Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves co...Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves complex interactions between environmental and host factors,leading to chronic inflammation and tissue remodeling.Purpose of review:This narrative review synthesizes recent research on the predisposing factors of CRS and their potential influence on disease endotypes,aiming to enhance understanding of this multifaceted condition.Recent findings:Identified predisposing factors include allergy,asthma,immune deficiency,gastroesophageal reflux,nasal anatomical variations,microbial infections,and others.Bacteria and biofilms,particularly Staphylococcus aureus,are significant in disease onset and severity.Immune deficiency may predispose individuals to CRS,and NSAID-exacerbated respiratory disease(N-ERD)is associated with more severe symptoms.Gastroesophageal reflux disease(GERD)and primary ciliary dyskinesia(PCD)also contribute to CRS development,with PCD leading to impaired mucociliary clearance and chronic inflammation.Conclusion:CRS is a multifactorial disease with various predisposing factors influencing its development and endotypic classification.Understanding these factors and their interactions with the immune system is crucial for developing targeted treatments and improving patient outcomes.展开更多
Work-related diseases can have health consequences including stress- and mental health-related disorders, musculoskeletal disorders, and cancer and skin complaints due to exposure to biological agents. We aimed to inv...Work-related diseases can have health consequences including stress- and mental health-related disorders, musculoskeletal disorders, and cancer and skin complaints due to exposure to biological agents. We aimed to investigate the prevalence of work-related diseases among bank employees and the independent risk factors for these diseases and to highlight measures that can be taken to prevent the occurrence of such diseases, to improve holistic health, and to raise awareness about work-related disease. Data were collected during face-to-face interviews (n = 796) in the recruitment phase of an international public bank in Istanbul, Türkiye or during periodic examinations in the bank between 2017 and 2019. Data, including socio-demographic characteristics, medical anamneses, physical examination results, laboratory findings, occupational accidents, and occupational disease frequency data, were retrospectively examined, and the results were statistically evaluated. Data were analyzed using the SPSS Statistics 17.0 (IBM Corporation, Armonk, NY, USA) package program. Results were considered statistically significant at p < 0.05. Age, female gender, dust exposure, vibration in the workplace were found to be significantly associated with musculoskeletal disorders, while age and work-related noise was found to be related to digestive system problems and dust exposure had significant relation with psychiatric disorders. Work-related diseases among bank employees are a priority that should be addressed by all relevant authorities to enable people to lead healthy lives in physical, mental, spiritual, and social terms.展开更多
AIM: To evaluate the predisposing factors for peritoneal perforation and intrabiliary rupture and the effects of these complications on surgical outcome in liver hydatid disease.METHODS: A total of 372 patients with l...AIM: To evaluate the predisposing factors for peritoneal perforation and intrabiliary rupture and the effects of these complications on surgical outcome in liver hydatid disease.METHODS: A total of 372 patients with liver hydatid cysts who had undergone surgical treatment were evaluated retrospectively. Twenty eight patients with peritoneal perforation, 93 patients with spontaneous intrabiliary perforation, and 251 patients with noncomplicated hydatid cysts were treated in our clinics.RESULTS: When the predisposing factors for complications were evaluated, younger age, superf icial position, and larger cyst dimensions (P < 0.05; range, 0.0010.017) increased peritoneal perforation rates. It was shown that older age increased cyst dimensions, and presence of multiple and bilobar cysts increased intrabiliary rupture rates (P < 0.05; range, 0.0010.028). Partial pericystectomy and drainage was the most frequent surgical procedure in all groups (71.6%). The incidence of postoperative complications in the peritoneal perforated group, in the intrabiliary ruptured group, and in the noncomplicated group was 25%, 16.1% and 5.5%, respectively. When compared, complication rates were significantly different (P = 0.002). When length of hospital stay was compared, there was no signif icant difference between the groups (P > 0.05). The overall recurrence rate was 3.8% (14 patients), but there was not any statistical difference among the patient groups (P = 0.13). The early postoperative mortality rate was 1.1%. CONCLUSION: In peritoneally perforated and intrabiliary ruptured cases, the most important steps are irrigation of the peritoneal cavity and clearance of the cystic material from the biliary tree.展开更多
Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives:...Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives: To determine the predisposing factors and predominant microbiological diagnosis of corneal ulcers seen at the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria. Materials and Methods: This is a preliminary report of an on-going longitudinal descriptive study of all consenting corneal ulcer patients managed at the FETHA eye clinic over a 4-month period. Information obtained were socio-demographic data, presenting complaints, duration of symptoms prior to presentation, history of preceding trauma, medications used before presentation, presenting and final visual acuity and microbiological diagnosis. Results: A diagnosis of corneal ulcer was made in 8 out of the 852 outpatients seen over the study period giving a hospital prevalence rate of 0.59%. Five patients (62.50%) were males, five (62.50%) were farmers and 4 patients (50%) were above 60 years of age. The microbial diagnoses were bacterial keratitis 37.5% (Staphylococcus aureus), fungal keratitis 25% (Fusarium spp. and aspergillus) and acanthamoeba (25%). None of the patients ever used contact lenses. There was a history of eye trauma in 50% of the patients. All the eyes presented blind after a period of failed attempts to treat by self or quacks. Mean duration before presentation was two weeks. Treatment improved the visual acuity in 37.5% of patients. Conclusion: Bacteria, fungi and acanthamoeba organisms were the microbiological isolates from the scrapings of corneal ulcer patients seen in the eye clinic of FETHA;with bacterial organisms being the most common. Farming activities, preceding eye trauma, delayed presentation, self-medication and use of traditional eye medications (TEM) were common findings among the patients. A future larger study is recommended to confirm the findings of this study. Eye health education campaigns should be directed at farmers to encourage early presentation to hospitals.展开更多
Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff ...Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.展开更多
AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospit...AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediatelyprocessed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients(41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones(n = 46; 56.8%) benign stricture(n = 29; 35.8%) and malignancy(n = 6; 7.4%) with cholangitis in 50(61.7%) patients. The retrieved stent sizes were 7 Fr(n = 62; 76.5%) and 10 Fr(n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas(n = 38), Citrobacter(n = 23), Klebsiella(n = 22), Staphylococcus(n = 20), Serratia(n = 16), Escherichia coli(n = 14), Streptococcus(n = 13), Enterococcus(n = 13), Aeromonas(n = 12), Proteus(n = 10) and Enterobacter(n = 9). Protein concentration according to gender(0.547 ± 0.242 mg/ml vs 0.458 ± 0.259 mg/ml; P = 0.115) as well as age > 60 years and < 60 years(0.468 ± 0.295 mg/ml vs 0.386 ± 0.238 mg/ml; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender(0.052 ± 0.021 mg/ml vs 0.049 ± 0.016 mg/ml; P < 0.0001) and age(0.051 ± 0.026 mg/ml vs 0.038 ± 0.016 mg/ml; P < 0.011). Protein concentration in the biofilm was significantly higher(0.555 ± 0.225 mg/ml vs 0.419 ± 0.276 mg/ml; P = 0.018) in patients with cholangitis, lower(0.356 ± 0.252 mg/ml vs 0.541 ± 0.238 mg/ml; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher(0.609 ± 0.240 mg/ml vs 0.476 ± 0.251 mg/ml; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration.CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. longer indwelling duration had more biofilm formation.展开更多
Atrial fibrillation （AF） is the most frequent arrhythmia. Due to population aging, AF is a growing epidemic and its importance will continue to increase in the next decades. Although the prevalence of AF is high in ...Atrial fibrillation （AF） is the most frequent arrhythmia. Due to population aging, AF is a growing epidemic and its importance will continue to increase in the next decades. Although the prevalence of AF is high in advanced age, the number of subjects with predisposing factors for AF is even higher. Most of these factors increase the risk of atrial fibro- sis, an important component of atrial arrhythmia mecha- nisms. In fact, the new techniques to detect atrial fibrosis are showing the strong association between atrial fibrosis and AF risk. Regarding predisposing factors for AF, interatrial block （LAB） seems to be a key factor.展开更多
AIM： To analyze the epidemiological, clinical and laboratory findings of infectious keratitis.METHODS： A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was...AIM： To analyze the epidemiological, clinical and laboratory findings of infectious keratitis.METHODS： A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols.RESULTS： Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor （51.4%）, followed by diabetes mellitus （15.1%）. Cultures were positive in 110 scraping samples （44.5%）： 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 （4.5%） samples. The most common fungal pathogen was Aspergillus spp. （41%）. The most common bacterial isolates were Staphylococcus aureus （38.2%） and Pseudomonas aeruginosa （21.8%）.CONCLUSION： Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration.展开更多
Objective:This study aimed to identify the influence of predisposing,enabling,and reinforcing factors and the adherence to medication behavior among tuberculosis patients in Selogiri Wonogiri Public Health Center.Meth...Objective:This study aimed to identify the influence of predisposing,enabling,and reinforcing factors and the adherence to medication behavior among tuberculosis patients in Selogiri Wonogiri Public Health Center.Methods:This study employed a descriptive cross-sectional research design.A questionnaire was used to collect primary data.Secondary data were obtained from patient treatment cards(Form TB 01).This research was carried out at Selogiri Health Center from November to December 2017.The participants were patients,both new and old patients,who had completed their treatment in the last 2 months or more,recorded from January 2016 to December 2017.A total sampling technique was used in this study.Logistic regression analysis was used to analyze the influence of predisposing,enabling,and reinforcing factors and the adherence to medication among tuberculosis patients.Results:The results of logistic regression analysis indicated that there were four independent variables that have a significant relationship with treatment variables,namely education(odds ratio(OR)=0.025;95%confidence interval(CI)=0.001-0.039);knowledge(OR=3.37;95%CI=0.19-57.71);type of drug(OR=0.448;95%CI=0.012-16.07),and means of transportation(OR=25.77;95%CI=1.33-500.47).Conclusions:Education,knowledge,type of drug,and means of transportation influence medication compliance among tuberculosis patients.Therefore,supporting patients during medication program of tuberculosis is needed to improve their adherence medication during multidrug therapy.展开更多
BACKGROUND Patients admitted to intensive care unit(ICU) after cardiac surgery develop acute kidney injury(AKI) immediately post-operation. We hypothesized that AKI occurs mainly due to perioperative risk factors and ...BACKGROUND Patients admitted to intensive care unit(ICU) after cardiac surgery develop acute kidney injury(AKI) immediately post-operation. We hypothesized that AKI occurs mainly due to perioperative risk factors and may affect outcome.AIM To assess peri-operative risk factors for AKI post cardiac surgery and its relationship with clinical outcome.METHODS This was an observational single center, tertiary care setting study, which enrolled 206 consecutive patients, admitted to ICU after cardiac surgery. Patients were followed-up until ICU discharge or death, in order to determine the incidence of AKI, perioperative risk factors for AKI and its association with outcome.Univariate and multivariate logistic regression analysis was performed to assess predictor variables for AKI development.RESULTS After ICU admission, 55 patients(26.7%) developed AKI within 48 h. From the logistic regression analysis performed, high EuroScore Ⅱ(OR: 1.18;95%CI: 1.06-1.31, P = 0.003), white blood cells(WBC) pre-operatively(OR: 1.0;95%CI: 1.0-1.0, P = 0.002) and history of chronic kidney disease(OR: 2.82;95%CI: 1.195-6.65, P = 0.018) emerged as independent predictors of AKI among univariate predictors. AKI that developed AKI had longer duration of mechanical ventilation [1113(777–2195) vs 714(511–1020) min, P = 0.0001] and ICU length of stay [70(28–129) vs 26(21–51) h, P = 0.0001], higher rate of ICU-acquired weakness(16.4% vs 5.3%, P =0.015), reintubation(10.9% vs 1.3%, P = 0.005), dialysis(7% vs 0%, P = 0.005), delirium(36.4% vs 23.8%, P = 0.001) and mortality(3.6% vs 0.7%, P = 0.046).CONCLUSION Patients present frequently with AKI after cardiac surgery. EuroScore Ⅱ, WBC count and chronic kidney disease are independent predictors of AKI development. The occurrence of AKI is associated with poor outcome.展开更多
This research describes a quantitative,rapid,and low-cost methodology for debris flow susceptibility evaluation at the basin scale using open-access data and geodatabases.The proposed approach can aid decision makers ...This research describes a quantitative,rapid,and low-cost methodology for debris flow susceptibility evaluation at the basin scale using open-access data and geodatabases.The proposed approach can aid decision makers in land management and territorial planning,by first screening for areas with a higher debris flow susceptibility.Five environmental predisposing factors,namely,bedrock lithology,fracture network,quaternary deposits,slope inclination,and hydrographic network,were selected as independent parameters and their mutual interactions were described and quantified using the Rock Engineering System(RES)methodology.For each parameter,specific indexes were proposed,aiming to provide a final synthetic and representative index of debris flow susceptibility at the basin scale.The methodology was tested in four basins located in the Upper Susa Valley(NW Italian Alps)where debris flow events are the predominant natural hazard.The proposed matrix can represent a useful standardized tool,universally applicable,since it is independent of type and characteristic of the basin.展开更多
AIM:To study and compare the predisposing factors and clinical features of pediatric,adult,and elderly rhegmatogenous retinal detachment(RRD).METHODS:This is an observational analytic crosssectional study in which pat...AIM:To study and compare the predisposing factors and clinical features of pediatric,adult,and elderly rhegmatogenous retinal detachment(RRD).METHODS:This is an observational analytic crosssectional study in which patients with RRD admitted for surgery during 6mo period were divided into 3 age groups:pediatric(<18y),adult(18-60y),and elderly(>60y).Patients’demographic data,clinical features,RRD predisposing factors/features including myopia(axial length≥26.5 mm),aphakia/pseudophakia,blunt trauma,peripheral retinal degenerations,history of RRD in the fellow eye,and surgical interventions/findings were recorded and analyzed.RESULTS:Totally 142 patients(142 eyes)were studied:26(18.31%)pediatrics,86(60.56%)adults,and 30(21.13%)elderly.Elderly patients had a significantly higher intraocular pressures and cataracts compared to the other 2 groups(P=0.04).The RRD extent was larger in pediatric group(mostly 4 quadrants)compared to adults and elderly(mostly 2 quadrants),but it was not statistically insignificant(P=0.242).There were not statistically significantly differences in proliferative vitreoretinopathy(PVR)rate,posterior vitreous detachment(PVD)rate,number,site,shape,and size of breaks in three groups.All three groups had macular detachment in all eyes.Myopia and peripheral retinal degenerations were found to be more significant in adults(P=0.049,P=0.035,respectively),while blunt trauma was higher but insignificant in pediatric eyes(P=0.052).Pars plana vitrectomy(PPV)with silicone oil as a tamponade was the most used surgery in all groups.CONCLUSION:There are no significant difference in PVR rate in pediatric eyes but a significant higher rate of total RRD.Blunt trauma is more frequent in pediatrics eyes while myopia and/or peripheral retinal degenerations are more frequent in older ages.The rate of PPV as a choice for surgery is similar among all age groups.展开更多
The Mako area located in the region of Kedougou is characterized by very hilly terrains with hardly accessible zones. This situation makes it difficult to map these terrains and exposes the populations to the permanen...The Mako area located in the region of Kedougou is characterized by very hilly terrains with hardly accessible zones. This situation makes it difficult to map these terrains and exposes the populations to the permanent risk of a rock slide. The issue of this paper is to evaluate the instabilities susceptibility at the Mako zone located at the hilliest zone of Senegal. It is done using Geographic Information Systems (GIS). The predisposing factors that are slope, lithology, hydrography, fracturing, land use are defined by the GIS and field data then are confirmed by field observations. According to field observations, more possible scenarios are SC1 and SC4 at the dry season and rainy season respectively. The instabilities susceptibility maps are taken from weighted overlay of these factors and they show that hilly areas are the most susceptible to rockslide or landslide when fractures are present with percent of moderate to high susceptibility between 13% and 22%. These percentages increase and can reach more than 40% with an intense water flow during the rainy season. Hazard can reach up to two hundred meters of foothill according to maps.展开更多
Background: To identify predictors of humerus shaft fractures nonunion in adults whatever the type of treatment performed. Patients and Methods: We conducted a retrospective study among patients who had a fracture of ...Background: To identify predictors of humerus shaft fractures nonunion in adults whatever the type of treatment performed. Patients and Methods: We conducted a retrospective study among patients who had a fracture of the humeral shaft moving towards healing or nonunion. Patients were treated in the orthopedic trauma unit of Sylvanus Olympio Teaching Hospital and two other private clinics in Lomé between January 2008 and June 2012. On the X-ray of each patient, we measured the angulation, the diastasis, and inter fragmentary contact. For each included patient, we looked for: age, sex, medical history, body mass index (BMI), according to the third location of the shaft fracture, the type of fracture according to AO classification and the type of opening according Tscherne classification. Results: During the study period, 184 patients with humeral shaft fracture were identified. Of these 108 were men. The mean age of patients was 37.3 years. The fractures were treated conservatively in 100 patients (54.3%), 78 treated surgically and six (3.3%) have discharged from hospital against medical advice for traditional treatment. The factors that were associated with nonunion of humerus shaft fractures in these patients were: the opening of the fracture (RR = 4.5;95% CI = [2.9;7.1]), the presence of immediately radial paralysis (RR = 5.6;95% CI = [3.7;8.5]), the existence of other associated lesions or fracture (RR = 1.8;95% CI = [1.1;3.1]), energy of the trauma (RR = 2.3;95% CI = [1.3;4.4]) and type III classification of Tscherne (RR = 0.3;95% CI = [0.2;0.6]). After multivariate analysis, factors that remained significantly associated with the failure of consolidation were: the existence of diastasis > 2 mm (OR = 7.6;95% CI = [2.2;25.6)), the Body Mass Index (BMI) > 25 (OR = 1.3;95% CI = [1.1 - 1.6]) and the existence of other bone lesion (OR = 4.3;95% CI = [1.4 - 18.9]). Conclusion: BMI greater than 25, the existence of an interfragmentary gap of more than 2 mm and existence of other bone lesions are significant risk factors for nonunion in humerus shaft fractures. The traditional treatment, common singular factor to the African environment, should not be ignored. Control of these predictors is necessary in carrying out the treatment of humerus shaft fractures.展开更多
Purpose:Deep vein thrombosis(DVT)of the left and right lower extremities was treated in the same way,but the left and right extremities received different levels of attention.This study aimed to investigate the differ...Purpose:Deep vein thrombosis(DVT)of the left and right lower extremities was treated in the same way,but the left and right extremities received different levels of attention.This study aimed to investigate the differences between the right and left lower extremity deep vein thrombosis(LEDVT).Methods:Clinical characteristics of LEDVT patients from July 2020 to June 2022 were retrospectively analyzed to compare the incidence of LEDVT on different limbs,demographics,predisposing factors,and anatomical characteristics.The exclusion criteria were bilateral LEDVT and recurrent thrombosis.Measured data was analyzed using independent samples t-test or Mann-Whitney test.Count data were analyzed by Chi-square test.A p<0.05 was considered a statistically significant difference.Results:There were 478 patients included in this study and the ratio of left to right LEDVT on the left and right limbs was 3.16:1(363:115).Left LEDVT predominantly affected female,with the major aged>50 years(50-60 years:16.80%;>60 years:57.30%).The primary predisposing factor was iliac vein compression syndrome,with iliofemoral thrombosis being the main type.Male patients with LEDVT on the right limb were predominant and the age of onset was usually≤60 years(52.17%).The main predisposing factor was recent surgery or trauma(<30 days)and femoropopliteal thrombosis was the main type.In more detail,the left iliac vein was compressed mainly in the proximal segment,and the right iliac vein was compressed mainly in the intermediate and distal segments.Recent surgery or trauma to the locomotor system and genitourinary system often induced LEDVT.Conclusion:The incidence of LEDVT on the left is significantly higher than that on the right.LEDVT on different sides has different characteristics,which is crucial for prevention and diagnosis in the relevant population so there are also differences in treatment of the affected limbs.展开更多
基金supported by the Health Science and Technology Development Project of Huaiyin District,Huai’an,Jiangsu Province(HYWJ2024009)of China.
文摘Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves complex interactions between environmental and host factors,leading to chronic inflammation and tissue remodeling.Purpose of review:This narrative review synthesizes recent research on the predisposing factors of CRS and their potential influence on disease endotypes,aiming to enhance understanding of this multifaceted condition.Recent findings:Identified predisposing factors include allergy,asthma,immune deficiency,gastroesophageal reflux,nasal anatomical variations,microbial infections,and others.Bacteria and biofilms,particularly Staphylococcus aureus,are significant in disease onset and severity.Immune deficiency may predispose individuals to CRS,and NSAID-exacerbated respiratory disease(N-ERD)is associated with more severe symptoms.Gastroesophageal reflux disease(GERD)and primary ciliary dyskinesia(PCD)also contribute to CRS development,with PCD leading to impaired mucociliary clearance and chronic inflammation.Conclusion:CRS is a multifactorial disease with various predisposing factors influencing its development and endotypic classification.Understanding these factors and their interactions with the immune system is crucial for developing targeted treatments and improving patient outcomes.
文摘Work-related diseases can have health consequences including stress- and mental health-related disorders, musculoskeletal disorders, and cancer and skin complaints due to exposure to biological agents. We aimed to investigate the prevalence of work-related diseases among bank employees and the independent risk factors for these diseases and to highlight measures that can be taken to prevent the occurrence of such diseases, to improve holistic health, and to raise awareness about work-related disease. Data were collected during face-to-face interviews (n = 796) in the recruitment phase of an international public bank in Istanbul, Türkiye or during periodic examinations in the bank between 2017 and 2019. Data, including socio-demographic characteristics, medical anamneses, physical examination results, laboratory findings, occupational accidents, and occupational disease frequency data, were retrospectively examined, and the results were statistically evaluated. Data were analyzed using the SPSS Statistics 17.0 (IBM Corporation, Armonk, NY, USA) package program. Results were considered statistically significant at p < 0.05. Age, female gender, dust exposure, vibration in the workplace were found to be significantly associated with musculoskeletal disorders, while age and work-related noise was found to be related to digestive system problems and dust exposure had significant relation with psychiatric disorders. Work-related diseases among bank employees are a priority that should be addressed by all relevant authorities to enable people to lead healthy lives in physical, mental, spiritual, and social terms.
文摘AIM: To evaluate the predisposing factors for peritoneal perforation and intrabiliary rupture and the effects of these complications on surgical outcome in liver hydatid disease.METHODS: A total of 372 patients with liver hydatid cysts who had undergone surgical treatment were evaluated retrospectively. Twenty eight patients with peritoneal perforation, 93 patients with spontaneous intrabiliary perforation, and 251 patients with noncomplicated hydatid cysts were treated in our clinics.RESULTS: When the predisposing factors for complications were evaluated, younger age, superf icial position, and larger cyst dimensions (P < 0.05; range, 0.0010.017) increased peritoneal perforation rates. It was shown that older age increased cyst dimensions, and presence of multiple and bilobar cysts increased intrabiliary rupture rates (P < 0.05; range, 0.0010.028). Partial pericystectomy and drainage was the most frequent surgical procedure in all groups (71.6%). The incidence of postoperative complications in the peritoneal perforated group, in the intrabiliary ruptured group, and in the noncomplicated group was 25%, 16.1% and 5.5%, respectively. When compared, complication rates were significantly different (P = 0.002). When length of hospital stay was compared, there was no signif icant difference between the groups (P > 0.05). The overall recurrence rate was 3.8% (14 patients), but there was not any statistical difference among the patient groups (P = 0.13). The early postoperative mortality rate was 1.1%. CONCLUSION: In peritoneally perforated and intrabiliary ruptured cases, the most important steps are irrigation of the peritoneal cavity and clearance of the cystic material from the biliary tree.
文摘Background: Microbial keratitis often results in poor visual outcome despite treatment. A revision of treatment protocol based on local evidence may be required in order to obtain better treatment outcome. Objectives: To determine the predisposing factors and predominant microbiological diagnosis of corneal ulcers seen at the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria. Materials and Methods: This is a preliminary report of an on-going longitudinal descriptive study of all consenting corneal ulcer patients managed at the FETHA eye clinic over a 4-month period. Information obtained were socio-demographic data, presenting complaints, duration of symptoms prior to presentation, history of preceding trauma, medications used before presentation, presenting and final visual acuity and microbiological diagnosis. Results: A diagnosis of corneal ulcer was made in 8 out of the 852 outpatients seen over the study period giving a hospital prevalence rate of 0.59%. Five patients (62.50%) were males, five (62.50%) were farmers and 4 patients (50%) were above 60 years of age. The microbial diagnoses were bacterial keratitis 37.5% (Staphylococcus aureus), fungal keratitis 25% (Fusarium spp. and aspergillus) and acanthamoeba (25%). None of the patients ever used contact lenses. There was a history of eye trauma in 50% of the patients. All the eyes presented blind after a period of failed attempts to treat by self or quacks. Mean duration before presentation was two weeks. Treatment improved the visual acuity in 37.5% of patients. Conclusion: Bacteria, fungi and acanthamoeba organisms were the microbiological isolates from the scrapings of corneal ulcer patients seen in the eye clinic of FETHA;with bacterial organisms being the most common. Farming activities, preceding eye trauma, delayed presentation, self-medication and use of traditional eye medications (TEM) were common findings among the patients. A future larger study is recommended to confirm the findings of this study. Eye health education campaigns should be directed at farmers to encourage early presentation to hospitals.
文摘Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.
基金Supported by Indian Council of Medical Research,New Delhi,India,No.5/4/3-4/10-NCD-Ⅱ
文摘AIM To quantify the components in biofilms and analyze the predisposing factors involved in occlusion of biliary stents. METHODS In a prospective study conducted from April 2011 to March 2014 at a tertiary care hospital, all consecutive patients who required endoscopic biliary stent exchange/removal were included. Etiology of the biliary disease was diagnosed by imaging, cytology and on follow-up. Clinical details of patients with biliary stent retrieval were noted. All extracted stents were collected in sterile containers and immediatelyprocessed for quantification of biofilm proteins and polysaccharides. Molecular identification of commonly known and unknown bacteria was performed by polymerase chain reaction and density gradient gel electrophoresis methods. RESULTS Eighty one patients(41 males) with age range of 20-86 years were studied. The underlying causes for stent insertion were bile duct stones(n = 46; 56.8%) benign stricture(n = 29; 35.8%) and malignancy(n = 6; 7.4%) with cholangitis in 50(61.7%) patients. The retrieved stent sizes were 7 Fr(n = 62; 76.5%) and 10 Fr(n = 19; 23.5%) with 65 days median insertion duration. Polybacterial consortia were detected in 90.1% of the stents. The most common bacteria identified by polymerase chain reaction alone and/or sequencing were Pseudomonas(n = 38), Citrobacter(n = 23), Klebsiella(n = 22), Staphylococcus(n = 20), Serratia(n = 16), Escherichia coli(n = 14), Streptococcus(n = 13), Enterococcus(n = 13), Aeromonas(n = 12), Proteus(n = 10) and Enterobacter(n = 9). Protein concentration according to gender(0.547 ± 0.242 mg/ml vs 0.458 ± 0.259 mg/ml; P = 0.115) as well as age > 60 years and < 60 years(0.468 ± 0.295 mg/ml vs 0.386 ± 0.238 mg/ml; P = 0.205) was non-significant. However, polysaccharide concentration was significant both according to gender(0.052 ± 0.021 mg/ml vs 0.049 ± 0.016 mg/ml; P < 0.0001) and age(0.051 ± 0.026 mg/ml vs 0.038 ± 0.016 mg/ml; P < 0.011). Protein concentration in the biofilm was significantly higher(0.555 ± 0.225 mg/ml vs 0.419 ± 0.276 mg/ml; P = 0.018) in patients with cholangitis, lower(0.356 ± 0.252 mg/ml vs 0.541 ± 0.238 mg/ml; P = 0.005) in the 10 Fr group than the 7 Fr group, and significantly higher(0.609 ± 0.240 mg/ml vs 0.476 ± 0.251 mg/ml; P = 0.060) in stents of ≥ 6 mo of indwelling time. However presence/absence of cholangitis, size of stent, indication of stent insertion and indwelling time did not affect the quantity of polysaccharide concentration.CONCLUSION Plastic stents retrieved from patients with biliary tract disease showed polymicrobial organisms with higher protein content among patients with cholangitis and those with smaller diameter stents. longer indwelling duration had more biofilm formation.
文摘Atrial fibrillation （AF） is the most frequent arrhythmia. Due to population aging, AF is a growing epidemic and its importance will continue to increase in the next decades. Although the prevalence of AF is high in advanced age, the number of subjects with predisposing factors for AF is even higher. Most of these factors increase the risk of atrial fibro- sis, an important component of atrial arrhythmia mecha- nisms. In fact, the new techniques to detect atrial fibrosis are showing the strong association between atrial fibrosis and AF risk. Regarding predisposing factors for AF, interatrial block （LAB） seems to be a key factor.
文摘AIM： To analyze the epidemiological, clinical and laboratory findings of infectious keratitis.METHODS： A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols.RESULTS： Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor （51.4%）, followed by diabetes mellitus （15.1%）. Cultures were positive in 110 scraping samples （44.5%）： 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 （4.5%） samples. The most common fungal pathogen was Aspergillus spp. （41%）. The most common bacterial isolates were Staphylococcus aureus （38.2%） and Pseudomonas aeruginosa （21.8%）.CONCLUSION： Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration.
文摘Objective:This study aimed to identify the influence of predisposing,enabling,and reinforcing factors and the adherence to medication behavior among tuberculosis patients in Selogiri Wonogiri Public Health Center.Methods:This study employed a descriptive cross-sectional research design.A questionnaire was used to collect primary data.Secondary data were obtained from patient treatment cards(Form TB 01).This research was carried out at Selogiri Health Center from November to December 2017.The participants were patients,both new and old patients,who had completed their treatment in the last 2 months or more,recorded from January 2016 to December 2017.A total sampling technique was used in this study.Logistic regression analysis was used to analyze the influence of predisposing,enabling,and reinforcing factors and the adherence to medication among tuberculosis patients.Results:The results of logistic regression analysis indicated that there were four independent variables that have a significant relationship with treatment variables,namely education(odds ratio(OR)=0.025;95%confidence interval(CI)=0.001-0.039);knowledge(OR=3.37;95%CI=0.19-57.71);type of drug(OR=0.448;95%CI=0.012-16.07),and means of transportation(OR=25.77;95%CI=1.33-500.47).Conclusions:Education,knowledge,type of drug,and means of transportation influence medication compliance among tuberculosis patients.Therefore,supporting patients during medication program of tuberculosis is needed to improve their adherence medication during multidrug therapy.
文摘BACKGROUND Patients admitted to intensive care unit(ICU) after cardiac surgery develop acute kidney injury(AKI) immediately post-operation. We hypothesized that AKI occurs mainly due to perioperative risk factors and may affect outcome.AIM To assess peri-operative risk factors for AKI post cardiac surgery and its relationship with clinical outcome.METHODS This was an observational single center, tertiary care setting study, which enrolled 206 consecutive patients, admitted to ICU after cardiac surgery. Patients were followed-up until ICU discharge or death, in order to determine the incidence of AKI, perioperative risk factors for AKI and its association with outcome.Univariate and multivariate logistic regression analysis was performed to assess predictor variables for AKI development.RESULTS After ICU admission, 55 patients(26.7%) developed AKI within 48 h. From the logistic regression analysis performed, high EuroScore Ⅱ(OR: 1.18;95%CI: 1.06-1.31, P = 0.003), white blood cells(WBC) pre-operatively(OR: 1.0;95%CI: 1.0-1.0, P = 0.002) and history of chronic kidney disease(OR: 2.82;95%CI: 1.195-6.65, P = 0.018) emerged as independent predictors of AKI among univariate predictors. AKI that developed AKI had longer duration of mechanical ventilation [1113(777–2195) vs 714(511–1020) min, P = 0.0001] and ICU length of stay [70(28–129) vs 26(21–51) h, P = 0.0001], higher rate of ICU-acquired weakness(16.4% vs 5.3%, P =0.015), reintubation(10.9% vs 1.3%, P = 0.005), dialysis(7% vs 0%, P = 0.005), delirium(36.4% vs 23.8%, P = 0.001) and mortality(3.6% vs 0.7%, P = 0.046).CONCLUSION Patients present frequently with AKI after cardiac surgery. EuroScore Ⅱ, WBC count and chronic kidney disease are independent predictors of AKI development. The occurrence of AKI is associated with poor outcome.
文摘This research describes a quantitative,rapid,and low-cost methodology for debris flow susceptibility evaluation at the basin scale using open-access data and geodatabases.The proposed approach can aid decision makers in land management and territorial planning,by first screening for areas with a higher debris flow susceptibility.Five environmental predisposing factors,namely,bedrock lithology,fracture network,quaternary deposits,slope inclination,and hydrographic network,were selected as independent parameters and their mutual interactions were described and quantified using the Rock Engineering System(RES)methodology.For each parameter,specific indexes were proposed,aiming to provide a final synthetic and representative index of debris flow susceptibility at the basin scale.The methodology was tested in four basins located in the Upper Susa Valley(NW Italian Alps)where debris flow events are the predominant natural hazard.The proposed matrix can represent a useful standardized tool,universally applicable,since it is independent of type and characteristic of the basin.
文摘AIM:To study and compare the predisposing factors and clinical features of pediatric,adult,and elderly rhegmatogenous retinal detachment(RRD).METHODS:This is an observational analytic crosssectional study in which patients with RRD admitted for surgery during 6mo period were divided into 3 age groups:pediatric(<18y),adult(18-60y),and elderly(>60y).Patients’demographic data,clinical features,RRD predisposing factors/features including myopia(axial length≥26.5 mm),aphakia/pseudophakia,blunt trauma,peripheral retinal degenerations,history of RRD in the fellow eye,and surgical interventions/findings were recorded and analyzed.RESULTS:Totally 142 patients(142 eyes)were studied:26(18.31%)pediatrics,86(60.56%)adults,and 30(21.13%)elderly.Elderly patients had a significantly higher intraocular pressures and cataracts compared to the other 2 groups(P=0.04).The RRD extent was larger in pediatric group(mostly 4 quadrants)compared to adults and elderly(mostly 2 quadrants),but it was not statistically insignificant(P=0.242).There were not statistically significantly differences in proliferative vitreoretinopathy(PVR)rate,posterior vitreous detachment(PVD)rate,number,site,shape,and size of breaks in three groups.All three groups had macular detachment in all eyes.Myopia and peripheral retinal degenerations were found to be more significant in adults(P=0.049,P=0.035,respectively),while blunt trauma was higher but insignificant in pediatric eyes(P=0.052).Pars plana vitrectomy(PPV)with silicone oil as a tamponade was the most used surgery in all groups.CONCLUSION:There are no significant difference in PVR rate in pediatric eyes but a significant higher rate of total RRD.Blunt trauma is more frequent in pediatrics eyes while myopia and/or peripheral retinal degenerations are more frequent in older ages.The rate of PPV as a choice for surgery is similar among all age groups.
文摘The Mako area located in the region of Kedougou is characterized by very hilly terrains with hardly accessible zones. This situation makes it difficult to map these terrains and exposes the populations to the permanent risk of a rock slide. The issue of this paper is to evaluate the instabilities susceptibility at the Mako zone located at the hilliest zone of Senegal. It is done using Geographic Information Systems (GIS). The predisposing factors that are slope, lithology, hydrography, fracturing, land use are defined by the GIS and field data then are confirmed by field observations. According to field observations, more possible scenarios are SC1 and SC4 at the dry season and rainy season respectively. The instabilities susceptibility maps are taken from weighted overlay of these factors and they show that hilly areas are the most susceptible to rockslide or landslide when fractures are present with percent of moderate to high susceptibility between 13% and 22%. These percentages increase and can reach more than 40% with an intense water flow during the rainy season. Hazard can reach up to two hundred meters of foothill according to maps.
文摘Background: To identify predictors of humerus shaft fractures nonunion in adults whatever the type of treatment performed. Patients and Methods: We conducted a retrospective study among patients who had a fracture of the humeral shaft moving towards healing or nonunion. Patients were treated in the orthopedic trauma unit of Sylvanus Olympio Teaching Hospital and two other private clinics in Lomé between January 2008 and June 2012. On the X-ray of each patient, we measured the angulation, the diastasis, and inter fragmentary contact. For each included patient, we looked for: age, sex, medical history, body mass index (BMI), according to the third location of the shaft fracture, the type of fracture according to AO classification and the type of opening according Tscherne classification. Results: During the study period, 184 patients with humeral shaft fracture were identified. Of these 108 were men. The mean age of patients was 37.3 years. The fractures were treated conservatively in 100 patients (54.3%), 78 treated surgically and six (3.3%) have discharged from hospital against medical advice for traditional treatment. The factors that were associated with nonunion of humerus shaft fractures in these patients were: the opening of the fracture (RR = 4.5;95% CI = [2.9;7.1]), the presence of immediately radial paralysis (RR = 5.6;95% CI = [3.7;8.5]), the existence of other associated lesions or fracture (RR = 1.8;95% CI = [1.1;3.1]), energy of the trauma (RR = 2.3;95% CI = [1.3;4.4]) and type III classification of Tscherne (RR = 0.3;95% CI = [0.2;0.6]). After multivariate analysis, factors that remained significantly associated with the failure of consolidation were: the existence of diastasis > 2 mm (OR = 7.6;95% CI = [2.2;25.6)), the Body Mass Index (BMI) > 25 (OR = 1.3;95% CI = [1.1 - 1.6]) and the existence of other bone lesion (OR = 4.3;95% CI = [1.4 - 18.9]). Conclusion: BMI greater than 25, the existence of an interfragmentary gap of more than 2 mm and existence of other bone lesions are significant risk factors for nonunion in humerus shaft fractures. The traditional treatment, common singular factor to the African environment, should not be ignored. Control of these predictors is necessary in carrying out the treatment of humerus shaft fractures.
基金supported by Natural Science Foundation of Chongqing,China(grant No.CSTB2023NSCQ-MSX0723).
文摘Purpose:Deep vein thrombosis(DVT)of the left and right lower extremities was treated in the same way,but the left and right extremities received different levels of attention.This study aimed to investigate the differences between the right and left lower extremity deep vein thrombosis(LEDVT).Methods:Clinical characteristics of LEDVT patients from July 2020 to June 2022 were retrospectively analyzed to compare the incidence of LEDVT on different limbs,demographics,predisposing factors,and anatomical characteristics.The exclusion criteria were bilateral LEDVT and recurrent thrombosis.Measured data was analyzed using independent samples t-test or Mann-Whitney test.Count data were analyzed by Chi-square test.A p<0.05 was considered a statistically significant difference.Results:There were 478 patients included in this study and the ratio of left to right LEDVT on the left and right limbs was 3.16:1(363:115).Left LEDVT predominantly affected female,with the major aged>50 years(50-60 years:16.80%;>60 years:57.30%).The primary predisposing factor was iliac vein compression syndrome,with iliofemoral thrombosis being the main type.Male patients with LEDVT on the right limb were predominant and the age of onset was usually≤60 years(52.17%).The main predisposing factor was recent surgery or trauma(<30 days)and femoropopliteal thrombosis was the main type.In more detail,the left iliac vein was compressed mainly in the proximal segment,and the right iliac vein was compressed mainly in the intermediate and distal segments.Recent surgery or trauma to the locomotor system and genitourinary system often induced LEDVT.Conclusion:The incidence of LEDVT on the left is significantly higher than that on the right.LEDVT on different sides has different characteristics,which is crucial for prevention and diagnosis in the relevant population so there are also differences in treatment of the affected limbs.
