Advances in Medicine最新文献

Introduction: One of the top ten major public health problems in developing countries including Ethiopia is the intestinal parasitic infection. Most of the time, intestinal parasitic infections do not show clinical signs and symptoms and also have a number of potential carriers, such as food handlers, which makes it too difficult to eradicate and control.

Objective: The aim of this study is to assess the prevalence and associated factors of intestinal parasitic infection among food handlers at prison, East and West Gojjam, Ethiopia, 2017.

Methods: An institution-based cross-sectional study design was conducted at East and West Gojjam prison. A total of 416 study participants, with a response rate of 82.7%, were included in the study for both stool exam and questioner. Data were collected using a structured questionnaire, and the sample was collected and examined based on the standard parasitological procedure. Epi data Version 3.1 was used to enter data, and SPSS version 20 was used to analyze the data.

Results: The overall prevalence of intestinal parasitic infections in the present study was 61.9%. The most prevalent parasite was A. lumbricoides (157 (45.6%)). Protozoan infection was higher than helminth infection. Multiple intestinal infections were identified; among study participants, 34.6% had double infection. The most significant associated factors of intestinal parasitic infections were fingernail status, residence, information about food contamination related to intestinal parasitic infection, income, and handwashing before having contact with food and after toilet with water only.

Conclusions: A high proportion of intestinal parasitic infection was detected among food handlers working at East and West Gojjam prison. Training must be given to the food handlers on personal hygienic conditions (finger trimming, handwashing after toilet and before having contact with food with water and soap, etc.).

Heart failure and aging of the heart show many similarities regarding hemodynamic and biochemical parameters. There is evidence that heart failure in experimental animals and humans is accompanied and possibly exacerbated by increased activity of protein phosphatase (PP) 1 and/or 2A. Here, we wanted to study the age-dependent protein expression of major members of the protein phosphatase family in human hearts. Right atrial samples were obtained during bypass surgery. Patients (n=60) were suffering from chronic coronary artery disease (CCS 2-3; New York Heart Association (NYHA) stage 1-3). Age ranged from 48 to 84 years (median 69). All patients included in the study were given β-adrenoceptor blockers. Other medications included angiotensin-converting enzyme (ACE) or angiotensin-receptor-1 (AT₁) inhibitors, statins, nitrates, and acetylsalicylic acid (ASS). 100 µg of right atrial homogenates was used for western blotting. Antibodies against catalytic subunits (and their major regulatory proteins) of all presently known cardiac serine/threonine phosphatases were used for antigen detection. In detail, we studied the expression of the catalytic subunit of PP1 (PP1c); I₁ ^PP1 and I₂ ^PP1, proteins that can inhibit the activity of PP1c; the catalytic subunit of PP2A (PP2Ac); regulatory A-subunit of PP2A (PP2A_A); regulatory B56α-subunit of PP2A (PP2A_B); I₁ ^PP2A and I₂ ^PP2A, inhibitory subunits of PP2A; catalytic and regulatory subunits of calcineurin: PP2B_A and PP2B_B; PP2C; PP5; and PP6. All data were obtained within the linear range of the assay. There was a significant decline in PP2Ac and I₂ ^PP2A expression in older patients, whereas all other parameters remained unchanged with age. It remains to be elucidated whether the decrease in the protein expression of I₂ ^PP2A might elevate cardiac PP2A activity in a detrimental way or is overcome by a reduced protein expression and thus a reduced activity of PP2Ac.

Neoplastic polypoid mucosal lesions of the gallbladder are increasingly being reported in cholecystectomy specimens. However, due to the absence of unified terminology and reporting criteria, the body of scientific evidence on their classification, prognosis, and management is scarce and sometimes controversial. While they have different histomorphologic features (gastric foveolar, gastric pyloric gland, biliary, and intestinal), a significant immunohistochemical overlap exists which highlights their mixed cell lineage with a dominant cell type in each, establishing the subcategory. Because of many shared attributes, intracholecystic papillary-tubular neoplasm (ICPN) has been introduced as an umbrella terminology. ICPNs of the pyloric subtype are lesions larger than 1 cm, as most of the smaller ones are clinically insignificant and represent polypoid hyperplasia rather than a true neoplasm. In this review, we will focus on the pyloric gland adenomas as the most frequent histologic subtype of ICPNs.

Nosocomial infections remain a major cause of mortality and morbidity worldwide. Despite the highly specialized interventions and policies, the rate of infection is still high due to the emergence of antimicrobial-resistant bacteria. This study described the prevalence of bacterial nosocomial infections and antimicrobial susceptibility pattern of isolates among patients admitted at Hiwot Fana Specialized University Hospital, Eastern Ethiopia. A hospital-based cross-sectional study was conducted among 394 nosocomial infection-suspected patients from March 2017 to July 2017. Data were collected using a structured questionnaire. Specimens from the respective site of infections were collected and examined for the presence of pathogenic bacteria and their antimicrobial susceptibility using standard culture and serological tests. Data were summarized using descriptive statistics. The prevalence of culture-confirmed bacterial nosocomial infection was 6.9% (95% CI: 4.3-7.9). Staphylococcus aureus (18.5%) was the most common isolate followed by Escherichia coli (16.7%). S. aureus showed 80% resistance to chloramphenicol and erythromycin, and 70% to cephalexin and tetracycline, respectively. A methicillin-resistant S. aureus made up 88.9% of all S. aureus isolates. Pseudomonas aeruginosa showed 83.7% resistance to each of ceftazidime and cephalexin, and 66.7% to chloramphenicol. The most common multidrug-resistant isolates were P. aeruginosa (30.4%) and S. aureus (21.7%). The prevalence of nosocomial infections in this study was comparable with other findings; however, the high rates of antimicrobial resistant isolates represent a substantial threat to the patients, communities, health care providers, and modern medical practices. Bacterial nosocomial infection treatment should be supported by culture isolation and antimicrobial susceptibility testing.

Serratia marcescens (S. marcescens) is an Enterobacteriaceae microorganism that is widespread in the environment, which may be the source of nosocomial infections, rare in the newborn but severe, and often in the form of outbreaks. The aim of our study is to report our experience, during an outbreak of S. marcescens, to show the severity of this germ, with review of the literature. Our study was retrospective, including 8 newborns with S. marcescens nosocomial infection, collected in the neonatal intensive care unit of Mohammed VI University Medical Hospital, during the epidemic period, over a period of 2 months (July and August 2016). The mean gestational age of the cases was 36 weeks of amenorrhea. Boys accounted for 75% of the cases. The average weight was 1853 grams. All the patients were initially placed under empiric antibiotic therapy based on ceftriaxone and gentamicin. The mean duration of nosocomial infection, diagnosed in all cases by blood cultures, was 7 days. The strains of S. marcescens were in 75% of the cases sensitive to the cephalosporins, intermediate sensitivity in 12.5% of cases and resistant in 12.5% of cases. The outcome was fatal in 62.5% of cases. S. marcescens nosocomial infections are often reported on epidemic series, and their eradication is not always easy.

Introduction: Overweight and obesity are a threat to the public health following their association with noncommunicable diseases, such as type 2 diabetes mellitus, cardiovascular disease, and some cancers. Despite this fact, the information on overweight and obesity, particularly in most developing countries, is still scarce to address the problem. This article partly addresses the gap through the findings of a cross-sectional survey that was conducted in Dodoma Region, Central Tanzania, to determine the prevalence and correlates of abdominal obesity among adults.

Methods: Using a community-based cross-sectional survey, data were generated from the participants who aged 18 years and above. Simple random sampling and Kish selection table techniques were used to get the sample who responded through a face-to-face-administered questionnaire. Waist circumference was measured using the guideline of the WHO protocol of measuring waist and hip circumference. Abdominal obesity is defined as a condition with waist circumference >102 cm for men and >88 cm for women. Prevalence was computed with a 95% confidence interval. Simple and multiple logistic regression models were fitted to identify the risk factors associated with abdominal obesity.

Results: A total of 840 respondents took part in the study. The overall prevalence of abdominal obesity was found to be 24.88% (209/840). The prevalence of abdominal obesity was significantly higher among women than men (35.14% vs. 6.89%, p < 0.0001) and higher among urban dwellers (33.56%) than their rural counterparts (15.56%). Correlates of abdominal obesity was found to be gender, marital status, place of residence, age, education level, and the time used in watching television.

Conclusion: This study revealed a high prevalence of abdominal obesity among the people living in the Dodoma Region. Increased age, urban residence, more time spent on television, less walking per day, and being ever married were all associated with having abdominal obesity in this population.

Spontaneous coronary artery dissection is a less known pathology by the cardiologists and represents a real challenge especially to the interventional cardiologist. The positive diagnosis is based on the visualization of intimal flap with the false lumen by intracoronary imaging means. This entity particularly interests young people without classic cardiovascular risk factors of atherosclerosis and female during the peripartum period. We report, in this paper, our experience in the University Hospital Center of Mohammed VI, Oujda, Morocco, about 7 cases diagnosed by coronary angiography during 3 years of practice while comparing our results with data from large series published in the literature. The purpose of this work is to draw more attention to this particular pathology that is becoming more and more common.

Extrapelvic endometriosis is a rare entity that presents serious challenges to researchers and clinicians. Endometriotic lesions have been reported in every part of the female human body and in some instances in males. Organs that are close to the uterus are more often affected than distant locations. Extrapelvic endometriosis affects a slightly older population of women than pelvic endometriosis. This might lead to the assumption that it takes several years for pelvic endometriosis to "metastasize" outside the pelvis. All current theories of the pathophysiology of endometriosis apply to some extent to the different types of extrapelvic endometriosis. The gastrointestinal tract is the most common location of extrapelvic endometriosis with the urinary system being the second one. However, since sigmoid colon, rectum, and bladder are pelvic organs, extragenital pelvic endometriosis may be a more suitable definition for endometriotic implants related to these organs than extrapelvic endometriosis. The sigmoid colon is the most commonly involved, followed by the rectum, ileum, appendix, and caecum. Most lesions are confined in the serosal layer; however, deeper lesion can alter bowel function and cause symptoms. Bladder and ureteral involvement are the most common sites concerning the urinary system. Unfortunately, ureteral endometriosis is often asymptomatic leading to silent obstructive uropathy and renal failure. Surgical excision of the endometriotic tissue is the ideal treatment for all types of extrapelvic endometriosis. Adjunctive treatment might be useful in selected cases.

Objective: To investigate effectiveness of systematic periodontal treatment in the long term in HIV-infected patients undergoing highly active antiretroviral treatment.

Methods: Longitudinal, prospective, open-label case series over a period of nine years. Periodontal treatment was performed by scaling and root planing and supportive periodontal care (SPC) at regular intervals. To measure effectiveness, reductions of pocket probing depths were defined as primary study endpoint.

Results: During the study period, there was a proportional increase in periodontal pockets ≥4 mm of +53% and in pockets ≥ 6 mm of +100%. Mean pocket depth reductions on patient's level were, however, 0.4 mm nine years after scaling and root planing and supportive periodontal care (p=0.180). No teeth were lost during the observation period.

Conclusions: In terms of best evidence available, it is concluded that systematic periodontal treatment including SPC is effective in virologically controlled HIV infection and can be performed in dental practice safely.

The primary outcome of the present study was to assess the percentage of pocket closure, and the secondary aim was to evaluate the clinical performance in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, and gingival recession (REC) after the use of cavitron ultrasonic surgical aspirator (CUSA) in deep infrabony defects. Fourteen deep infrabony defects in 11 patients who were previously treated with active periodontal therapy followed by one year of supportive periodontal therapy (at least three sessions) were additionally treated by the aid of CUSA. Eighty-six percent of the initial defects (12 out of 14) resulted in a PD < 5 mm, showing complete resolution six months after CUSA treatment, without any adverse event and with negligible pain (VAS from 0 to 3). CUSA showed potential as a method to promote pocket healing, reduce PPD, and increase clinical attachment (P < 0.001) in deep infrabony defects. This trial is registered with ClinicalTrials.gov NCT03567161.