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BMC Primary Care Dec 2023Shigellosis is an acute diarrheal disease transmitted through contaminated food, water, objects, poor hand hygiene, or sexual activity. Healthcare providers (HCP) may...
BACKGROUND
Shigellosis is an acute diarrheal disease transmitted through contaminated food, water, objects, poor hand hygiene, or sexual activity. Healthcare providers (HCP) may not be aware of the multiple routes of Shigella transmission, populations at increased risk, or importance of antibiotic susceptibility testing (AST). This study assessed HCP knowledge and clinical practices regarding shigellosis and antibiotic resistance.
METHODS
Porter Novelli Public Services administered a web-based survey (Fall DocStyles 2020) to HCP in the United States. Pediatricians, primary care physicians, nurse practitioners, and physician assistants completed questions about knowledge and clinical practice of acute diarrhea and shigellosis.
RESULTS
Of 2196 HCP contacted, 1503 responded (68% response rate). Most identified contaminated food (85%) and water (79%) as routes of Shigella transmission; fewer recognized person-to-person contact (40%) and sexual activity (18%). Men who have sex with men (MSM) were identified as being at risk for shigellosis by 35% of respondents. Most reported counseling patients to wash hands (86%) and avoid food preparation (77%) when ill with shigellosis; 29% reported recommending avoiding sex. Many HCP reported treating shigellosis empirically with ciprofloxacin (62%) and azithromycin (32%), and 29% reported using AST to guide treatment.
CONCLUSIONS
We identified several gaps in shigellosis knowledge among HCP including MSM as a risk group, person-to-person transmission, and appropriate antibiotic use. Improving HCP education could prevent the spread of shigellosis, including drug-resistant infections, among vulnerable populations.
Topics: Male; Humans; United States; Dysentery, Bacillary; Homosexuality, Male; Sexual and Gender Minorities; Shigella; Anti-Bacterial Agents; Diarrhea; Anti-Infective Agents; Water
PubMed: 38087210
DOI: 10.1186/s12875-023-02213-3 -
Arquivos de Neuro-psiquiatria Jul 2024was an early designation used for cervical dystonia. The origin of this name is attributed to French physician and writer François Rabelais in the mid-sixteenth...
was an early designation used for cervical dystonia. The origin of this name is attributed to French physician and writer François Rabelais in the mid-sixteenth century. This early description of torticollis in the book was an inspiration for the understanding of cervical dystonia. The art expressed in Rabelais' literature ‒ which was immortalized by the drawings of Gustave Doré ‒ influenced poetry, art, and photography, and led to the adoption of the term in the neurological sciences.
Topics: Torticollis; France; History, 16th Century; Neurology; Famous Persons
PubMed: 38740023
DOI: 10.1055/s-0044-1786764 -
Racial and Gender Representation Trends Among National Obstetrics and Gynecology Society Leadership.Journal of Minimally Invasive Gynecology Dec 2023The purpose of this study is to review the trends in racial and gender representation among the various national obstetrics and gynecology societies' presidents over the...
STUDY OBJECTIVE
The purpose of this study is to review the trends in racial and gender representation among the various national obstetrics and gynecology societies' presidents over the past 15 years.
DESIGN
A retrospective cross-sectional study.
SETTING
Data obtained from publicly available information on official websites of the professional societies studied.
PATIENTS
Presidents of national societies in obstetrics and gynecology.
INTERVENTIONS
The study was performed by obtaining publicly available data for past presidents from the official websites of the professional societies studied. Gender and race were inferred based on name and image. Racial classification was selected using the United States Census classification system. Educational background, residency training, and practice type were also collected. Assessment of 15-year trends was completed using linear regression analysis and differences in representation was assessed using analysis of variance and post hoc analysis.
MEASUREMENTS AND MAIN RESULTS
Over 15 years, there were 134 presidents elected for the 10 obstetrics and gynecology societies. Of those leaders, 85.2% were white, 8.2% Asian, and 5.2% black; 59% were men and 41% were women. During the study period, there was a significantly increasing slope for representation of women (+2.3% per year; 95% confidence interval, 0.4-4.2; p = .016). The representation of nonwhite presidents (+1.5% per year; 95% confidence interval, 0.2-2.8; p = .028) increased significantly during the same time period.
CONCLUSION
Over the last 15 years, less than 50% of obstetrics and gynecology national societies' presidents were women and most were of white race. However, there has been an increasing trend in the ratio of women to men and nonwhite to white representation among presidents of obstetrics and gynecology national societies.
Topics: Male; Female; Humans; United States; Gynecology; Leadership; Cross-Sectional Studies; Retrospective Studies; Obstetrics
PubMed: 37562764
DOI: 10.1016/j.jmig.2023.08.002 -
Scientific Reports Aug 2023Self-related visual information, especially one's own face and name, are processed in a specific, prioritized way. However, the spatio-temporal brain dynamics of...
Self-related visual information, especially one's own face and name, are processed in a specific, prioritized way. However, the spatio-temporal brain dynamics of self-prioritization have remained elusive. Moreover, it has been unclear whether this prioritization is an effect of enhancement and amplification, or rather a facilitating automatization of processing self-referential information. In this EEG study, 25 married women (who changed their surnames after marriage, so that their past and present surnames could be used as stimuli) performed a detection task with faces and names from five categories: self, self from the past, friend, famous, and unknown person. The aim was to determine the temporal and spatial characteristics of early electrophysiological markers of self-referential processing. We report results of event-related component (ERP) and time-frequency analyses. In the ERPs, the earliest self-relevance effect was displayed only 300 ms after stimulus onset in the midfrontal N2, and later in the parietal P3b, independently of the stimulus type. No self-relevance effect was found on the N170 component. However, local theta power at the occipito-temporal (visual) areas and inter-regional theta phase coherence between the visual and midfrontal areas showed that self-relevance differentiation of faces began already about 100-300 ms after stimulus onset. No such early effects were found for names. The results are discussed in terms of the time-course, functional localization, stimulus-specificity, and automatization of self-prioritization.
Topics: Humans; Female; Animals; Facial Recognition; Brain; Cell Communication; Friends; Gastropoda
PubMed: 37620563
DOI: 10.1038/s41598-023-41071-y -
Urologie (Heidelberg, Germany) Sep 2023While Felix Martin Oberländer (born in Dresden, Saxony, Germany) is remembered in German-speaking urology and abroad, and his name has been honored since 1997 with an... (Review)
Review
While Felix Martin Oberländer (born in Dresden, Saxony, Germany) is remembered in German-speaking urology and abroad, and his name has been honored since 1997 with an award named after him, the memory and knowledge of Arthur Kollmann of Leipzig (Saxony, Germany) seems to have been nearly forgotten within urology in Germany and abroad. However, the memory of him in other fields of science in which he was involved, e.g., puppets and puppetry-based research, remain vivid up to now.
Topics: Male; Humans; Urologists; Urology; Germany; Awards and Prizes; Play and Playthings
PubMed: 37581645
DOI: 10.1007/s00120-023-02163-9 -
European Heart Journal. Quality of Care... May 2024Although the importance of hypertension in patients with cancer is widely recognized, little is known about the risk of developing hypertension in patients with a... (Observational Study)
Observational Study
BACKGROUND AND AIMS
Although the importance of hypertension in patients with cancer is widely recognized, little is known about the risk of developing hypertension in patients with a history of cancer.
METHODS AND RESULTS
This retrospective observational cohort study analysed data from the JMDC Claims Database between 2005 and 2022, including 78 162 patients with a history of cancer and 3692 654 individuals without cancer. The primary endpoint was the incidence of hypertension.During a mean follow-up period of 1208 ± 966 days, 311 197 participants developed hypertension. The incidence of hypertension was 364.6 [95% confidence interval (CI) 357.0-372.2] per 10 000 person-years among those with a history of cancer, and 247.2 (95% CI 246.3-248.1) per 10 000 person-years in those without cancer. Individuals with a history of cancer had an elevated risk of developing hypertension, according to multivariable Cox regression analyses [hazard ratio (HR) 1.17, 95% CI 1.15-1.20]. Both cancer patients requiring active antineoplastic therapy (HR 2.01, 95% CI 1.85-2.20), and those who did not require active antineoplastic therapy (HR 1.14, 95% CI 1.12-1.17) had an increased risk of hypertension. A multitude of sensitivity analyses confirmed the robustness of the relationship between cancer and incident hypertension. Patients with certain types of cancer were found to have a higher risk of developing hypertension than those without cancer, with varying risks dependent on the type of cancer.
CONCLUSION
Our analysis of a nationwide epidemiological database revealed that individuals with a history of cancer have a higher risk of developing hypertension, and this finding applies to both cancer patients who require active antineoplastic therapy and those who do not.
Topics: Humans; Neoplasms; Hypertension; Male; Female; Retrospective Studies; Incidence; Middle Aged; Risk Factors; Risk Assessment; Follow-Up Studies; Aged; Adult
PubMed: 37321962
DOI: 10.1093/ehjqcco/qcad036 -
Nutrients Oct 2023Flavonoids, known for their antioxidant properties, can prevent reactive oxygen species (ROS) and influence athletic performance through various physiological and... (Meta-Analysis)
Meta-Analysis Review
Flavonoids, known for their antioxidant properties, can prevent reactive oxygen species (ROS) and influence athletic performance through various physiological and metabolic mechanisms. However, there are conflicting results after summarizing and analyzing the relevant literature. Hence, it is warranted to evaluate the overall impact of flavonoids on athletic performance in healthy adults based on a comprehensive and systematic review and meta-analysis. After searching four databases for literature published since their respective establishments until February 2023 and conducting publication bias and quality assessments, a total of 22 studies were ultimately included. The names and doses of flavonoids, various outcome measurements, as well as types of training, were extracted from included studies. The athletic performance outcomes from the included studies were categorized into 'performance tests' and 'exercise tolerance,' depending on the type of training undertaken. Several statistical results, such as pooled effect size (ES), among others, were implemented by meta-analysis using the random effects model. The results of meta-analysis suggest that there is currently sufficient evidence (ES = -0.28; 95% confidence interval (CI): [-0.50, -0.07]; = 0.01 and ES = 0.23; 95% CI: [0.07, 0.39]; = 0.005) to support the notion that flavonoid supplementation enhanced athletic performance in performance tests and exercise tolerance. In addition, among the subgroups, nonsignificant results were observed for athletes ( = 0.28) and acute supplementation ( = 0.41) in performance tests, as well as athletes ( = 0.57) and acute supplementation ( = 0.44) in exercise tolerance. Meanwhile, significant results were found for non-athletes ( = 0.04) and long-term supplementation ( = 0.02) in performance tests, as well as non-athletes ( = 0.005) in performance tests and long-term supplementation ( = 0.006) in exercise tolerance. The nonsignificant results were likely due to the limitation in the number of related papers, sample sizes, optimal dosage, duration, type of flavonoids, and other factors. Therefore, future research should focus on further investigating these relationships with larger sample sizes, optimal dosage, duration, and type of flavonoids to provide more robust conclusions.
Topics: Humans; Adult; Flavonoids; Athletic Performance; Exercise Tolerance; Athletes; Dietary Supplements
PubMed: 37960199
DOI: 10.3390/nu15214547 -
Current Opinion in Neurobiology Dec 2023Technical and methodological advances in recent years have brought new ways to tackle major classical questions in insect motor control. Particularly, significant... (Review)
Review
Technical and methodological advances in recent years have brought new ways to tackle major classical questions in insect motor control. Particularly, significant advancements were achieved in comprehending brain descending control by characterizing descending neurons, their targets in the ventral nerve cord (VNC), and how local networks there integrate sensory information. While physiological experiments in larger insects brought us a better understanding of how sensory modalities are processed locally in the VNC, the development and improvement of genetic tools, principally in Drosophila, opened the door to individually characterize actors at these three levels of information flow in behavioral control. This brief review brings together the names and roles of some of those actors, by highlighting the most significant findings from our perspective.
Topics: Animals; Neurons; Drosophila; Drosophila Proteins; Insecta
PubMed: 37865029
DOI: 10.1016/j.conb.2023.102766 -
Culture, Medicine and Psychiatry Dec 2023There is ample evidence that homelessness is associated with high rates of morbidity and mortality. Street Medicine seeks to eliminate these disparities by providing...
There is ample evidence that homelessness is associated with high rates of morbidity and mortality. Street Medicine seeks to eliminate these disparities by providing healthcare on the streets to people who are unsheltered. While extant research describes health disparities for the unsheltered and programmatic approaches to addressing housing instability, there are few published studies describing how healthcare providers build and maintain relationships with patients on the street. This insight is central to specifying how street medicine differs from traditional forms of care and defining aspects of street medicine that contribute to successful patient engagement. Through a collaboration between Operation Safety Net (OSN), a street medicine provider in Pittsburgh, Pennsylvania, and [name redacted], an exploratory qualitative study was designed and implemented using harm reduction principles as a guiding framework. Qualitative interviews were conducted with eleven OSN street medicine providers and a thematic analysis using a deductive approach was used to analyze the data. Findings identified the ways that relational harm reduction was central to all aspects of patient care provided through this program. Major themes included: (1) individualism, or meeting patients where they are figuratively and literally; (2) humanism, which refers to valuing and holding true regard for patients; and (3) nonjudgmental care, in which providers do not hold negative attitudes toward patients and their decisions. These themes are consistent with relational principles of harm reduction. Challenges that were discussed also aligned with these principles and included frustration with systems providing care that did not meet patients' individualized needs, and pain and trauma experienced by providers upon losing patients for whom they genuinely cared. Understanding these relational principles of harm reduction may help providers operationalize ways to effectively engage and maintain homeless patients in care and subsequently bridge the gap to traditional models of care. This study may provide valuable insights to expand the street medicine field in research and applied clinical and community settings.
Topics: Humans; Harm Reduction; Qualitative Research; Health Personnel; Ill-Housed Persons
PubMed: 36229766
DOI: 10.1007/s11013-022-09807-z -
Deutsche Medizinische Wochenschrift... Aug 2023The rate of mistakes and near misses in clinical medicine remains staggering. The tendency to cover up mistakes is rampant in "name-blame-shame" cultures. The need for... (Review)
Review
BACKGROUND
The rate of mistakes and near misses in clinical medicine remains staggering. The tendency to cover up mistakes is rampant in "name-blame-shame" cultures. The need for safe forums where mistakes can be openly discussed in the interest of patient safety is evident. Following a comprehensive review of the literature, a semi-structured weekly conference, named "mistake of the week" (MOTW), was introduced, enabling physicians to voluntarily discuss their mistakes and near-misses. The MOTW is intended to encourage cultural change in how physicians approach, process, accept and learn from their own and their peers' mistakes. This study seeks to assess if physicians appreciate, benefit from and are motivated to participate in MOTW.
METHODS
Physicians and medical students of the I. and II. at the Academic Teaching Hospital Klinikum Konstanz (Germany) were eligible to participate voluntarily. Four groups of physicians (n=3-6) and one group of medical students (n=5) volunteered to participate in focus group interviews, which were videotaped, transcribed and analyzed.
RESULTS
The following success factors are crucial for dealing with and voluntarily disclosing mistakes and near-misses: 1. Exemplification ("follow the boss's lead"), 2. Fixed time slots and a clear forum, 3. Reporting mistakes without fear of penalty or punishment, 4. A trusting working atmosphere. The key effects of the MOTW approach are: 1. People report their mistakes more, 2. Relief, 3. Psychological safety, 4. Lessons learned/errors (potentially) reduced.
DISCUSSION
The MOTW conference models an ideal forum to mitigate hierarchy and promote a sustainable organizational dynamic in which mistakes and near misses can be discussed in an environment free from "name-blame-shame", with the ultimate goal of potentially improving patient care and safety.
Topics: Humans; Patient Safety; Physicians; Fear; Surveys and Questionnaires; Academic Medical Centers; Medical Errors
PubMed: 37308082
DOI: 10.1055/a-2061-1554