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BackgroundStroke is a significant global cause of mortality and long-term disability, potentially influenced by infections that heighten systemic inflammation and thrombotic events. The full impact of influenza vaccination on stroke remains uncertain. This systematic review and meta-analysis aimed to investigate the association between influenza immunization and stroke incidence.MethodsWe searched for randomized controlled trials (RCTs), case–control, and cohort studies published in PubMed/Medline, Cochrane-Central-Register-of-Controlled-Trials (CENTRAL), and Embase until 5 December 2022, and identified articles investigating the effect of influenza vaccine on stroke occurrence. All articles were screened by two independent reviewers. We performed a meta-analysis to investigate the risk of stroke occurrence in vaccinated vs. unvaccinated individuals. The random-effects model was used in all statistical analyses.ResultsAmong the 26 articles meeting our criteria, 10 were retrospective cohort studies, 9 were case–control studies, 3 were prospective cohort studies, 3 were RCTs and 1 case-series. Overall, the studies showed a significant decrease in the risk of stroke incidence/hospitalization among vaccinated patients (OR = 0.81, 95% CI [0.77–0.86], p = 0.00001). Furthermore, studies showed flu vaccine decreases the occurrence of mortality among stroke patients (OR = 0.50, 95% CI [0.37–0.68], p = 0.00001). Sub-group analysis revealed significant protective effect for patients with specific comorbidities including atrial fibrillation (OR = 0.68, 95% CI [0.57–0.81], p = 0.0001), diabetes (OR = 0.76, 95% CI [0.66–0.87], p = 0.0001), Chronic obstructive pulmonary disease (OR = 0.70, 95% CI [0.61–0.81], p = 0.00001), and hypertension (OR = 0.76, 95% CI [0.70–83], p = 0.00001).ConclusionThe current meta-analysis further supports prior findings that influenza vaccination reduces stroke risk, particularly in patients with comorbidities. Guidelines should promote vaccination for at-risk individuals.

Background: Dental calculus is mineralized dental plaque formed on teeth and dental prosthesis surfaces in the oral cavity. Urinary stone is a crystal aggregation formed in urinary system due to minerals saturation present in urine. The structure of dental calculus is similar to that of urinary stone. Objective: To assess oral hygiene and gingival status in patients with urinary stone. And compared with healthy subjects. Patients and Methods: Sixty participants, 25-40 years, were involved in this study who were divided into study and control group. The study group involved patients with urinary stone while the control group involved healthy subjects. Clinical parameters including plaque, calculus and gingival indices were recorded for all participants. The correlation between the recorded clinical parameters was estimated. Results: The study group mean (±SD) plaque (1.435±0.499), gingival (0.995±0.288) and calculus (1.28 ±0.66) indices were found to be significantly high compared with control group(0.868±0.265), (0.602±0.265) (0.501±0.457 ) respectively. The formed calculus was positively associated with accumulated plaque (r: 0.608, p < 0.05) and gingival inflammation(r: 0.612, p < 0.05). Conclusion: Urinary stone patients were associated with more plaque and calculus accumulation, and had worse gingival inflammation compared to healthy participants. Thus, they need to be more aware of their gingival health status and improved preventive care of oral health.

Up to 30% of patients with obsessive-compulsive disorder (OCD) exhibit an inadequate response to serotonin reuptake inhibitors (SRIs). To date, genetic predictors of OCD treatment response have not been systematically investigated using genome-wide association study (GWAS). To identify specific genetic variations potentially influencing SRI response, we conducted a GWAS study in 804 OCD patients with information on SRI response. SRI response was classified as 'response' (n=514) or 'non-response' (n=290), based on self-report. We used the more powerful Quasi-Likelihood Score Test (the MQLS test) to conduct a genome-wide association test correcting for relatedness, and then used an adjusted logistic model to evaluate the effect size of the variants in probands. The top single-nucleotide polymorphism (SNP) was rs17162912 (P=1.76 × 10(-8)), which is near the DISP1 gene on 1q41-q42, a microdeletion region implicated in neurological development. The other six SNPs showing suggestive evidence of association (P

Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and urges and repetitive, intentional behaviors that cause significant distress and impair functioning. The OCD Collaborative Genetics Association Study (OCGAS) is comprised of comprehensively assessed OCD patients with an early age of OCD onset. After application of a stringent quality control protocol, a total of 1065 families (containing 1406 patients with OCD), combined with population-based samples (resulting in a total sample of 5061 individuals), were studied. An integrative analyses pipeline was utilized, involving association testing at single-nucleotide polymorphism (SNP) and gene levels (via a hybrid approach that allowed for combined analyses of the family- and population-based data). The smallest P-value was observed for a marker on chromosome 9 (near PTPRD, P=4.13 × 10(-)(7)). Pre-synaptic PTPRD promotes the differentiation of glutamatergic synapses and interacts with SLITRK3. Together, both proteins selectively regulate the development of inhibitory GABAergic synapses. Although no SNPs were identified as associated with OCD at genome-wide significance level, follow-up analyses of genome-wide association study (GWAS) signals from a previously published OCD study identified significant enrichment (P=0.0176). Secondary analyses of high-confidence interaction partners of DLGAP1 and GRIK2 (both showing evidence for association in our follow-up and the original GWAS study) revealed a trend of association (P=0.075) for a set of genes such as NEUROD6, SV2A, GRIA4, SLC1A2 and PTPRD. Analyses at the gene level revealed association of IQCK and C16orf88 (both P

Shewanella is an emerging human pathogen. It mostly causes skin and soft tissue infections. Osteosynthesis-associated infection involving Shewanella are rare and in most cases are secondary to direct contamination following open fractures in aquatic environments. Here, we present a rare case of hematogenous osteosynthesis-associated infection involving Shewanella algae affecting an 18-year-old patient who was operated on for 12th thoracic vertebrae and 4th lumbar vertebrae fractures occurring in an aquatic environment. We performed surgical debridement with subsequent double course parenteral antibiotherapy that was then adapted to bacteria sensitivities for three weeks. After a follow-up of six months, the patient had no signs of recurrent infection. The presence of infected dermabrasions and the concordance between germs isolated in operative samples and in blood cultures presumes that the contamination was hematogenous.

Abstract Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.

Background: Invasive candidiasis (IC) has emerged worldwide as an important healthcare associated infection caused by Candida species. Nowadays, data on the epidemiology of IC and the antifungal susceptibility of Candida isolates in Tunisia are still limited. Hence, this study aimed to analyze the incidence, species distribution and antifungal susceptibility of Candida strains in the university hospital Sahloul (Sousse, Tunisia). Methods: A five-year (2016 to 2020) retrospective study was conducted including all Candida isolates recovered from blood, other sterile body fluids and deep-seated samples from hospitalized patients. Candida species were identified using the VITEK®2 automated system and the antifungal susceptibilities were determined by the Vitek®2 YST cards and/or the E-test method. Results: During the reported period, 138 nonrepetitive Candida isolated from separate patients were identified with a mean annual incidence of 1,04 case per 1000 admissions. Candida albicans (C. albicans) was the predominant species (42%), followed by C. parapsilosis (19,6%), C. tropicalis (11,6%) and C. glabrata (6,5%). The total resistance rates of fluconazole, voriconazole, amphotericin B and echinocandins were 6,7%, 2,9%, 2,9% and 3,4% respectively. The highest antifungal resistance rates were found with fluconazole (6,7%). This rate significantly increased from 5.3% in 2017 to 10,5% in 2020 (p=0,01). Echinocandins showed excellent in-vitro activities against the majority of Candida species. Conclusion: The present study provides valuable local surveillance data on the epidemiology and antifungal susceptibilities of invasive Candida species which can be useful to guide an appropriate empiric and targeted antifungal therapy.

Abstract Palliative care is critical to redundancy in cancer patients seeking to improve their quality of life. Evaluation should be incorporated into clinical practice routines at all stages of cancer. The Edmonton Symptom Assessment System (ESAS) was used to rate the intensity of ten symptom evaluations designed and validated for cancer patients in various languages and cultures. Therefore, the study aims to assess the symptoms reported using ESAS scores to identify patients who would benefit from palliative care that can improve the integration of palliative care into standard cancer care at An-Najah National University Hospital (NNUH). A cross-sectional study was selected for 271 cancer patients using a convenience sampling method at NNUH. Demographic, clinical, and lifestyle characteristics are described. Furthermore, patients' moderate to severe symptoms (score > 4) were obtained using ESAS-R. The survey consisted of 271 patients, with a response rate of 95%. The average age of the patients was 47 ± 17.7 years, ranging from 18 to 84 years. The male-to-female ratio was approximately 1:1, 59.4% of the patients were outpatients, and 153 (56.5%) had hematologic malignancies. Fatigue (62.7%) and drowsiness (61.6%) were the most common moderate to severe symptoms in ESAS. Furthermore, pain (54.6%), nausea (40.2%), lack of appetite (55.0%), shortness of breath (28.5%), depression (40.6%), anxiety (47.2%) and poor well-being (56.5%) were reported. In conclusion, fatigue and drowsiness were the most reported symptoms according to the ESAS scale among cancer patients, while moderate to severe symptoms were reported in cancer patients using the ESAS. The ESAS is a functional tool for assessing cancer patients' symptoms and establishing palliative care services.