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Introduction Dyspnoea is common in patients with giant paraoesophageal hernia (PEH). Pulmonary aspiration has not previously been recognised as a significant contributory factor. Aspiration pneumonia in association with both gastro-oesophageal reflux disease (GORD) and PEH has a high mortality rate. There is debate about routine anti-reflux measures with surgical repair. Reflux aspiration has been examined in a consecutive cohort using scintigraphic scanning and symptoms. Methods Reflux aspiration scintigraphy (RASP) results and symptoms were evaluated in consecutive patients with PEH managed in our service between January 2012 and March 2017. Results PEH was diagnosed in 96 patients. Preoperative reflux pulmonary scanning was performed in 70 patients: 54 were female (77.1%) and the mean age was 68 years (range 49–85). Dyspnoea was the most common symptom (77.1%), and a symptomatic history of aspiration was seen in 18 patients (25.7%). Clinical aspiration was confirmed by RASP in 13 of these cases. Silent RASP aspiration occurred in a further 27 patients without clinical symptoms. RASP was negative in five patients with clinical symptoms of aspiration. No aspiration by either criterion was present in 27 patients. Dysphagia was negatively related to aspiration on RASP (pConclusion GORD, dyspnoea and silent pulmonary aspiration are frequent occurrences in the presence of giant PEH. Subjective aspiration was the most specific and positive predictor of pulmonary aspiration. Dyspnoea in PEH patients may be caused by pulmonary aspiration, cardiac compression and gas trapping. The high rate of pulmonary aspiration in PEH patients may support anti-reflux repair.

Background Cutaneous leishmaniasis (CL) is a tropical infection with a relatively high incidence rate in Iran. The present study aimed to explore the time trend and associated factors of CL in Dezful, in southwest Iran. Methods This case series study was conducted on all CL patients registered from 2014 to 2019. The descriptive analysis of the data was done using SPSS 20 software and the time series model on the number of cases was run through Interactive Time Series Modeling software. Results A total of 5349 leishmaniasis cases were identified in the study area during 2014–2019. The highest incidence rate was 35 840 per 100 000 in 2014. The fitted time series model revealed a decreasing trend with an annual periodic pattern. The mean age of infection was 19.82 y (standard deviation 21.87). The infection was most frequent in the 1–10 y age group (41.7%). Also, females were more prone to leishmaniasis (54.7%). Most lesions were located on the hand (23.1%), face (19.7%), and forearm (17.75%) and 48.5% of patients had only one lesion. Conclusions The results revealed a decreasing trend of leishmaniasis in Dezful. It has been predicted that this infection will reach a minimum rate (300 per 100 000) in the winter of 2021.

Most existing biocontainment units (BCUs) in U.S. hospitals are designed to care for a limited number of patients infected with epidemiologically significant pathogens. The COVID-19 pandemic presented substantial challenges to hospital preparedness and operations because of its high incidence rate and the high risk of transmission to staff members. This article describes a novel practice innovation: a hospital-wide deployment of nurses on a trained BCU team to support hospital staff in safely caring for patients with COVID-19. Their responsibilities included assisting in the development of guidelines and providing training on safety protocols and the appropriate use of personal protective equipment. The authors show how this deployment contributed significantly to staff education and support during the pandemic.

Chronic obstructive pulmonary disease (COPD) is a disease with high incidence rate and mortality rates worldwide. It is the third leading cause of death in the world. Nevertheless, little progress has been made in treating and preventing the disease. Under these circumstances, the concept of “early COPD” was proposed. Although this concept is not new, most health-care workers do not fully understand early COPD and tend to confuse it with mild COPD. In this review, we mainly discuss the definition of early COPD and the developmental trajectory of lung function. Although patients with early COPD have no symptoms, their lung function is already lower than that of normal people. A relatively complete definition is needed to identify this group of people. Reduced lung function is the diagnostic criterion for COPD, but lung development is a long-term dynamic process. In addition to smoking and air pollution, we should pay more attention to prenatal and childhood risk factors, for example, parents smoking, birth weight, preterm birth, mode of delivery, childhood respiratory infections and childhood asthma. Health-care workers need to be fully aware of early COPD, to reduce the morbidity of COPD and take effective measures to prevent these risk factors.

Background Active screening for tuberculosis (TB) involves systematic detection of previously undiagnosed TB disease or latent TB infection (LTBI). It may be an important step toward elimination of TB among Inuit in Canada. We aimed to evaluate the cost-effectiveness of community-wide active screening for TB infection and disease in 2 Inuit communities in Nunavik. Methods We incorporated screening data from the 2 communities into a decision analysis model. We predicted TB-related health outcomes over a 20-year time frame, beginning in 2019. We assessed the cost-effectiveness of active screening in the presence of varying outbreak frequency and intensity. We also considered scenarios involving variation in timing, impact and uptake of screening programs. Results Given a single large outbreak in 2019, we estimated that 1 round of active screening reduced TB disease by 13% (95% uncertainty range -3% to 27%) and was cost saving compared with no screening, over 20 years. In the presence of simulated large outbreaks every 3 years thereafter, a single round of active screening was cost saving, as was biennial active screening. Compared with a single round, we also determined that biennial active screening reduced TB disease by 59% (95% uncertainty range 52% to 63%) and was estimated to cost Can$6430 (95% uncertainty range -$29 131 to $13 658 in 2019 Can$) per additional active TB case prevented. With smaller outbreaks or improved rates of treatment initiation and completion for people with LTBI, we determined that biennial active screening remained reasonably cost-effective compared with no active screening. Interpretation Active screening is a potentially cost-saving approach to reducing disease burden in Inuit communities that have frequent TB outbreaks.

Resumen: La vía de PD-1/PD-L1 atenúa la destrucción de tejidos al limitar la actividad de las células T, situación que el cáncer puede utilizar a su favor. El bloqueo de la vía PD-1/PD-L1 proporciona entonces, una base para la inmunoterapia contra el cáncer, lo cual resulta muy prometedor al considerar las altas tasas de incidencia y mortalidad que presenta dicha enfermedad en la actualidad. La presente investigación consiste en una revisión bibliográfica descriptiva realizada mediante la consulta de la base de datos Sistema de Bibliotecas, Documentación e Información (SIBDI) de la Universidad de Costa Rica y el sitio web Google Scholar (Google Académico). El objetivo de esta revisión es determinar la función de la vía de PD-1/PD-L1 como punto de control inmunológico, junto con la aplicación y el alcance de los fármacos inhibidores de PD-1 y PD-L1 en la inmunoterapia contra el cáncer. Se concluye que los inhibidores de PD-1/PD-L1 presentan altas tasas de respuesta antitumoral y supervivencia, así como una mejor tolerancia en comparación a fármacos antitumorales tradicionales. Finalmente, se recomienda la terapia combinada y el uso de biomarcadores para obtener una mayor supervivencia libre de progresión tumoral, una terapia personalizada y un resultado favorable para el paciente.

O envelhecimento populacional somado à alta incidência de doenças crônicas degenerativas é um desafio para o Sistema Único de Saúde. O presente estudo teve por objetivos (i) realizar o levantamento do perfil alimentar de pacientes idosos com Hipertensão Arterial Sistêmica e Diabetes Mellitus, atendidos pela Unidade Básica de Saúde Campo da Água Verde em Canoinhas/SC; (ii) classificar os indivíduos em grupos homogêneos, com base em seu perfil alimentar; e, (iii) mensurar a contribuição das características dos indivíduos para a sua classificação nos grupos pré-determinado. A metodologia estudo consitiu em coleta de dados, obtidos através de entrevista formal, em que foram abordados aspectos relacionados às características individuais (idade, sexo, peso, altura, prática de exercícios físicos) e quais os alimentos consumidos durante as refeições diárias. Os dados coletados foram analisados através de estatística descritiva, análise de cluster, teste de Mann-Whitney e Regressão Logit. Entre os resultados obtidos: frequência de citações dos alimentos consumidos nas refeições diárias; os participantes foram divididos em dois grupos de acordo com o seu perfil alimentar; os idosos pertencentes ao Grupo A apresentaram melhor qualidade de dieta, com maior consumo de alimentos minimamente processados no almoço e jantar, quando comparados aos indivíduos do Grupo B, que apresentaram maior consumo de alimentos processados e ultraprocessados no jantar. Por fim, concluiu-se que o aumento de 1 ponto no IMC de um indivíduo que se enquadram nas condições do estudo implica num aumento de 14% das chances deste indivíduo apresentar uma alimentação menos saudável.

Background: Coronavirus disease-19 (COVID-19) is a growing pandemic around the globe that was initially discovered in Wuhan in December 2019. Despite the relatively high incidence of cutaneous manifestations in COVID-19, their role in early recognition and disease progression has not been fully investigated. Aim of this study: To report the possible incidence of the cutaneous lesion in COVID 19 patients and to describe various cutaneous manifestations and their correlation with other clinical features in Covid-19 positive patients to facilitate diagnosis and prognostications toward this virus. Methods: This research was conducted as a cross-sectional study. Skin lesions photography and their analysis were collected by dermatologists from 18 cities in Iraq between September 2020 to January 2021. The data were processed using statistical package SPSS version 23. Results: A total of 3117 confirmed COVID-19 cases were included in this study. Around 268 patients developed skin lesions with age ranged between 8 to 84 years. Of these skin lesions, 46.2% developed during the illness with minority erupting during the prodromal phase, whilst 38.8% appeared after hospitalization. The most common skin lesion was in the form of urticarial 36.74% followed by herpetic lesions 28.4%, maculopapular rash 11.74% and the remainder being candidiasis, oral thrush, chilblains, and other skin conditions. The most affected area was the torso (46%) followed by limbs, face, fingers, and toes. Conclusion: This study demonstrated the high incidence rate of dermatological lesions in different phases of COVID-19 with urticarial rash being the most frequent clinical pattern.

Background and aims Mobile phone addiction (MPA) has recently aroused much attention due to its high incidence and considerable health hazards. Although some existing studies have documented that physical activity is negatively associated with MPA, it is little known about the potential effects underlying this relation. The aim of this study was to investigate the relationship between physical activity and MPA among undergraduates in China, and to further examine the moderating effect of exercise type in the relation between them. Methods By the quota sampling, a total of 650 participants engaged in this survey and completed relevant measurements including physical activity rating scale-3 (PARS-3) and mobile phone addiction tendency scale (MPATS). Results Gender (β = 0.271, P < 0.05) and major (β = −0.169, P < 0.05) could significantly predict MPA, respectively, and physical activity was an imperative protective factor to decrease MPA (β = −0.266, P < 0.001). While the physical activity level enhanced from none exercise to medium exercise, an optimum dose-response relationship would emerge between physical activity and MPA (F (3,604) = 4.799, P < 0.01). Most important, the relation between physical activity and MPA can be moderated by exercise type. Especially in terms of aerobic endurance exercise, the higher level of physical activity the undergraduates performed, the lower degree of MPA would be suffered by them (β = −0.266, P < 0.001). Discussion These findings could be conducive to better understand the positive and potential effects of physical activity on the intervention in MPA, and served as a persuasive evidence that as for university students, actively engaging in aerobic endurance exercise with the medium activity level would be a practicable exercise strategy to deal with MPA in daily lifestyle behavior.

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.

Vestibular migraine (VM) and Menière’s disease (MD) are common neurotological disorders causing episodic vertigo. Sometimes, VM is accompanied by cochlear symptoms suggestive for MD. Therefore, in those cases, the differential diagnosis between the two disorders can be difficult. Moreover, a comorbidity with migraine in MD patients is widely reported, up to the hypothesis of a possible MD-VM overlapping syndrome. In this brief case report, we consider the clinical history of a family presenting high incidence of subjects fulfilling the diagnostic criteria of VM and single case fulfilling criteria for definite MD. The relationship between VM and MD is still under debate; anyway, it can be speculated that commonly shared genetic mutations could play a role as predisposing factors in both disorders. A congenital nystagmus in the family was present too, but its correlation with the other conditions is still not clear. Future goal of our work will be to assess genetics in this family.

Mob justice fatalities are a gross violation of human rights as they represent extra-legal punishment. There is a paucity of research relating to the demographics of at-risk groups, nature of injuries and the impact to the Forensic Pathology Service at national and provincial levels. This was a retrospective study over 10 years (1 April 2006 to 31 March 2016) at Germiston Forensic Pathology Service Medico-legal Mortuary. The objectives were to describe the demographics of the victims of fatal mob justice, describe the trends of the number of fatalities and causes of death over time, assess hospitalization frequency, describe the nature and location of injuries sustained, and to report on ancillary investigations performed. A total of 354 cases were analyzed. All victims were Black (100%), with 99.4% of the sample group being male. The largest proportion was aged between 21-30 years (49.2%) with the majority having South African citizenship (68.9%). The majority of deaths were due to blunt force injuries (92.4%) with blunt force head injury being the most prevalent (79.9%). Half of the victims died on the scene (50.6%; n = 175). Hospitalization occurred in 49.4% (n = 175) of cases, of which, 56.3% died within 24 h of hospital admittance. Ancillary tests were ordered in 22.6% of cases. Adequate resources should be distributed to appropriate departments to engage with and monitor communities in high incidence areas to curb these killings.

Few studies have examined the long-term prognosis of Chinese patients with intracerebral hemorrhage (ICH). This study assessed the clinical characteristics and predictors of vascular events occurring within 5 years after ICH. We included consecutive patients diagnosed with first-ever ICH between June 2013 and December 2014. Based on follow-up data (collected until December 2019), we used multivariable logistic regression to examine the clinical characteristics and long-term predictors of vascular events (including recurrent ICH, ischemic stroke, and acute coronary syndrome) in patients who survived more than 30 days after ICH. Across the 307 patients in our analysis, the 5-year mortality rate was 28.01%. Within 5 years after ICH, major vascular events were observed in 62 patients (17.82%, 95% CI 13.78–21.82%). We observed high incidence of recurrent ICH (8.91%) and ischemic stroke (10.06%), but low incidence of acute coronary syndrome (1.15%). Most cases of recurrent ICH (80.65%) occurred within 3 years after ICH. Age ≥56 years and history of ischemic stroke or transient ischemic attack (TIA) were identified as predictors of cardiovascular and cerebrovascular events. ICH survivors are at high risk of both cardiovascular and cerebrovascular events, especially older patients (≥56 years) and those who experienced ischemic stroke or TIA prior to their first ICH. Recurrent ICH is more likely to occur within the first three years after first ICH than at later times. Clinicians should monitor patients closely for adverse events, particularly during the first three years after initial ICH.

Asthma is a respiratory disease with a clinically high incidence, and repeated attacks of asthma severely affect the quality of life and even pose a threat to health, leading to severe burdens on families and even the society. A thorough understanding of the pathogenesis of asthma is essential for the prevention and treatment of asthma. This study aimed to examine the effect of the microRNA miR-27a on asthma and its relationship with mitogen activated protein kinase 4 (MAP2K4). Patients with asthma admitted to our hospital from August 2016 to August 2018 and healthy participants in the same period were included in this prospective analysis. The mRNA expression levels of miR-27a and MAP2K4 in peripheral blood were determined. Airway smooth muscle cells (ASMCs) were used to study the effects of miR-27a and MAP2K4 on cell biological behavior. The relationship between miR-27a and MAP2K4 was verified using dual-luciferase reporter assay. miR-27a expression was increased and MAP2K4 mRNA expression was decreased in asthma (P < 0.05). Increasing miR-27a expression and inhibiting MAP2K4 expression could enhance the activity of ASMCs, whereas inhibiting miR-27a expression and increasing MAP2K4 expression had the opposite effect (P < 0.05). Dual-luciferase reporter assay results showed that the fluorescence activity of MAP2K4-wild type was inhibited by increased miR-27a expression (P < 0.05). miR-27a promotes the proliferation and invasion of ASMCs by targeting MAP2K4 and is involved in the occurrence of asthma.

Background: Suicide is a public health problem in the world. In Chile, suicide rates increased since 1990 with regional differences in rates. Aim: To analyze the geographical distribution of deaths due to suicide that occurred in the Region of Araucanía between the years 2004-2015. Material and Methods: The geographic distribution of suicide in the Araucania Region at district level (2004-2015) was analyzed using death data available at the web page of the Ministry of Health. Socio-demographic variables of suicide were characterized. The spatial distribution of suicide rates was represented using cartography, and suicide spatial clusters were identified through spatial-temporal exploration. Results: There were 1,562 suicides, 86% in men, with a mean rate of 13.07 x105 inhabitants. The highest rates were registered in people aged over 70 years. Most individuals committing suicide were active workers. Hanging was the most common method to accomplish suicide. The territories from the coastal area in Cautín, and Nahuelbuta registered the highest suicide rates. Two statistically significant conglomerates with high incidence of suicide cases were identified. Conclusions: The use of geographic methods and the disaggregation of suicide cases at district level, allowed the identification of territorial variability in the distribution of suicide rates within the Araucanía Region. Spatial patterns of areas with high suicide risk were found.

Acute myeloid leukemia (AML), the most common form of leukemia amongst adults, is one of the most important hematological malignancies. Epidemiological data show both high incidence rates and low survival rates, especially in secondary cases among adults. Although classic and novel chemotherapeutic approaches have extensively improved disease prognosis and survival, the need for more personalized and target-specific methods with less side effects have been inevitable. Therefore, immunotherapeutic methods are of importance. In the following review, primarily a brief understanding of the molecular basis of the disease has been represented. Second, prior to the introduction of immunotherapeutic approaches, the entangled relationship of AML and patient’s immune system has been discussed. At last, mechanistic and clinical evidence of each of the immunotherapy approaches have been covered.

In spite of high incidence of α-thalassemia as the most common inherited disorder of hemoglobin (Hb) production in Southeast Asia, the role of point mutations in this aspect not still well known. This fact can lead to missing rare variants of α-thalassemia mutations by the routine screening, which they may need to be screened for possibility of causing Hb H disease. In this study we found two insertions in alpha1 gene which cause to Hb H disease. One of the insertions, 108/109, is a new findings and another one, codon 44, is the mutation which has been followed for the first time. These new molecular findings about changes in α-globin production which results in decreased of hemoglobin (Hb) value, have high-impact clinical importance.

An assessment of the clinical data and outcome of patients with oesophageal atresia (OA) with very low birth weight (VLBW) was completed.With ethical consent, we reviewed the records of 327 successive patients with OA from 1980 to 2020. Main outcome measures survival and oesophageal repair were compared between patients with VLBW(≤1500 g) and with BW1500 g.Thirty-four (10%) patients had VLBW. Gross types of OA in VLBW were similar as in other patients: A (15%/7%), B (3%/3%), C (78%/82%), D (3%/4%), E (0%/7%), F (0%/1%) (p = 0.16-0.99). In VLBW the incidence of congenital heart disease (CHD) (47%) and trisomy 13/18 and Cri du Chat (15%) were higher than in BW1500 g (23% and 1%), (p = 0.001 both). In VLBW one-month mortality was 35% vs 4% in patients with BW1500 g (p 0.001), overall mortality 56% and 8% (p 0.001), respectively. Cause of one-month mortality in VLBW (12 patients) were CHD w/wo chromosomal abnormality (n = 7), cerebral hemorrhage (n = 2), gastric perforation (n = 1), anastomotic leakage (n = 1) and pulmonary hemorrhage (n = 1). Of VLBW patients 79% and of other patients 99% underwent oesophageal repair (p 0.001). Repair in VLBW patients included early (n = 18) or delayed (n = 5) end-to-end anastomosis and reconstruction (n = 4). Anastomotic complications occurred in 24% of patients with VLBW and in 17% with BW1500 g, (p = 0.31). From 1980-2000 to 2001-2020 survival in VLBW changed from 11% to 81% (p = 0.002). During 2001 - 2020 all VLBW patients underwent repair.OA with VLBW had high incidence of life-threatening associated anomalies and decreased survival. Recently survival and rate of oesophageal repair have improved significantly.

Most international clinical guidelines recommend 5–10 mm clinical margins for excision of melanoma in situ (MIS). While the evidence supporting this is weak, these guidelines are generally consistent. However, as a result of the high incidence of subclinical extension of MIS, especially of the lentigo maligna (LM) subtype, wider margins will often be needed to achieve complete histologic clearance. In this review, we assessed all available contemporary evidence on clearance margins for MIS. No randomized trials were identified and the 31 non-randomized studies were largely retrospective reviews of single-surgeon or single-institution experiences using Mohs micrographic surgery (MMS) for LM or staged excision (SE) for treatment of MIS on the head/neck and/or LM specifically. The available data challenge the adequacy of current international guidelines as they consistently demonstrate the need for clinical margins > 5 mm and often > 10 mm. For LM, any MIS on the head/neck, and/or ≥ 3 cm in diameter, all may require wider clinical margins because of the higher likelihood of subclinical spread. Histologic clearance should be confirmed prior to undertaking complex reconstruction. However, it is not clear whether wider margins are necessary for all MIS subtypes. Indeed, it seems that this is unlikely to be the case. Until optimal surgical margins can be better defined in a randomized trial setting, ideally controlling for MIS subtype and including correlation with histologic excision margins, techniques such as preliminary border mapping of large, ill-defined lesions and, most importantly, sound clinical judgement will be needed when planning surgical clearance margins for the treatment of MIS.

Optic neuritis is an ocular disorder whose pathogenesis has not been fully determined, although autoimmune mechanisms have been suggested to be involved in its development. In recent years, anti-aquaporin-4 antibody (AQP4-Ab) and anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab) have been shown to play major roles in the development of optic neuritis. Because these two antibodies target different tissues, optic neuritis can be classified by the type of antibody. AQP4-Ab-positive optic neuritis responds poorly to steroid therapy and has a poor prognosis in terms of visual acuity. On the other hand, MOG-Ab-positive optic neuritis responds favorably to steroid therapy but is likely to recur when the dosage of steroids is reduced or discontinued. We first present the high incidence of idiopathic optic neuritis and discuss these relatively newer disease concepts of AQP4-Ab-positive optic neuritis and MOG-Ab-positive optic neuritis.

Bovine tuberculosis (bTB) is mainly caused by Mycobacterium bovis. In Mexico, dairy cattle play an important role in the persistence and spread of the bacillus. In order to describe M. bovis genetic diversity, we genotyped a total of 132 strains isolated from slaughtered cattle with bTB suggestive lesions between 2009 and 2010 in Hidalgo, Mexico, using a panel of 9-loci mycobacterial interspersed repetitive unit-variable number of tandem repeats (MIRU-VNTR) and spoligotyping. We found 21 spoligotypes, and 124 isolates were grouped in 13 clusters. The most frequent spoligotypes were SB0121 (49, 37.1%) and SB0673 (27, 20.5%); three new spoligotypes were reported SB02703, SB02704 and SB02705. We observed 37 MIRU-VNTR patterns, 107 isolates were grouped in 12 clusters and 25 isolates were unique. Spoligotypes SB0121, SB0673, SB0140, SB0145 and SB0120 showed marked subdivision applying MIRU-VNTR method; meanwhile, spoligotypes SB0971 and SB0327 showed single MIRU-VNTR profiles. The Hunter-Gaston discriminatory index (HGDI) was 0.88, 0.78 and 0.90 for 9-loci MIRU-VNTR, spoligotyping and both methods, respectively. Additionally, allelic diversity (h) analysis showed high diversity for QUB3232, QUB26 and QUB11b with h = 0.79, 0.66 and 0.63, respectively. Overall, high genetic variability was observed among M. bovis isolates. Thus, the use of 9-loci MIRU-VNTR panel is enough to describe genetic diversity, evolution and distribution of M. bovis. This study supports the use of these tools for subsequent epidemiological studies in high incidence areas.

Pneumoconiosis refers to a spectrum of pulmonary diseases caused by inhalation of mineral dust, usually as the result of certain occupations. The main pathological features include chronic pulmonary inflammation and progressive pulmonary fibrosis, which can eventually lead to death caused by respiratory and/or heart failure. Pneumoconiosis is widespread globally, seriously threatening global public health. Its high incidence and mortality lie in improper occupational protection, and in the lack of early diagnostic methods and effective treatments. This article reviews the epidemiology, safeguard procedures, diagnosis, and treatment of pneumoconiosis, and summarizes recent research advances and future research prospects.

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.

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

For almost 20 years, therapeutic hypothermia has been a cornerstone of modern post-cardiac arrest care lowering mortality, and improvin neurologic outcome compared to conventional therapy. This was challenged by the first TTM-trial in 2013, which did not show a benefit for hypothermia at 33°C compared to controlled normothermia at 36°C. Now, the TTM2 trial showed no benefit of hypothermia compared to fever prevention alone. While TTM1 and TTM2 suggest that hypothermia might not be helpful, a deep dive into the trials reveals that this conclusion does not hold true. Here, we focus on patient selection, suboptimal application of hypothermia, interaction of standard sedation with hypothermia, high incidence of post-arrest fever, and withdrawal of life support based on per-protocol neurologic prognostication in the TTM2-trial. Of particular interest, contemporary trials and registries using intravascular cooling in TTM-like patients repeatedly reported much lower mortality rates than those described in both TTM1 and TTM2.

Made available in DSpace on 2022-04-29T08:29:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-02-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Low-to-middle-income countries often have high incidence of surgical site infection (SSI). To assess spatial and sociodemographic predictors of SSI rates, this study analysed and georeferenced governmental surveillance data from 385 hospitals located in inner São Paulo State, Brazil. In multi-variate models, SSI rates were positively associated with distance from the state capital [incidence rate ratio (IRR) for each 100 km 1.19, 95% confidence interval (CI) 1.07–1.32], and were lower for non-profit (IRR 0.95, 95% CI 0.37–0.85) and private (IRR 0.47, 95% CI 0.31–0.71) facilities compared with public hospitals. Georeferencing results reinforced the need to direct SSI-prevention policies to hospitals located in areas distant from the state capital. Department of Infectious Diseases Botucatu School of Medicine São Paulo State University Department of Biostatistics Botucatu Institute of Biosciences São Paulo State University Center for Epidemiological Surveillance São Paulo State Health Department Department of Infectious Diseases Botucatu School of Medicine São Paulo State University Department of Biostatistics Botucatu Institute of Biosciences São Paulo State University FAPESP: 2019/18775-5

This article covers an important subject clinical course of arterial hypertension in patients with metabolic abnormalities with obesity and anxiety-depressive disorders. Relevance of this topic is defined with high incidence of each aforementioned conditions and their influence on quality of life and social functioning of patients. Review of literature covers subjects of comorbidity and multimorbidity. Relevant data are presented which are focusing on complex management of arterial hypertension co-existing with obesity and anxiety-depressive disorders.В обзорной статье рассматривается важная проблема течение артериальной гипертензии у пациентов с ожирением и тревожно-депрессивными расстройствами. Актуальность рассматриваемой темы определяется значительной частотой возникновения каждого из этих патологических состояний, а также их влиянием на качество жизни и социальное функционирование пациентов. В статье освещаются проблемы коморбидности и мультиморбидности. Представлены данные литературы по комплексному лечению артериальной гипертензии, сочетающейся с ожирением и тревожно-депрессивными расстройствами с использованием антидепрессантов.

Coronavirus infection has a multiple im - pact on the coagulation system and anti - coagulant therapies. Patients admitted with COVID-19 have un - usually high incidence of coagulation ab - normalities. The incidence of atrial fibrillation (AF) seems also to be more frequent among COVID-19 out- and especially inpatients. Among COVID-19 patients receiving oral anticoagulant therapy, for minimizing the risk of bleeding or thromboembolic complications there should also be considered the renal and hepatic functions and drugdrug interactions of oral anticoagulant and COVID-19 therapy. In case of direct anticoagulants, in addition to the benefits of better safety, more favorable treatment ad - he rence, and fixed dosing, the use of this class of drugs does not require laboratory mo nitoring of efficacy, which may be of exp licit benefit in terms of social distancing and health network burdens. This study reviews the possible interactions of drugs used for viral infection and anticoagulation, and in addition to the issues of coagulopathy associated with COVID-19, we discuss also the concerning difficulties of continued anticoagulant therapy related to the social distancing measures. © 2021 Literatura Medica Publishing House. All rights reserved.

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.

Ciprofloxacin belongs to the fluoroquinolone family, which exhibits biological activity against both gram-positive and gram-negative bacteria. The previously mentioned drug is of utmost importance due to the high incidence of resistance caused by other antibiotics. Thus, numerous research studies has been conducted to determine Ciprofloxacin as well as its metabolites owing to their contribution in the drug’s biological activity. Liquid chromatography, gas chromatography, capillary electrophoresis and other separation techniques were used to develop, adapt and implement analytical techniques for the drug analysis. Other studies has made use of the hyphenation between liquid chromatography and mass spectrometry for Ciprofloxacin assay for quality control, biological fluids, animal tissues and numerous sample types. The recent advances in the ionization methods has led to the use of direct mass spectrometry techniques to analyze various sample types. This mini review aims to focus on the various analytical techniques and recent technologies implemented for Ciprofloxacin analysis.

O câncer colorretal (CCR) é uma neoplasia de alta incidência em todo o mundo. Corresponde a terceira causa de morte oncológica em países industrializados. No Brasil, segundo as estatísticas do Instituto Nacional de Câncer (INCA), a neoplasia maligna colorretal é a quarta causa de óbitos por câncer em homens e a terceira causa em mulheres. Dessa forma sendo considerado um dos mais importantes problemas de saúde pública mundial. O presente estudo tem por objetivo comprovar os fatores que influenciam no prognóstico dessa doença, incluindo margem de ressecção circunferencial, invasão linfovascular e onvasão perineural. Tais fatores são fundamentais para o melhor manejo desses pacientes, e consequentemente a redução da taxa de mortalidade.

Background Extrahepatic biliary duct injury (BDI) remains a complicated issue for surgeons. Although several approaches have been explored to address this problem, the high incidence of complications affects postoperative recovery. As a nonimmunogenic scaffold, an animal-derived artificial bile duct (ada-BD) could replace the defect, providing good physiological conditions for the regeneration of autologous bile duct structures without changing the original anatomical and physiologic conditions. Aim To evaluate the long-term feasibility of a novel heterogenous ada-BD for treating extrahepatic BDI in pigs. Methods Eight pigs were randomly divided into two groups in the study. The animal injury model was developed with an approximately 2 cm segmental defect of various parts of the common bile duct (CBD) for all pigs. A 2 cm long novel heterogenous animal-derived bile duct was used to repair this segmental defect (group A, ada-BD-to-duodenum anastomosis to repair the distal CBD defect; group B, ada-BD-to-CBD anastomosis to repair the intermedial CBD defect). The endpoint for observation was 6 mo (group A) and 12 mo (group B) after the operation. Liver function was regularly tested. Animals were euthanized at the above endpoints. Histological analysis was carried out to assess the efficacy of the repair. Results The median operative time was 2.45 h (2-3 h), with a median anastomosis time of 60.5 min (55-73 min). All experimental animals survived until the endpoints for observation. The liver function was almost regular. Histologic analysis indicated a marked biliary epithelial layer covering the neo-bile duct and regeneration of the submucosal connective tissue and smooth muscle without significant signs of immune rejection. In comparison, the submucosal connective tissue was more regular and thicker in group B than in group A, and there was superior integrity of the regeneration of the biliary epithelial layer. Despite the advantages of the regeneration of the bile duct smooth muscle observed in group A, the effect on the patency of the ada-BD grafts in group B was not confirmed by macroscopic assessment and cholangiography. Conclusion This approach appears to be feasible for repairing a CBD defect with an ada-BD. A large sample study is needed to confirm the durability and safety of these preliminary results.

Sink-bathing is common practice among parents. However, this puts infants and young children at unrecognized risk for burn injuries. As the only verified pediatric burn center in a large urban area, we treat burn patients from a large variation in socioeconomic status. This provides us a unique opportunity to examine sink-burn injury patterns, circumstances surrounding these burns, identify areas with high incidence and put in place an injury prevention outreach initiative. This retrospective study included patients treated for sink-bathing burns at our burn center in an 8.5-year period. Analysis of 71 patients revealed infants under one year of age are most commonly afflicted. Additionally, that families of low-socioeconomic means are disproportionately affected. Understanding the different circumstances surrounding sink-bathing burns allows us to be more specific in our community education efforts and efficiently guide our resources.

Hypertension is a chronic disease. The high incidence of hypertension currently requires commitment to achieving sustainable management of hypertension. One way to achieve it is by providing adequate support for patient self-care management. Success in self-care management is influenced by several factors, such as age, sex, education, and family support. Lack of family support as identified in previous studies was the concern that motivated the researchers in the present study to investigate the aspect of family support further. Family influences patients' decision-making, and has an important role to support the patient. This study aimed to identify family's level of knowledge, attitude, and behavior in supporting hypertensive patients' self-care management. The respondents were 90 family members of hypertensive patients of three community health care centers in Denpasar. The sample was picked using a consecutive sampling technique. Data were collected using a questionnaire and observation form. The findings of this study show that 68.9% of the respondents had good knowledge, 46.7% had a moderate attitude, and 62.2% showed a behavior that supports patient self-care management.

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 Parastomal hernia is a type of incisional hernia occurring in abdominal integuments in the vicinity of a stoma. The best surgical approach for PSH remains controversial. Most studies report short follow-up time after surgery and a low number of cases to allow conclusions. Actually, we don't have a relevant recommendation about an optimal surgical technique or the most effective mesh for PSH repair. Presentation of the case Once packaged the latero-lateral mechanical anastomosis to restore the continuity of the intestinal tract of the patient, an adequate disinfection of trough of the stoma was done. The lateral and medial margins of the defect are then transposed towards each other and kept side by side with a gripper; a 60 mm tristaple linear stapler was placed, incorporating both edges and the charge is fired to obtain a perfect synthesis of the retromuscular plane. Discussion In the literature has been described several surgical techniques for its repair: suture repair, relocation, mesh-based technique with open or laparoscopic approach. Both, the simple corrective surgery of Thorlakson in 1965 and the use of the peritoneomuscular flap for closing the defect, suggested by Bewes, led to high incidence of recurrence. An important reduction in the rate of parastomal hernia derives also from the mesh reinforcement of the stoma trephine. Conclusion The authors suggest that this technique should be help the surgeons to repair parastomal hernia in patients with multiple risk factors to develop a recurrence of parastomal hernia., Highlights • The best surgical approach for Parastomal Hernia repair (PSH) remains controversial. • Causes that predispose to the development of incisional hernia are multiple, such as obesity and diabetes. • This technique may help the surgeons to repair the PSH in patients with risk factors to develop a recurrence after surgery.

BackgroundThere is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years.MethodsRetrospective, single centre study from the North West of England, newly diagnosed with type 1 diabetes between 2014 and 2018 (n= 58). HbA1c, blood pressure, lipids and body mass index (BMI) data were collected from electronic patient records from the time of diagnosis until the end of 2 years, stratified by age 16–24 years or ≥ 25 years at presentation.ResultsFor those aged 16–24 years (n= 31), median (IQR), HbA1c improved at 6 months from 83 (63–93) to 51.5 (46–75) mmol/mol (p= 0.001) and remained stable 6–24 months. For those ≥ 25 years (n= 27), HbA1c declined from 91 (70–107) to 65 (50–89) mmol/mol, (p< 0.01) at 6 months and declined further to 52 mmol/mol (44–70) at 24 months. At 24 months, 27.8% of all individuals had an HbA1c ≥ 69 mmol/mol. Approximately, a third met LDL (< 2 mmol/L) and total cholesterol (< 4 mmol/L) targets. A total of 58.6% of individuals were overweight/obese (BMI > 25 kg/m2) at 24 months compared to 45.8% at baseline. There were no significant blood pressure changes during the follow-up.ConclusionsIn both age groups, significant improvement of HbA1c occurred within the first 6 months of diagnosis with no statistical difference between the two groups at any of the time points up to 24 months. Despite significant improvements in HbA1c, majority had levels > 53 mmol/mol at 24 months. Alongside the high incidence of obesity and dyslipidaemia, our data support the need for further intensification of therapy from diagnosis of type 1 diabetes.

Background Malaria remains a significant public health concern in Indonesia. Knowledge about spatial patterns of the residual malaria hotspots is critical to help design elimination strategies in Kotabaru district, South Kalimantan, Indonesia. Methods Laboratory-confirmed malaria cases from 2012 to 2016 were analysed to examine the trend in malaria cases. Decomposition analysis was performed to assess seasonality. Annual spatial clustering of the incidence and hotspots were identified by Moran's I and the local indicator for spatial association, respectively. Results The annual parasite incidence of malaria was significantly reduced by 87% from 2012 to 2016. Plasmodium vivax infections were significantly much more prevalent over time, followed by Plasmodium falciparum infections (p Conclusions A spatially explicit decision support system is needed to support surveillance and control programs in the identified high-risk areas to succeed in the elimination goal of 2030.

Head and neck squamous cell carcinoma (HNSCC) is a malignancy with relatively high incidence and poor prognosis. RNA-binding proteins (RBPs) were reported to be dysregulated in multiple cancers and were closely associated with tumor initiation and progression. However, an integrated analysis of the roles of RBPs in HNSCC has not been conducted. In the present study, we obtained transcriptome data and corresponding clinical information of HNSCC patients from The Cancer Genome Atlas database and screened out differentially expressed RBPs between tumor and normal tissues. Subsequently, we utilized a series of bioinformatics analyses to elucidate the potential functions and prognostic value of these RBPs in HNSCC. As a result, a total of 88 aberrantly expressed RBPs were identified, including 63 downregulated and 25 upregulated RBPs. Functional enrichment analysis suggested that the differentially expressed RBPs mainly participated in mRNA metabolic processes, RNA processing, RNA transport, regulation of RNA stability, RNA degradation, and mRNA surveillance pathway. Three RBP genes (

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.

Decitabine is a hypomethylating drug that is used to treat myelodysplastic syndrome (MDS) at a recommended dose and schedule (20 mg/m2 per day, for 5 consecutive days). However, due to its relatively high incidence of side effects and its effects on neoplastic cells, many studies have begun to explore the clinical application of a low dose of decitabine for treating MDS. In this retrospective study, we examined the effects of a very-low-dose decitabine schedule for treating MDS. A total of 13 patients diagnosed with de novo MDS received a schedule of intravenous decitabine administration at 6 mg/m2 per day for 7 days, repeated every 4 weeks. The complete response rate was 30.8%, and the overall response rate was 69.2%. In patients with complete remission, the median time to granulocyte recovery greater than 0.5 × 109/L during complete remission (CR) was 15 days. In patients with remission, the median time to granulocyte recovery greater than 0.5 × 109/L was 10.5 days. The 1-year survival rate was 72.7% and the median survival was 28.0 months. In summary, we demonstrated that a very-low-dose decitabine schedule has an appreciable response and survival rate, as well as appreciable tolerance and medical compliance for treating MDS.

This meta-analysis explores the role of the posterior cerebellum Crus I/II in social mentalizing. We identified over 200 functional magnetic resonance imaging (fMRI) studies via NeuroSynth that met our inclusion criteria and fell within bilateral Crus II areas related to ‘sequencing’ during mentalizing (coordinates ±24 −76 −40; from earlier studies) and mere social ‘mentalizing’ or self-related emotional cognition (coordinates ±26 −84 −34; from NeuroSynth), located in the cerebellar mentalizing network. A large majority of these studies (74%) involved mentalizing or self-related emotional cognition. Other functions formed small minorities. This high incidence in Crus II compares very favorably against the lower base rate for mentalizing and self-related emotions (around 35%) across the whole brain as revealed in NeuroSynth. In contrast, there was much less support for a similar role of Crus I (coordinates −40 −70 −40 from earlier ‘sequencing’ studies) as only 35% of the studies were related to mentalizing or self-related emotions. The present findings show that a domain-specific social mentalizing functionality is supported in the cerebellar Crus II. This has important implications for theories of the social cerebellum focusing on sequencing of social actions, and for cerebellar neurostimulation treatments.

Management of the pediatric burn patient presents a variety of clinical challenges for the pediatric anesthesiologist. Despite the high incidence of burn injuries, standard management strategies are far from universal. The complex physiologic changes presented by burn injuries present airway management and resuscitation challenges and mandate careful consideration of adequate nutritional support. Long hospital stays with frequent operations and dressing changes necessitate creative approaches to anxiolysis and pain control. Underutilized modalities warranting further research include regional anesthesia and nonpharmacologic approaches, such as virtual reality. Further research and collaboration between burn centers are needed to standardize care for this population.

We detected 213 lodging QTLs and demonstrated that drought-induced stem lodging in grain sorghum is substantially associated with stay-green and plant height suggesting a critical role of carbon remobilisation. Sorghum is generally grown in water limited conditions and often lodges under post-anthesis drought, which reduces yield and quality. Due to its complexity, our understanding on the genetic control of lodging is very limited. We dissected the genetic architecture of lodging in grain sorghum through genome-wide association study (GWAS) on 2308 unique hybrids grown in 17 Australian sorghum trials over 3 years. The GWAS detected 213 QTLs, the majority of which showed a significant association with leaf senescence and plant height (72% and 71%, respectively). Only 16 lodging QTLs were not associated with either leaf senescence or plant height. The high incidence of multi-trait association for the lodging QTLs indicates that lodging in grain sorghum is mainly associated with plant height and traits linked to carbohydrate remobilisation. This result supported the selection for stay-green (delayed leaf senescence) to reduce lodging susceptibility, rather than selection for short stature and lodging resistance per se, which likely reduces yield. Additionally, our data suggested a protective effect of stay-green on weakening the association between lodging susceptibility and plant height. Our study also showed that lodging resistance might be improved by selection for stem composition but was unlikely to be improved by selection for classical resistance to stalk rots.

O presente estudo teve por objetivo avaliar a presença de LER/DORT (lesões por esforços repetitivos/distúrbios osteomusculares relacionados ao trabalho) entre os funcionários dos serviços gerais do Campus Dom Bosco da Universidade Federal de São João del-Rei. Trata-se de um estudo original, com delineamento transversal, em que a amostra foi composta por 24 funcionários, os quais foram submetidos à aplicação de uma ficha de anamnese, avaliação postural e realização de testes clínico-ortopédicos específicos. Os dados foram analisados pelo programa GrhamPrism 5.0, considerando o nível de significância de 5%. Os resultados demonstraram que existe alta incidência de distúrbios musculoesqueléticas entre os funcionários avaliados. As alterações posturais mais encontradas foram: as protrusões e inclinações da cabeça, elevações dos ombros, escápulas elevadas e aladas, hipercifose torácica, retificação torácica, hiperlordose lombar, escoliose, joelhos em valgo, varo e recurvatum e calcâneosem valgo. Deste modo, infere-se que a alta incidência de alterações posturais pode estar relacionada a atividade exercida pelo servidor, bem como a postura que este adota ao realizar tais atividades. Tal fato aponta a necessidade da realização de intervenções terapêuticas e preventivas que visem minimizar e prevenir tais danos nessa população.

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.