study aimed to estimate whether metabolic syndrome (MetS) and its components could be used to predict cardiovascular disease (CVD) in a longitudinal analysis in a rural elderly Chinese population. Method At baseline during 2012–2013, a total of 2486 elderly from rural Chinese were enrolled and were followed up during 2015–2017. Stroke and coronary heart disease (CHD) were included in CVD and were diagnosed by clinicians. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) criteria were used to define MetS separately. Result Hazard ratios adjusting for CHD, stroke and CVD in those with MetS using the NCEP ATP III criteria in females were 1.27 (95 % CI 0.73, 2.21), 1.54 (95 % CI 0.99, 2.40) and 1.45 (95 % CI 1.00, 2.10), respectively; 1.33 (95 % CI 0.77, 2.32), 1.44 (95 % CI 0.92, 2.25) and 1.36 (95 % CI 0.94, 1.97), respectively, with the AHA/NHLBI criteria; and 1.10 (95 % CI 0.89,1.36), 1.62 (95 % CI 1.03, 2.55) and 1.36 (95 % CI 0.93, 1.97), respectively, with the IDF criteria. Additionally, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95 % CI 1.01, 2.52). However, among rural elderly males, neither MetS nor its components predicted new-onset CVD. Conclusions MetS is correlated with high incidence of CVD among rural elderly female, and only using the NCEP ATP III criteria to define MetS could make the incidence of CVD obvious difference. In order to reduce rural elderly CVD, effective measures to prevent, diagnose, and treat MetS should be enacted in a timely manner, especially among females.

Background The vaginal microbiota (VMB) are the set of microorganisms residing in the human vagina. During pregnancy, their composition is Lactobacillus-dominant in most Caucasian women. Previous studies suggest that the VMB of women with African ancestry is more likely to be non-Lactobacillus dominant (dysbiotic) compared to other populations, and possibly relate to the high incidence of pregnancy complications, such as preterm birth. This work reviewed the literature on VMB composition in pregnant women from sub-Saharan Africa. Methods A search was conducted in PubMed and Embase databases following PRISMA guidelines. Observational and intervention studies analysing VMB communities from sub-Saharan African pregnant women using molecular techniques were included. Results Ten studies performed in seven sub-Saharan African countries were identified. They independently showed that Lactobacillus-dominant VMB (particularly L. iners or L. crispatus) or VMB containing Lactobacilli are the most prevalent, followed by a more diverse anaerobe-dominant VMB, in the studied populations. The majority of pregnant women with a sexually-transmitted infection had a Lactobacillus-dominant VMB, but with a significantly higher presence of anaerobic species. Conclusion In agreement with studies performed in other populations, Lactobacillus species are the most prevalent VMB species during pregnancy in sub-Saharan African women. The frequency of diverse anaerobe-dominant VMB is high in these populations. In Africa, studies on VMB in pregnancy are scant, heterogeneous in methodology, and knowledge remains limited. More insights on VMB composition and their possible sequalae among these populations is needed.

Background The incidence of hyponatremia is high in supratentorial tumors. However, most studies of supratentorial tumors have included patients with sellar/suprasellar tumors. It is common knowledge that sellar tumors have higher incidence and severity of hyponatremia. Incidence of hyponatremia is not known if we exclude sellar/suprasellar tumors. Therefore, this study was designed to evaluate the incidence of hyponatremia in supratentorial tumors after excluding sellar/suprasellar tumors. Methods After institutional ethics committee approval and written informed consent, adult patients with supratentorial tumors (nonsellar/suprasellar) were recruited, and data were collected prospectively. In all patients, serum electrolytes were measured every 2 to 3 days. Hyponatremia was defined as serum sodium of Results A total of 61 patients’ data were analyzed. There were 31 male and 30 female patients with an average age of 44 years. There were 23 meningiomas, 36 gliomas, and 2 other tumors. Forty patients (66%) developed hyponatremia during hospital stay. There were 29 mild cases (serum sodium 131–134 mEq/L), 7 were moderate (serum sodium 126–130 mEq/L), and 4 were severe (serum sodium Conclusion The incidence of hyponatremia is high in supratentorial tumor patients after excluding sellar/suprasellar lesions. In the majority of patients, the disturbance is mild. Hyponatremic patients has a longer hospital stay and higher mortality.

Covid-19 disease caused by novel coronavirus (SARS-CoV-2) is a highly contagious epidemic that originated in Wuhan, Hubei Province of China in late December 2019. World Health Organization (WHO) declared Covid-19 as a pandemic on 12th March 2020. Researchers and policy makers are designing strategies to control the pandemic in order to minimize its impact on human health and economy round the clock. The SARS-CoV-2 virus transmits mostly through respiratory droplets and through contaminated surfacesin human body.Securing an appropriate level of safety during the pandemic situation is a highly problematic issue which resulted from the transportation sector which has been hit hard by COVID-19. This paper focuses on developing an intelligent computing model for forecasting the outbreak of COVID-19. The Facebook Prophet model predicts 90 days future values including the peak date of the confirmed cases of COVID-19 for six worst hit countries of the world including India and six high incidence states of India. The model also identifies five significant changepoints in the growth curve of confirmed cases of India which indicate the impact of the interventions imposed by Government of India on the growth rate of the infection. The goodness-of-fit of the model measures 85% MAPE for all six countries and all six states of India. The above computational analysis may be able to throw some light on planning and management of healthcare system and infrastructure., Graphical abstract Image, graphical abstract

ObjectivesWe described incidence trends of keratinocyte carcinomas (KCs)—namely basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)—in the Australian state of Tasmania.MethodsWe identified histologically confirmed KCs within the Tasmanian Cancer Registry (TCR) and conducted assessments to ensure data quality. Age-standardised incidence rates were calculated for first (1985–2018) and annual KCs (1978–2018). Average annual percentage changes were computed using Joinpoint regression models.ResultsThe TCR is a reliable source of KC data. A total of 83,536 people were registered with a KC between 1978 and 2018. Age-standardised incidence rates of first KCs increased on average by 3% per annum for BCCs and 4% per annum for SCCs, reaching 363/100,000 and 249/100,000 in 2018, respectively. Age-standardised incidence rates of annual KCs increased on average by 5% per annum for BCCs and 6% per annum for SCCs, up to 891/100,000 and 514/100,000 in 2018, respectively. This increase was steeper for females than males and highest during the late 1980s and early 1990s. A change in trend around 2014 suggested that incidence rates have started to decline.ConclusionWhile the incidence of KCs in Tasmania increased substantially over 41 years, rates have recently plateaued and started to decline. The findings may reflect changes in sun exposure behaviours due to awareness campaigns, but high incidence rates in 2018 indicate that KCs still pose a substantial burden to this population.

The currently available RESCUE RNA base editing system demonstrates considerable potential for the treatment of genetic diseases at the transcriptional level. However, the relatively high incidence of off-target events hampers the precise RNA editing, thereby limiting its use in the clinical setting. This study describes a new RNA base editing method, named ecRESCUE, which utilizes inducible stabilization of the protein ecDHFR DD fused at the C-terminal of the original RESCUE system. In vitro experiments in 293T cells showed that the ecRESCUE editor markedly reduced the incidence of off-target single nucleotide polymorphisms without affecting the RNA A-to-I and C-to-U base editing efficiency. Altogether, these results demonstrate that the inducible ecRESCUE system represents an attractive approach to regulate and improve the outcome of the available RNA base editor with reduced off-targeting activity. Video Abstract Supplementary Information The online version contains supplementary material available at 10.1186/s12964-021-00759-2.

In a recent issue of Clinical Kidney Journal (CKJ), Gutierrez-Peña et al. reported a high incidence and prevalence of advanced chronic kidney disease (CKD) in Aguascalientes, Mexico. This contradicts Global Burden of Disease estimates, which should be updated. A key component of this high burden of CKD relates to young people ages 20–40 years in whom the cause of CKD was unknown [CKD of unknown aetiology (CKDu)]. The incidence of kidney replacement therapy in this age group in Aguascalientes is among the highest in the world, second only to Taiwan. However, high-altitude Aguascalientes, with a year-round average temperature of 19°C, does not fit the geography of other CKDu hotspots. Furthermore, kidney biopsies in young people showed a high prevalence of focal segmental glomerulosclerosis. Potential causes of CKDu in Aguascalientes include the genetic background (no evidence, although podocytopathy genes should be explored) and environmental factors. The highest prevalence of CKD was found in Calvillo, known for guava farming. Thus guava itself, known to contain bioactive, potentially nephrotoxic molecules and pesticides, should be explored. Additionally, there are reports of water sources in Aguascalientes contaminated with heavy metals and/or pesticides. These include fluoride (increased levels found in Calvillo drinking water) as well as naturally occurring arsenic, among others. Fluoride may accumulate in bone and cause kidney disease years later, and maternal exposure to excess fluoride may cause kidney disease in offspring. We propose a research agenda to clarify the cause of CKDu in Aguascalientes that should involve international funders. The need for urgent action to identify and stem the cause of the high incidence of CKD extends to other CKD hotspots in Mexico, including Tierra Blanca in Veracruz and Poncitlan in Jalisco.

Background In the context of the high incidence of breast cancer and the high frequency of breast cosmetic surgeries, malignant and/or premalignant lesions are frequently detected incidentally in postoperative histopathology specimens. The current literature does not provide clear practice guidelines for the use of preoperative imaging prior to non-oncological breast surgeries. Objectives In this study, we aimed to determine the current practices of plastic surgeons at King Abdulaziz University Hospital (KAUH) and their use of preoperative breast imaging before non-oncological breast surgeries. Design Non-intervention/ retrospective record review. Settings Department of Radiology at King Abdulaziz University Hospital (KAUH). Methods In 08/06/2017 at King Abdulaziz University Hospital, we conducted a single-center, retrospective chart review of the medical files of candidates for non-oncological breast surgery in order to examine preoperative imaging requests by plastic surgeons in the period 01/01/2013 to 08/06/2017. Main outcome measures The practice of plastic surgeons at KAUH in requesting preoperative imaging prior non-oncological breast surgeries. Sample size 104 patients. Results We found that, in the period 2013 to 2017, 104 women who underwent non-oncological breast surgeries were evaluated for recent preoperative breast imaging. Only 37 patients (35.6%) were found to have had preoperative imaging, and only less than one fifth (19.4%) of those 37 patients had abnormal preoperative imaging results, all of which were negative for malignancy. Conclusions Although the yield of malignancy on preoperative breast imaging was zero in women seeking non-oncological breast surgeries at KAUH, we recommend the establishment of unified practice guidelines to be followed by plastic surgeons for better postoperative screening in different risk groups. Limitations Lack of follow up of patients postoperatively for any development of malignancy.

Ulcerative colitis (UC) is a chronic recurrent intestinal inflammatory disease characterized by high incidence and young onset age. Recently, there have been some interesting findings in the pathogenesis of UC. The mucus barrier, which is composed of a mucin complex rich in O-glycosylation, not only provides nutrients and habitat for intestinal microbes but also orchestrates the taming of germs. In turn, the gut microbiota modulates the production and secretion of mucins and stratification of the mucus layers. Active bidirectional communication between the microbiota and its ‘slimy’ partner, the mucus barrier, seems to be a continually performed concerto, maintaining homeostasis of the gut ecological microenvironment. Any abnormalities may induce a disorder in the gut community, thereby causing inflammatory damage. Our review mainly focuses on the complicated communication between the mucus barrier and gut microbiome to explore a promising new avenue for UC therapy., Gut microbiome: Slimy symbiosis Gaining a better understanding of the bidirectional communication between the gut microbiome and the colon’s mucus layer, which covers and protects intestinal tissue, could aid in developing effective treatments for ulcerative colitis (UC). Increasing evidence links gut microbiome imbalance to UC, a form of inflammatory bowel disease. Xiaohong Zhang at Ningbo University in China and co-workers have reviewed gut microbiome–mucus layer interactions. They report that the mucus layer, comprised of a firm sterile inner layer, and a loose, densely colonized outer layer, nourishes and provides a home for ‘good’ microbes, while excluding pathogens. In turn, good microbes promote mucus layer production and stratification. Without adequate dietary fiber, gut microbes over-consume the mucus layer, exposing intestinal tissue and causing inflammation. This article provides clue for investigating treatments for inflammatory bowel diseases, including UC.

Background Patients with fibroadenomas in axillary accessory breasts (AABs) have a palpable mass, cyclic axillary pain, and aesthetic concerns that must be addressed. We compared the baseline patient characteristics, AAB characteristics, and surgical outcomes of patients with AABs with and without fibroadenomas undergoing surgical excision. We also monitored the patients for recurrence of axillary fibroadenomas. Methods This retrospective study involved 2310 women who underwent AAB excision from 2014 to 2019. Patients with and without a palpable fibroadenoma were divided into a fibroadenoma group and non-fibroadenoma group, respectively. All patients underwent complete excision of accessory mammary gland (AMG) tissue, including fibroadenomas in the AABs. We removed the fibroadenoma and the AMG tissue with a minimal axillary incision. Results Thirty-nine patients had a palpable fibroadenoma in the AAB, and all patients in the fibroadenoma group had cyclic axillary pain and a palpable axillary mass. There were no significant differences in the patients’ age, weight of the AMG tissue, liposuction volume, or fibroadenoma laterality between the two groups. The body mass index in the fibroadenoma group was lower than that in the non-fibroadenoma group (19.9 vs. 22.3 kg/m2, respectively; P P Conclusions Complete excision of the AMG tissue and fibroadenoma is appropriate in patients with an AAB with a fibroadenoma. Surgeons should also consider the high incidence of concurrent fibroadenomas in the normal breasts on the chest.

Purpose Women with large and/or ptotic breasts are generally not considered candidates for nipple-sparing mastectomy because of concerns regarding the high incidence of postoperative complications including ischemic complications. Therefore, we adopted a vertical skin resection technique for nipple-sparing mastectomy, and obtained satisfactory results following immediate autologous breast reconstruction. In this study, we aimed to describe our operative technique and review its outcomes. Methods Between January 2010 and March 2017, immediate autologous breast reconstructions were performed in 28 patients with moderate or large ptotic breasts after nipple-sparing mastectomy using the vertical reduction pattern. Grade II ptosis was observed in 12 patients, and 16 patients were classified as having grade III ptosis. Results Of the 28 patients, 21 received abdominal free flap reconstruction. In the remaining 7 patients, extended latissimus dorsi flaps were used in conjunction with anatomic implants. The mean weight of the excised breast tissue in the 2 groups was 575 g and 482 g, respectively. Satisfactory esthetic outcomes without major complications were achieved in all patients. Similar vertical reductions or mastopexies in the contralateral breast allowed better postoperative adjustment for symmetry. There was only 1 case of complete nipple necrosis; however, the problem was solved with "skin banking." No local recurrences or distant metastases were detected at follow-up (mean 18 months, range 4 months to 6 years). Conclusion To enhance cosmetic outcomes in patients with large and/or ptotic breasts, the vertical skin resection pattern for nipple-sparing mastectomy can be used to achieve better breast shape while preserving the nipple-areola complex. Moreover, it can improve the esthetic outcome without compromising oncologic safety.

Objectives To describe patients with scabies in a prison setting. Document what type of treatment was carried out. Prepare an intervention protocol to improve scabies control in the Penitentiary Center. Material and method All cases of scabies diagnosed in the Youth Detention Centre (La Roca del Vallès, Barcelona) between November 2018 and November 2019 were recorded. The treatment used was recorded. Bibliographical research on the protocols and treatment guidelines was carried out for community-acquired scabies. Results The study was performed with 762 inmates, of whom 61 patients were diagnosed with scabies. 39 patients' pathologies were detected at the time of admission to the center, 11 cases were diagnosed in the first 6 weeks after entering the prison, coinciding with the incubation period of the disease. Finally, 11 more were diagnosed when they had already been in prison for more than 6 weeks and therefore could be infected cases within the center. This parasitosis was detected mainly in inmates of North African origin, 14.7% of Algerian inmates and 14.2% of Moroccan inmates presented this pathology, compared to 1.6% among Spanish prisoners. All 61 patients were treated with permethrin and 8 cases had to repeat the treatment cycle due to apparent therapeutic failure. Research literature indicates that oral ivermectin should be the drug of first choice for the treatment of scabies in prison. Discussion The high incidence of scabies cases detected in prison led us to carry out a bibliographic review that brought about changes in the treatment protocol that may be of interest for the control of the disease in closed communities. Resumen Objetivos Describir el perfil de los internos que ingresan en un centro penitenciario afectos de sarna. Documentar qué tipo de tratamiento se les realizó. Elaborar un protocolo de intervención para mejorar el control de la sarna (escabiosis) en el centro penitenciario. Material y método Se registraron todos los casos de sarna diagnosticados en el Centro Penitenciario de Jóvenes (La Roca del Vallès, Barcelona) entre noviembre de 2018 y noviembre de 2019. Se registró el tratamiento que se realizó. Se hizo una búsqueda bibliográfica sobre los protocolos y las guías de tratamiento en la sarna adquirida en la comunidad. Resultados La población objeto del estudio fue de 762 reclusos, entre los cuales se diagnosticaron 61 pacientes con sarna; en 39 de ellos, se detectó la patología en el momento del ingreso al centro, 11 casos se diagnosticaron en las primeras seis semanas tras el ingreso en la prisión, coincidiendo con el periodo de incubación de la enfermedad, y 11 más fueron diagnosticados cuando ya llevaban en la prisión más de seis semanas y, por tanto, podrían ser casos contagiados dentro del centro. Esta parasitosis se detectó fundamentalmente en reclusos de origen norteafricano, el 14,7 % de los internos argelinos y el 14,2 % de los marroquíes presentaban esta patología, frente al 1,6 % entre los españoles. Los 61 pacientes fueron tratados con permetrina, y en ocho casos, fue necesario repetir el ciclo de tratamiento por un aparente fracaso terapéutico. La investigación bibliográfica indica que la ivermectina oral debe ser el fármaco de primera elección para el tratamiento de la sarna en prisión. Discusión La elevada incidencia de casos de sarna detectados en la prisión nos ha motivado a realizar una revisión bibliográfica que ha ocasionado cambios en el protocolo de tratamiento que pueden ser de interés para el control de la enfermedad en comunidades cerradas.

BackgroundThe ultra-Orthodox Jewish community has a unique lifestyle including minimal outdoor activity and intense, prolonged nearby work, beginning at a very young age. Their prevalence of myopia is extremely high. This paper provides a unique insight into the attitudes of this community towards myopia.MethodsUltra-Orthodox Jewish parents of children who came to the pediatric ophthalmology clinic in one tertiary care and two community centers in ultra-Orthodox-oriented cities were given a questionnaire. Demographic information, along with myopia prevalence in the family, was gathered. In addition, their attitudes and common knowledge regarding myopia were investigated.Results161 questioners were collected, mostly completed by mothers (n = 110, 68%). The average number of children per family was 6 (range 1–16). In 148 families (92%) at least one of the parents has myopia. The average parent refraction was − 4.5 diopters (range − 0.5 to 15 diopters). Out of 935 children, 410 (44%) wore glasses. Twelve parents (7%) believe that myopia is a disease and 94 (58%) reported that they are concerned because their child wears glasses. Twenty-four (15%) believe that glasses are a sign of a high education level. Regarding treating myopia progression, 144 (89%) think that myopia progression should be treated, but only 36 (22%) are aware of the available treatments for it.ConclusionThis study examines an insular community with a very high incidence of myopia. In this community most parents think that myopia progression should be treated but most of them are unaware of the currently available treatments.

الملخص: أهداف البحث: هدفت هذه الدراسة إلى التنبؤ بمعدلات الإصابة بحمى الضنك ووفياتها باستخدام السلاسل الزمنية ٢٠٠٦-٢٠١٦. طرق البحث: تم تجميع البيانات من غرفة عمليات حمى الضنك بجدة في مركز الرعاية الصحية الأولية بمدائن الفهد. وتم إجراء تحليل السلاسل الزمنية لجميع الحالات المؤكدة لحمى الضنك خلال الفترة ٢٠٠٦-٢٠١٦. النتائج: أظهرت تحليل السلاسل الزمنية وقوع حالات حمى الضنك ووفيات موسمية قوية، خاصة من شهر مايو إلى شهر سبتمبر، وسلوك متغير بمرور الوقت. وارتبطت درجة حرارة الهواء بشكل رئيس بحدوث حمى الضنك ولكن لم تتوافق مع معدل الوفيات، في حين أن الرطوبة النسبية لم تكن مرتبطة بشكل كبير مع أي حالة من حالات حمى الضنك أو الوفيات. الاستنتاجات: بسبب حالات حمى الضنك والوفيات الموسمية القوية بناء على السلسلة الزمنية من شهر مايو إلى شهر سبتمبر وعلاقتها بدرجة حرارة الهواء، نوصي بنشر هذه البيانات على أصحاب المصلحة لتحسين تدخلات مكافحة حمى الضنك في الفترات التي يتوقع حدوث ارتفاع الإصابات فيها. Abstract: Objectives: This study aimed to forecast the morbidity and mortality of dengue fever using a time series analysis from 2006 to 2016. Methods: Data were compiled from the Jeddah Dengue Fever Operations Room (RFOR) in a primary health care centre. A time series analysis was conducted for all confirmed cases of dengue fever between 2006 and 2016. Results: The results showed a significant seasonal association, particularly from May to September, and a time-varying behaviour. Air temperature was significantly associated with the incidence of dengue fever (p

Although the objective is to improve the quality of life, polymedication is directly associated with the increased likelihood that the patient will develop drug-related problems (DRP), thus compromising the treatment’s effectiveness, besides generating risks for the treatment and health. Thus, the present study performed pharmacotherapeutic follow-up in polymedicated patients from a community pharmacy service. The present study aimed to carry out pharmacotherapeutic follow-up in polymedicated patients using a community pharmacy service through a prospective and quantitative study in a pharmacy school at Campo Mourao, PR, Brazil. Twenty-six patients with chronic diseases and being treated with five or more medications were included in the study. The pharmacotherapeutic follow-up was performed based on the methodology proposed by the Dader method. Drugdex®, Dynamed, and ANVISA’s electronic files were used to evaluate the therapy. DRP were classified according to Rovers and Currie, and the Beers criteria were used to identify inappropriate drugs for the elderly. Most patients were elderly (80.8%), with three or more diseases and on average use of eight medications. 108 DRP (mean: 4.9 DRP/patient) were observed, which resulted in 76 proposals for pharmaceutical interventions to patients. Among the identified DRP, those related to safety (40.7%), effectiveness (35.2%), and adverse reactions (27.8%) were highlighted. Among the factors that can be pointed out as predisposing to the high incidence of PRM, polymedication, advanced age and the presence of chronic diseases stand out.

Background Esophageal cancer is associated with high incidence and mortality worldwide. Differential expression genes (DEGs) and weighted gene co-expression network analysis (WGCNA) are important methods to screen the core genes as bioinformatics methods. Methods The DEGs and WGCNA were combined to screen the hub genes, and pathway enrichment analyses were performed on the hub module in the WGCNA. The CCNB1 was identified as the hub gene based on the intersection between DEGs and the greenyellow module in WGCNA. Expression levels and prognostic values of CCNB1 were verified in UALCAN, GEPIA2, HCMDB, Kaplan–Meier plotter, and TIMER databases. Results We identified 1,044 DEGs from dataset GSE20347, 1,904 from GSE29001, and 2,722 from GSE111044, and 32 modules were revealed by WGCNA. The greenyellow module was identified as the hub module in the WGCNA. CCNB1 gene was identified as the hub gene, which was upregulated in tumour tissues. Moreover, esophageal cancer patients with higher expression of CCNB1 showed a worse prognosis. However, CCNB1 ‘might not play an important role in immune cell infiltration. Conclusions Based on DEGs and key modules related to esophageal cancer, CCNB1 was identified as the hub gene, which offered novel insights into the development and treatment of esophageal cancer.

Coronavirus disease-2019, which was declared by the WHO as a global pandemic in March 2020, was seen to be associated with high incidence of thromboembolic complication. The use of prophylactic anticoagulation was seen to have a survival benefit, especially in high-risk patients. The use of higher than standard-dose prophylaxis anticoagulation in critically ill patients may be warranted. There is no recommendation regarding the use of therapeutic dose anticoagulation, except for very high-risk patients only transiently until proving or disproving the presence of thromboembolic complications.

Caracterizar os aspectos demográficos e sociais e o ônus econômico do traumatismo craniencefálico no sistema público de saúde brasileiro na última década.Analisaram-se os dados provenientes da base de dados do Departamento de Informática do Sistema Único de Saúde referentes ao período entre janeiro de 2008 e dezembro de 2019.Entre 2008 e 2019 ocorreram, em média, no Brasil, 131.014,83 internações por traumatismo craniencefálico ao ano, com incidência de 65,54 por 100 mil habitantes. Deve-se salientar a elevada incidência de traumatismo craniencefálico em adultos idosos (acima de 70 anos), acompanhada de altas taxas de mortalidade. Além disso, há também elevada incidência de traumatismo craniencefálico em adultos jovens (20 a 29 anos e 30 a 39 anos). Os dados aqui apresentados demonstram uma proporção de traumatismos craniencefálicos de 3,6 homens/mulheres.Embora se acredite que os dados apresentados subestimem a incidência e mortalidade associadas com o traumatismo craniencefálico no Brasil, este estudo pode ajudar na implantação de futuras estratégias de promoção da saúde para a população brasileira e mundial, com o objetivo de diminuir a incidência, a mortalidade e os custos do traumatismo craniencefálico.To characterize the demographic, social, and economic burden of traumatic brain injury on the public health system in Brazil during the past decade.Data from the database of the Information Technology Department of the Unified Health System (DATASUS) from January 2008 to December 2019 were analyzed.There was a mean of 131,014.83 hospital admissions per year due to traumatic brain injury in Brazil from 2008 - 2019. The incidence was 65.54 per 100.000 inhabitants during the same period. The high incidence of traumatic brain injury in older adults (70 years old) accompanied by high mortality rates should be noted. In addition, there was a high incidence of traumatic brain injury in younger adults (20 to 29 years and 30 to 39 years). The data presented here demonstrates a 3.6 male-to-female ratio of traumatic brain injury incidence.Although we believe that the present data underestimate the incidence and mortality related to traumatic brain injury in Brazil, this study could assist in implementation of future health promotion strategies in the Brazilian population and worldwide aiming to reduce the incidence, mortality and costs of traumatic brain injury.

Background & objectives The North-Eastern (NE) region has the highest incidence of cancer in India, and is also burdened by higher prevalence of risk factors and inadequate cancer treatment facilities. The aim of this study was to describe the cancer profile of the NE region, focussing on the cancer sites that have high incidence and to identify research priorities. Methods Incidence data from population-based cancer registries (PBCRs) in the North-East region (8 States) were utilized and relevant literature was reviewed to identify risk factors. Results Aizawl district in Mizoram had the highest incidence of cancer in men [age-adjusted rate (AAR) of 269.4 per 100,000]. Among women, Papumpare district of Arunachal Pradesh had the highest incidence (AAR of 219.8) in India. East Khasi Hills district in Meghalaya had the highest incidence of oesophageal cancer (AAR of 75.4 in men and 33.6 in women). Aizawl district in Mizoram had the highest incidence of stomach (AAR-44.2 in men) and Papumpare district had highest incidence of stomach (AAR 27.1 in women), liver (AAR- 35.2 in men and 14.4 in women) and cervical cancers (AAR- 27.7). Lung cancer (AAR- 38.8 in men and 37.9 in women) and gall bladder cancer incidence (AAR- 7.9 in men and 16.2 in women) were highest in Aizawl and Assam (Kamrup urban) PBCRs, respectively. Nagaland had the highest incidence of nasopharyngeal cancer (AAR of 14.4 in men and 6.5 in women), a relatively rare cancer in other regions of India. Four States (Arunachal Pradesh, Manipur, Sikkim and Tripura) in NE had only one cancer treating facility. Interpretation & conclusions Further research on specific aetiological factors in the region and multi-disciplinary research for development of tools, techniques and guidelines for cancer control are the need of the hour.

Background Interventional endoscopic ultrasound-guided procedures (I-EUS) are widely accepted as salvage procedures in ERCP-failed cases, and to drain fluid collected in the abdominal cavity. Although I-EUS has a relatively high incidence of complications and is severe/fatal in some cases, no follow-up strategy has been established. In our institution, plain computed tomography (P-CT) is performed routinely the day after I-EUS. In this study, we evaluated the usefulness of routine P-CT the day after I-EUS, as a follow-up method, and propose an algorithm. Methods We retrospectively reviewed 81 patients who underwent I-EUS and evaluated the usefulness of P-CT, abdominal X-ray, laboratory data, and symptoms as a follow-up method. An adverse event (AE) was defined as an event requiring any treatment. Results Technical success, clinical success, and AE rates were 96.3%, 90.1%, and 18.9%, respectively. In total, 30 patients had abnormal findings among the follow-up methods: 6 cases underwent additional procedures, 8 underwent medical treatments, and 16 were observed. The sensitivity, specificity, and accuracy for detecting AEs were assessed based on P-CT (85.7%, 100%, and 97.5%), X-ray (7.1%, 100%, and 83.5%), laboratory data (71.4%, 83.0%, and 81.0%), and symptoms (92.9%, 86.2%, and 87.3%). The sensitivity and accuracy of the latter two items were as high as those for X-ray, but specificity was lower than those for X-ray and P-CT. Conclusions Routine P-CT the day after I-EUS was useful for detecting complications and deciding to perform an invasive salvage procedure. Symptoms and laboratory data were useful to supplement routine P-CT.

Ever since the pandemic of Coronavirus disease (COVID-19) emerged in Wuhan, China, it has been recognized as a global threat and several studies have been carried out nationally and globally to predict the outbreak with varying levels of dependability and accuracy. Also, the mobility restrictions have had a widespread impact on people’s behavior such as fear of using public transportation (traveling with unknown passengers in the closed area). Securing an appropriate level of safety during the pandemic situation is a highly problematic issue that resulted from the transportation sector which has been hit hard by COVID-19. This paper focuses on developing an intelligent computing model for forecasting the outbreak of COVID-19. The autoregressive integrated moving average (ARIMA) machine learning model is used to develop the best model for twenty-one worst-affected states of India and six worst-hit countries of the world including India. The best ARIMA models are used for predicting the daily-confirmed cases for 90 days future values of six worst-hit countries of the world and six high incidence states of India. The goodness-of-fit measures for the model achieved 85% MAPE for all the countries and all states of India. The above computational analysis will be able to throw some light on the planning and management of healthcare systems and infrastructure.

This paper analyses the role of the arms trade in the growth and spread of transnational crime in Africa. The work shows that the proliferation and ready availability of Small Arms and Light Weapons (SALW) on the continent is contributing in no small measure to political, economic and social insecurity in Africa. Major transnational crimes that the work identifies in Africa include drug trafficking, human and people trafficking, environmental crimes, arms trafficking and stolen vehicle trafficking. The work uses qualitative research methodology, which involves the extensive collection, collation and analysis of secondary data, to capture the essence and scope of the impacts of SALW on the growth and spread of transnational crime on the continent. A major and significant contribution of the work is the crucial connection that it establishes between the proliferation of SALW and the high incidence and recurrence of transnational crime in Africa. The work shows the destabilizing impacts of the proliferation of SALW in Africa and how these is contributing to the recurrence of conflicts and criminal activities on the continent. In its conclusion, the work recommends that in order for states on the continent to be able to proactively tackle transnational crime and the proliferation of SALW, they will have to do the following: carry-out an extensive and critical survey to create a database that will identify the nature of the different transnational crime that is carried-out in each regions; create (where it does not exist) and, strengthen and implement (where it exist) legislations and laws designed to tackle transnational crime; and encourage interagency cooperation and coordination among the affected states in the regions.

In China, the population is aging rapidly, and the elderly have enormous medical needs. However, the elderly are underrepresented in clinical research, potentially forcing them to use medical devices and treatments that may be not suitable for them. Elderly patients are characterized by multiple comorbidities, concomitant treatments, and high incidence of cognitive impairment, and consequently are at increased risk of participating in clinical research. To reduce the risks involved with the elderly participating in clinical research, guidance on the ethical review of geriatric research is necessary. Based on a literature review and panel discussion, we have developed the Ethical Guidance for Geriatric Clinical Research, aiming to provide guidance on the ethical review of geriatric clinical research.

Introduction The Nit-Occlud PDA device is a newer coil-type device with a high degree of efficacy and safety. There are concerns about the high incidence of immediate angiographic residual shunt with this device. Aim To compare immediate angiographic residual shunts and their outcomes following PDA device closure with the Nit-Occlud device. Material and methods A single-institution, retrospective chart review of PDA closures was performed. Thirty patients who underwent Nit-Occlud PDA closure were compared with 34 patients who underwent PDA closure with an Amplatzer Duct Occluder-1 (ADO-1) and 25 patients who underwent PDA closure with coils. Results The three groups were similar in age, weight, and procedural characteristics. The PDA dimensions were smaller in the coils group. Technical success in the ADO-1 and Nit-Occlud groups was 100%. A small angiographic residual shunt was seen more often in the Nit-Occlud group (70%) than in the ADO-1 (59%) and coils (26%) groups (p = 0.005). Most residual shunts in the Nit-Occlud group disappeared in the echocardiogram performed 4 h later (90% echocardiographic closure). Echocardiographic closure (100%) was seen at 2 months and 6 months in the Nit-Occlud group. No correlation was noted between the angiographic residual shunt and Nit-Occlud device orientation with respect to the ductus, the device-ductal angle or the number of loops at the pulmonary artery end. Conclusions Despite the higher immediate angiographic residual shunt rate in the Nit-Occlud group than the other groups, high echocardiographic closure rates were seen within hours after device closure, which persisted at follow-up. The angiographic residual shunt is not related to the device orientation and should not be a deterrent in using this device.

A retrospective analysis of 11 COVID-19 patients complicated with stroke was performed. It was found that the incidence of stroke in patients with COVID-19 was significantly higher than the average level of the general population (P=0.003), and the D-dimer levels of 11 stroke patients were significantly higher than other patients (P=0.004). The significant increase of D-dimer can be used as an early warning indicator of cerebral infarction. It is critical to have a response plan for treating acute stroke in COVID-19 patients.

Background Axial myopia is the most common type of myopia. However, due to the high incidence of myopia in Chinese children, few studies estimating the physiological elongation of the ocular axial length (AL), which does not cause myopia progression and differs from the non-physiological elongation of AL, have been conducted. The purpose of our study was to construct a machine learning (ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children. Methods In total, 1011 myopic children aged 6 to 18 years participated in this study. Cross-sectional datasets were used to optimize the ML algorithms. The input variables included age, sex, central corneal thickness (CCT), spherical equivalent refractive error (SER), mean K reading (K-mean), and white-to-white corneal diameter (WTW). The output variable was AL. A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups, including 4 groups used as training data and one group used as validation data. Six types of ML algorithms were implemented in our models. The best-performing algorithm was applied to predict AL, and estimates of the physiological elongation of AL were obtained as the partial derivatives of ALpredicted-age curves based on an unchanged SER value with increasing age. Results Among the six algorithms, the robust linear regression model was the best model for predicting AL, with a R2 value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL. Based on the partial derivatives of the ALpredicted-age curves, the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age, SER and K-mean. According to the model, the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean. Conclusions The physiological elongation of the AL is rarely recorded in clinical data in China. In cases of unavailable clinical data, an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL, which is especially useful when monitoring myopia progression in orthokeratology lens wearers.

Gastric cancer (GC) is a malignancy with high incidence and mortality rates worldwide. It has a severe impact on patients diagnosed and on society. With the rapid development of bioinformatics and detection technologies, non‑coding RNAs have been demonstrated to play important roles in gastric carcinogenesis, including circular RNAs (circRNAs) and long non‑coding RNAs (lncRNAs). Previous studies have indicated that these two types of RNAs with notable characteristics can serve as promising biomarkers for clinical diagnosis and prognosis. The identification of relevant mechanisms has revealed the immense potential of circRNAs and lncRNAs in the treatment of GC. However, there are still numerous issues that need to be resolved. The present review focuses on the clinical translation of circRNAs and lncRNAs into GC. Important achievements and currently existing limitations in this field of research are summarized from recent studies. The present review also proposes serviceable suggestions for further development.

Background and Aims: Hemoglobinopathies and thalassemias are the commonest single gene disorders in India. In Terai region of India, Hemoglobinopathies and thalassemias are the most common in the Tharu community. Therefore, in this study, we aim to evaluate the Hb variant analysis of hemoglobinopathies and thalassemias in a Tharu population in Lakhimpur Kheri Districts of Uttar Pradesh, India. Materials and Methods: Total 493 individuals were recruited in this study. The demographic details and blood samples were collected from different location at Kheri district during mega health camp. Hb variant analysis was performed by high performance liquid chromatography (HPLC) system beta thalassemia short program in BIO-RAD VARIANT. Results: Out of 493, 108 (21.9%) individual suffers with abnormal haemoglobinopathies. In which β-thalassemia trait is the commonest haemoglobinopathy (12.98%), followed by HbE trait (7.50%), and compound heterozygous HbS/β-Thalassemia trait (1.42%) in overall population. The HbF was significantly greater in HbS heterozygous (1.45 ± 1.41), whereas mean HbA2 was significantly greater in β-Thalassemia trait (5.17 ± 1.36). Conclusion: The high incidence of hemoglobinopathies and thalassemias were observed in Tharu community in Lakhimpur Kheri districts of Uttar Pradesh, Indian.

Crop lodging - the bending of crop stems from their upright position or the failure of root-soil anchorage systems - is a major yield-reducing factor in wheat and causes deterioration of grain quality. The severity of lodging can be measured by a lodging score (LS)- an index calculated from the crop angle of inclination (CAI) and crop lodged area (LA). LS is difficult and time consuming to measure manually meaning that information on lodging occurrence and severity is limited and sparse. Remote sensing-based estimates of LS can provide more timely, synoptic and reliable information on crop lodging across vast areas. This information could improve estimates of crop yield losses, inform insurance loss adjusters and influence management decisions for subsequent seasons. This research - conducted in the 600 ha wheat sown area in the Bonifiche Ferraresi farm, located in Jolanda di Savoia, Ferrara, Italy - evaluated the performance of RADARSAT-2 and Sentinel-1 data to discriminate and classify lodging severity based on field measured LS. We measured temporal crop status characteristics related to lodging (e.g. lodged area, CAI, crop height) and collected relevant meteorological data (wind speed and rainfall) throughout May-June 2018. These field measurements were used to distinguish healthy (He) wheat from lodged wheat with different degrees of lodging severity (moderate, severe and very severe). We acquired multi-incidence angle (FQ8-27° and FQ21-41°) RADARSAT-2 and Sentinel-1 (40°) images and derived multiple metrics from them to discriminate and classify lodging severity. As a part of our data exploration, we performed a correlation analysis between the image-based metrics and LS. Next, a multi-temporal discriminant analysis approach, including a partial least squares (PLS-DA) method, was developed to classify lodging severities. We used the area under the curve-receiver operating characteristics (AUC-ROC) and confusion matrices to evaluate the accuracy of the PLS-DA classification models. Results show that (1) volume scattering components were highly correlated with LS at low incidence angles while double and surface scattering was more prevalent at high incidence angles; (2) lodging severity was best classified using low incidence angle R-FQ8 data (overall accuracy 72%) and (3) the Sentinel-1 data-based classification model was able to correctly identify 60% of the lodging severity cases in the study site. The results from this first study on classifying lodging severity using satellite-based SAR platforms suggests that SAR-based metrics can capture a substantial proportion of the observed variation in lodging severity, which is important in the context of operational crop lodging assessment in particular, and sustainable agriculture in general.

Background Foot and mouth disease (FMD) is a highly infectious and contagious febrile vesicular disease of cloven-hoofed livestock with high socio-economic consequences globally. In Thailand, FMD is endemic with 183 and 262 outbreaks occurring in the years 2015 and 2016, respectively. In this study, we aimed to assess the spatiotemporal distribution of FMD outbreaks among cattle in Chiang Mai and Lamphun provinces in the northern part of Thailand during the period of 2015–2016. A retrospective space-time scan statistic including a space-time permutation (STP) and the Poisson and Bernoulli models were applied in order to detect areas of high incidence of FMD. Results Results have shown that 9 and 8 clusters were identified by the STP model in 2015 and 2016, respectively, whereas 1 and 3 clusters were identified by the Poisson model, and 3 and 4 clusters were detected when the Bernoulli model was applied for the same time period. In 2015, the most likely clusters were observed in Chiang Mai and these had a minimum radius of 1.49 km and a maximum radius of 20 km. Outbreaks were clustered in the period between the months of May and October of 2015. The most likely clusters in 2016 were observed in central Lamphun based on the STP model and in the eastern area of Chiang Mai by the Poisson and Bernoulli models. The cluster size of the STP model (8.51 km) was smaller than those of the Poisson and Bernoulli models (> 20 km). The cluster periods in 2016 were approximately 7 months, while 4 months and 1 month were identified by the Poisson, Bernoulli and STP models respectively. Conclusions The application of three models provided more information for FMD outbreak epidemiology. The findings from this study suggest the use of three different space-time scan models for the investigation process of outbreaks along with the follow-up process to identify FMD outbreak clusters. Therefore, active prevention and control strategies should be implemented in the areas that are most susceptible to FMD outbreaks.

This case of congenital tuberculosis (TB) emphasizes that TB should be suspected in newborns whose parents are from areas with high incidence of TB or who present with symptoms of an infection unresponsive to wide‐spectrum antibiotics.

Resumen En Colombia, especialmente en las unidades de cuidados intensivos, la candidemia es una causa frecuente de infección del torrente sanguíneo y representa el 88 % de las infecciones fúngicas en pacientes hospitalizados, con una mortalidad entre 36 y 78 %. Su incidencia en Colombia es mayor a la reportada en los países desarrollados e, incluso, en otros países de Latinoamérica. Para su manejo deben considerarse los factores de riesgo del paciente, luego valorar las características clínicas y, finalmente, hacer los estudios microbiológicos y, si es necesario, pruebas moleculares. En general, las guías estadounidenses, latinoamericanas y europeas recomiendan las equinocandinas como el tratamiento de primera línea de la candidemia y difieren en el uso de fluconazol dependiendo de la 'evidencia', la gravedad de la enfermedad, la exposición previa a los azoles y la prevalencia de Candida no albicans. Dada su gran incidencia en nuestro país, asociada con una elevada mortalidad, esta infección debe buscarse sistemáticamente en pacientes con factores de riesgo, con el fin de iniciar oportunamente el tratamiento antifúngico. Abstract In Colombia, especially in intensive care units, candidemia is a frequent cause of infection, accounting for 88% of fungal infections in hospitalized patients, with mortality ranging from 36% to 78%. Its incidence in Colombia is higher than that reported in developed countries and even higher than in other Latin American countries. First, the patient's risk factors should be considered, and then clinical characteristics should be assessed. Finally, microbiological studies are recommended and if the evidence supports its use, molecular testing. In general, American, Latin American, and European guides place the echinocandins as the first-line treatment for candidemia and differ in the use of fluconazole based on evidence, disease severity, previous exposure to azoles, and prevalence of Candida non-albicans. Taking into account the high incidence of this disease in our setting, it should be looked for in patients with risk factors to start a prompt empirical anti-fungal treatment.

Non-melanoma skin cancer is the most prevalent malignancy in fair-skinned people and its incidence is increasing. Recently, studies have suggested that antihypertensive drugs may increase the risk of these tumors, particularly hydrochlorothiazide, due to its photosensitizing properties. The Portuguese National Authority for Medicines and Health Products, INFARMED, has issued an alert to healthcare professionals concerning the increased risk of non-melanoma skin cancer in patients exposed to cumulative doses of this drug. However, study results have been heterogeneous and sometimes conflicting. The high incidence of non-melanoma skin cancer and the large number of patients under chronic hydrochlorothiazide therapy may thus have important public health consequences. In this article, the authors review the published evidence and conclude that there may be an association between hydrochlorothiazide use and the risk of non-melanoma skin cancer, but also point out some limitations of the studies in the literature. It is important to promote preventive strategies against sun exposure, regular skin examinations, and individual assessment of the benefits of hydrochlorothiazide use, particularly in patients with previous skin cancer. Resumo: O cancro cutâneo não-melanoma é a neoplasia mais prevalente na população caucasiana e a sua incidência está a crescer. Nos últimos anos um conjunto de estudos sugeriram que a terapêutica anti-hipertensora poderá aumentar o risco destes tumores, salientando-se a hidroclorotiazida, pelas suas propriedades fotossensibilizadoras. A crescente evidência disponível levou o INFARMED - Autoridade Nacional do Medicamento e Produtos de Saúde - a realizar um alerta dirigido aos profissionais de saúde para o risco de cancro cutâneo não-melanoma com a exposição dos doentes a doses cumulativas deste fármaco. Contudo, os resultados dos estudos têm-se revelado heterogéneos e, por vezes, contraditórios. A elevada incidência de cancro cutâneo não-melanoma e o grande número de indivíduos a cumprir terapêutica crónica com hidroclorotiazida poderá ter importantes repercussões em termos de saúde pública. Neste artigo, os autores propuseram-se a reunir e analisar a evidência científica disponível, tendo concluído uma possível associação entre a toma de hidroclorotiazida e o risco de cancro cutâneo não-melanoma, não esquecendo, no entanto, algumas limitações dos trabalhos existentes na literatura. O reforço de medidas educacionais para a adoção de estratégias preventivas face à exposição solar, a monitorização regular da pele e avaliação individual do benefício da terapêutica com hidroclorotiazida são importantes, em particular na presença de antecedentes pessoais de tumores de pele.

Mucopolysaccharidoses (MPSs) are a group of rare lysosomal storage diseases with multisystem manifestations, including carpal tunnel syndrome (CTS). This study comprised a systematic review of literature and hospital guidelines addressing the method and frequency of screening for carpal tunnel syndrome in mucopolysaccharidosis patients and a review of carpal tunnel syndrome in patients seen in the multidisciplinary mucopolysaccharidosis clinic of a pediatric hospital, in order to develop screening recommendations. The literature reported the importance of routine carpal tunnel syndrome screening from early childhood in patients with mucopolysaccharidosis I, II, IV, and VI. Screening methods included physical examination, nerve conduction studies, electromyography, and ultrasonography. Ten of 20 mucopolysaccharidosis patients in our series underwent carpal tunnel syndrome surgery. Given the high incidence of carpal tunnel syndrome at a young age in mucopolysaccharidosis, the authors recommend performing physical examination and obtaining patient and caregiver history for carpal tunnel syndrome every 6 months from the time of mucopolysaccharidosis diagnosis, supplemented by annual nerve conduction studies in cases with poor history or equivocal examination.

The high incidence of tuberculosis (TB) among prisoners calls for interventions to identify latent tuberculosis infection (LTBI) before disease onset. To identify LTBI prevalence among prisoners and factors associated with it, we conducted a cross-sectional study in Tianjin. We randomly sampled 959 HIV-negative adult prisoners by ward clusters in 5 prisons and determined LTBI by seropositivity using an interferon-γ release assay. The overall rate of LTBI was 52.0% (499/959) in the 5 facilities and ranged from 41.9% (72/172) to 60.9% (106/174). Age (adjusted odds ratio [aOR] 1.7, 95% CI 1.4-2.0 per 10 years), duration of imprisonment (aOR 1.2, 95 CI% 1.1-1.2 per year), previous incarceration (aOR 2.0, 95% CI 1.5-2.7), and facility-specific TB incidence (aOR 1.9, 95% CI 1.3-2.8) were risk factors for LTBI. These findings indicate possible TB transmission within prisons and suggest the necessity for early TB case detection, as well as prophylaxis.

Objectives Mitral valve (MV) repair in rheumatic patients is a challenging procedure and carries high incidence of early and late failure. We aimed in this study to evaluate the mid-term results of MV bileaflet augmentation to increase the depth of coaptation and achieve satisfactory results of repair. Patients and methods Between January 2015 and December 2018 at the National Heart Institute of Egypt, 24 rheumatic patients had leaflet augmentation with glutaraldehydetreated autologous pericardium as part of their mitral repair procedure. Their clinical and echocardiographic data were prospectively analyzed. Results The mean age of the rheumatic patients was 34.2 ± 14.7 years, range 20–50 years. Overall, 72.4% patients had predominant mitral regurgitation (MR), whereas 27.6% had mixed mitral stenosis and MR. Leaflet augmentation was performed in the posterior, anterior, and both leaflets in 5, 3, and 16 of patients, respectively. Additional repair procedures included commissurotomy and papillary muscle splitting. All repairs were stabilized with annuloplasty rings. The follow-up was complete in all patients with a mean follow-up of 22.4 ± 13.6 months. There was no mortality in this series. At the latest follow-up, the MR grade was none/trivial in eight of patients, mild in four, moderate in six, moderately severe in three, and severe in three patients. Two patients had redo mitral surgery. At 3 years postoperatively, the estimated rates of freedom from reoperation and valve failure were 95.8 and 90.6%, respectively. Conclusion Repair with leaflet augmentation in rheumatic disease resulted in good early and mid-term outcomes. A wider use of this technique may improve the success rate and prognosis of repair in complex rheumatic MV disease.