Advances in Preventive Medicine最新文献

Introduction: Hepatitis B virus infection is one of the commonest occupational risks in healthcare workers. However; there is limited evidence regarding the prevalence of hepatitis in health professionals in Ethiopia.

Objective: This study was aimed at assessing the prevalence of hepatitis B and associated factors in health professionals.

Methods: Institution based cross-sectional study was conducted among health professionals at University of Gondar Hospital from January to February, 2015. Self-administered questionnaire was used to collect sociodemographic variables and blood sample was also taken to determine hepatitis B virus sero-status. Chi square test with 95% confidence interval (CI) was computed to assess the associations of different factors with hepatitis B infection.

Result: A total of 332 health professionals (with a response rate of 92.2%) participated in the study. Most (98.5%) of health professionals were not vaccinated for hepatitis B. The prevalence of hepatitis B in health professionals at UOG hospital was found to be 4.52% (95% CI: 2.4, 6.5). Hepatitis B infection was more common among males (P value =0.0299).  Conclusion. The prevalence of hepatitis B in health professionals in this study was comparable with other studies done in Ethiopia among health professionals. Males were more affected than females for hepatitis B infection. Hepatitis B virus vaccine, treatment for the infected, and training on infection prevention should be more available for healthcare workers.

Obese African-American (AA) women are at high risk of hypertension (HT) and cardiovascular disease (CVD). Flow-mediated dilation (FMD) and arterial augmentation index (AI) are measures of endothelial function and arterial stiffness. Whether endothelial function and arterial stiffness predict risk of HT or CVD in obese African-American women with, versus without, parental histories of HT and whether aerobic exercise is an effective countermeasure remain unclear. The capacity for FMD is partly heritable. Therefore, we tested the hypotheses that less FMD and greater AI may be found in normotensive-obese, young-adult (18-26 year-old) AA women with hypertensive parents (n=10) than in a matched control group with normotensive parents (n=10) and that a single bout of aerobic exercise improves both endothelial function and arterial stiffness, with less improvement in the women with hypertensive parents. We studied each subject while at rest, 20 min before and 20 min after, 30 min of aerobic exercise. The exercise-induced changes and parental hypertension-related differences in AI were not significant. The exercise increased FMD in both of the groups with no significant difference in magnitude between the women with hypertensive and normotensive parents. FMD was significantly less in the women with hypertensive parents than in the women with normotensive parents after, but not before, the exercise (mean ±95% confidence interval of 11.3 ± 4.9% vs. 15.6 ± 4.9%, P=0.05). These findings suggest that a 30-min bout of aerobic exercise may improve FMD and unmask endothelial dysfunction in normotensive-obese, young-adult AA women with parental histories of HT. Future studies should determine whether regular aerobic exercise protects obese AA women from the endothelial dysfunction associated with diabetes and prevents CVD in this high-risk population.

Intensive therapeutic lifestyle modification programs, such as the Complete Health Improvement Program (CHIP), reduce cardiovascular disease (CVD) risk factors. However, there are little data on how participation in CHIP with a household member can affect CVD biomarkers. This study focuses on the benefit of joint participation of household members in CHIP in order to have a better outcome in improving CVD risk factors compared with lone or individual participation. Data from 20 CHIP classes offered from 2011 to 2015 in Athens, Ohio, where each class was conducted over 2-4 months, consisting of 16-18 sessions, were collected. Body mass index (BMI), blood pressure, fasting glucose, and lipid profiles were measured before and near the completion of each class. A statistically significant greater reduction in BMI (p = 0.003) in those who attended with a household member compared to those who attended as individuals was found. CHIP has some effect on various CVD risk factors for those who attend intensive therapeutic lifestyle modification programs with an accompanying household member. Hence, encouragement of participation with a family member or a "buddy" may be prudent, especially if weight reduction is a key program participation goal. Further evaluation of the "buddy effect" involving both of those residing in the same household and those who do not but nevertheless provide mutual support is warranted.

Telemedicine is now in vogue, allowing through computer and communication tools to be deployed in the field of health, such as cardiology, area in which it has shown interest, in international studies. As the population ages, older people are increasingly concerned with this innovative practice. We take a look at telemedicine projects in France concerning the elderly, in the field of cardiology.

Introduction: Staphylococcus aureus is a Gram-positive, catalase-positive, and coagulase-positive bacterial species commonly found on the skin and in the nose of most healthy individuals. The anterior nares of nose are the most frequent carriage sites for S. aureus in both adults and children. Methicillin resistance among S. aureus isolates has steadily increased worldwide.

Objective: The main objective of this study was to determine nasal carriage rate, antimicrobial susceptibility pattern, and associated risk factors of Staphylococcus aureus with special emphasis on MRSA among urban and rural elementary school children in Gondar, Northwest Ethiopia.

Method: A community based comparative cross-sectional study was conducted on 622 urban and rural elementary school children in Gondar from January 1^st to March 30^th, 2018. Data was collected using a questionnaire and nasal swab samples were collected by sterile cotton tip swab moistened with sterile normal saline. Collected samples were inoculated on mannitol salt agar and incubated aerobically at 37°C for 24 hrs. S. aureus was confirmed by observing colony characteristics and biochemical tests. MRSA was detected using cefoxitin disc by Modified Kirby-Bauer disk diffusion technique. Finally data was entered, cleared, and checked using Epi-info version 7 and exported to SPSS version 20 for analysis. Odds ratio and logistic regression were used for statistical association. P-value ≤ 0.05 at 95% CI was considered for statistical association.

Result: Of the 622 school children, the overall prevalence of S. aureus was 143/622 (23%). Of them, 14/143 (9.79%) were MRSA. The carriage rate in urban schools was 83/622 (13.3%) whereas it was 60/622 (9.6%) in rural schools. The prevalence of MRSA among urban schools, 9.1%, was higher than their urban counterparts, 0.7%. Gentamycin, clindamycin, and ciprofloxacin were the most effective whereas penicillin and tetracycline were resistant. Children's fathers' educational status and number of children in class room were significantly associated with S. aureus but only living in urban of children significantly associated with MRSA.

Conclusion: This study showed high prevalence of S. aureus and MRSA, 143/622 (23%) and 14/143 (9.79%), respectively. So, decolonization of nasal carriers of MRSA and reducing the number of students per classroom should be addressed. Moreover, regular large scale survey should be conducted to assess the burden and intervene accordingly.

Introduction: Nosocomial infections due to poor hand hygiene are a major cause of increasing morbidity, mortality, and health care costs among hospitalized patients worldwide. Hand hygiene is mandatory to prevent the transmission of health care associated infections especially where infectious diseases are common like Sub-Saharan Africa. Hand washing compliance among health professionals in general is unacceptably low especially in developing countries like Ethiopia.

Method: Institution-based cross-sectional study design was used to assess the knowledge and practice of hand washing among health professionals working in Dubti Referral Hospital. Structured self-administered pretested questionnaires were used. The data obtained were analyzed using SPSS version 23.

Result: Out of 91 respondents, majority, 60 (65.9%), of them were knowledgeable and 31 (34.1%) were not knowledgeable. However, the majority of health professionals, 51 (56.0%), had poor practice and 40 (43.0%) of them had good practice of hand washing.

Conclusion: Majority of health professionals were knowledgeable. However, they had poor practice of hand washing.

Introduction: Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies).

Methods: A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes.

Results: There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis.

Conclusion: There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes.

Ingestion of a single dose of alcohol, ranging from the intake of a moderate amount alcohol to binge drinking, is the most frequent form of alcohol consumption with poorly understood medical consequences and obscure prophylactics. The study was aimed to determine whether lycosome formulated phosphatidylcholine (PC-Lyc) containing two highly bioavailable antioxidants (PC and lycopene) ingested shortly before the alcohol-containing beverage may alleviate the biochemical markers of liver damage and parameters of biological oxidation associated with the intake of a moderate amount of alcohol. Healthy middle-aged volunteers were requested to consume a moderate amount of alcohol - 0.5 ml/kg or 1.0 ml/kg shortly after ingestion of a capsule containing 450 mg of regular phosphatidylcholine (PC, n=10), PC-Lyc (n=10), or placebo pill (PP, n=10). Serum levels of ethanol (EtOH), acetaldehyde (AA), liver-specific enzymes, total antioxidant capacity of serum (TAC), oxidized LDL (LDL-Px), and malonic dialdehyde (MDA) were measured at 1, 2.5, and 5 hours after dosing with alcohol. Ingestion of PC regardless of the formulation used had no effect on serum EtOH concentration dynamics. However, volunteers supplemented with PC-Lyc showed a better clearance of AA in serum as compared to other groups. There was a reduction in serum TAC values by 18.5% and 16.1% in both placebo groups ingesting 0.5 and 1.0 ml/kg of alcohol, respectively, at the end of observational period. This decline was preventable by supplementation of volunteers with PC and especially with PC-Lyc. Moreover, PC-Lyc promoted a reduction of serum MDA and reversed an increase in serum LDL-Px. In addition, ingestion of alcohol at 1.0 ml/kg dose caused a transient increase in serum alanine-aminotransferase activity which was abolished by both formulations of PC. Therefore, combinatory lycosomal formulation of PC and lycopene may prevent some metabolic abnormalities associated with single intake of moderate amount of alcohol. This trial is registered with ACTRN12617001335381.

Coronary heart disease continues to be the leading cause of death in the United States. Current attempts to treat atherosclerosis and coronary artery disease often involve pharmaceutical and surgical treatments. While these treatments are successful in managing the pain from coronary heart disease, they do little to prevent or stop it. There are a number of clinical strategies that are currently being researched to treat atherosclerosis through HDL-increasing therapies. These clinical studies have shown positive effects through nutritional intervention, exercise, stress reduction, and tobacco and alcohol cessation. These treatment options are explored in greater detail, including their potential to halt and even reverse atherosclerosis. The results from these recent studies and how they relate to the mechanism of reverse cholesterol transport are also critically examined. Reverse cholesterol transport is a multistep process resulting in the net movement of cholesterol from peripheral tissues back to the liver via the plasma. The mechanism of reverse cholesterol transport is also further explored in this review.

The feasibility of "point-of-care" screening for ideal cardiovascular health was explored in a pediatric specialty clinic setting. Children and adolescents aged 9-18 years (n=91) with treated and stabilized diseases were recruited at a pediatric endocrinology clinic. A table-top device was used to assay fingerstick samples for non-HDL cholesterol (non-HDL-C), which was used to divide participants into two groups based on the non-HDL-C threshold for comparison of the remaining metrics between groups. A significant number of children had low scores, and score frequency distribution was similar to larger retrospective studies, with few participants achieving none or all of the health metrics. Healthy diet was the metric least often achieved. Those with a non-HDL-C above the ideal threshold of 3.1 mmol/L (120 mg/dl) had a higher BMI percentile (p<0.01) and diastolic blood pressure percentile (p<0.05). We conclude that pediatric risk factor screening and scoring can be performed in a specialty clinic with meaningful cardiovascular health scores for patients and providers. Association of abnormal "point-of care" non-HDL-C levels with elevated BMI and blood pressure supports evidence for risk factor clustering and use of the ideal health construct in pediatric clinic settings.