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The Journal of Infection Jun 2024We examined long-term outcomes of toxic shock syndrome.
OBJECTIVES
We examined long-term outcomes of toxic shock syndrome.
METHODS
We conducted a matched cohort study of 630 patients with toxic shock syndrome and 5,009 healthy controls between 2006 and 2021 in Quebec, Canada. Outcomes included hospitalization for renal, cardiovascular, hepatic, and other morbidity during 15 years of follow-up. We estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the risk of these outcomes over time, comparing patients with toxic shock syndrome relative to matched controls.
RESULTS
Compared with healthy controls, rehospitalization rates at 15 years were higher for men with toxic shock syndrome (52.0 vs 30.0 per 100), but not women (38.7 vs 45.6 per 100). In men, toxic shock syndrome was associated with an elevated risk of renal (HR 17.43, 95% CI 6.35-47.82), cardiovascular (HR 2.57; 95% CI 1.52-4.34), and hepatic hospitalization (HR 19.83, 95% CI 4.72-83.34). In women, toxic shock syndrome was associated with renal hospitalization (HR 4.71, 95% CI 1.94-11.45). Streptococcal toxic shock was associated with a greater risk of rehospitalization than staphylococcal toxic shock.
CONCLUSIONS
Toxic shock syndrome is associated with rehospitalization up to 15 years later, especially in men. These patients may benefit from continued follow-up to prevent long-term morbidity.
PubMed: 38944286
DOI: 10.1016/j.jinf.2024.106213 -
Diabetes Research and Clinical Practice Jun 2024Effective diabetes management remains suboptimal in low-resourced countries including Ghana. We determined the effectiveness of hospital-community link diabetes...
OBJECTIVE
Effective diabetes management remains suboptimal in low-resourced countries including Ghana. We determined the effectiveness of hospital-community link diabetes management intervention on glycaemic control and other outcomes.
METHODS
A retrospective study design, using secondary data from the Ghana-Netherlands for Health Foundation diabetes programme. The z-test was used for proportions, to compare parameters between baseline (2017) and endpoint (2022). The Friedman test was used to assess changes in blood glucose levels, and the multivariable Logistic regression to identify factors associated with blood glucose control.
RESULTS
Analyses of 251 clinical records showed decline in median blood glucose levels across six years from 8.8 mmol/L (7.2-12.9) in 2017 to 6.5 mmol/L (5.7-7.2) (p = 0.001) in 2022, recording 43 % increase in patients attaining glycaemic control in 2022 (p = 0.001). The Friedman test showed significant reduction in glucose levels (χ = 319.2, p = 0.001), with an effect size of 0.25 using the Kendall test. The logistic regression analyses revealed that patients on metformin and Glibenclamide combination were more likely to achieve glycaemic control than those on metformin monotherapy (adjusted OR = 7.30, 95 % CI 2.31-23.01, p = 0.001).
CONCLUSION
The intervention achieved significant reduction in blood glucose levels. Patients with diabetes benefit from the hospital-community link diabetes management intervention regarding glycaemic control.
PubMed: 38944249
DOI: 10.1016/j.diabres.2024.111762 -
Transplantation and Cellular Therapy Jun 2024Center for International Blood and Marrow Transplant Research (CIBMTR) prepares an annual set of summary slides to detail the trends in transplantation and cellular...
BACKGROUND
Center for International Blood and Marrow Transplant Research (CIBMTR) prepares an annual set of summary slides to detail the trends in transplantation and cellular therapies. For the first time in the 2023 summary slides, CIBMTR incorporates data for patients receiving chimeric antigen receptor T-cell (CAR-T) infusions. In addition, the data on patient-reported outcomes (PROs) is also included.
OBJECTIVES
This report aims to update the annual trends in US HCT activity and incorporate data on the use of CAR-T therapies. Here we also aim to present and describe the development, implementation, and current status of the PRO data collection.
STUDY DESIGN
In August 2020, CIBMTR launched the Protocol for Collection of Patient Reported Outcomes Data (CIBMTR PRO Protocol). The CIBMTR PRO Protocol operates under a centralized infrastructure to reduce burden to centers. Specifically, PRO data is collected from a prospective convenience sample of adult HCT and CAR-T patients who received treatment at contributing centers and consented for research. Data are merged and stored with the clinical data and used under the governance of the CIBMTR Research Database Protocol. Participants answer a series of surveys developed by the Patient Reported Outcomes Measurement Information System© (PROMIS) focusing on physical, social and emotional, and others measures assessing financial well-being, occupational functioning, and social determinants of health. To complement traditionally measured clinical outcomes, the surveys are administered at the same timepoints that clinical data is routinely collected.
RESULTS
As of September 2023, PRO data from 993 patients across 25 different centers has been collected. With the goal of incorporating these important patient perspectives into standard clinical care, CIBMTR has added the PRO data to Data Back to Centers (DBtC). Through expanding the data types represented in the registry, CIBMTR aims to support holistic research accounting for the patient perspective in improving patient outcomes.
CONCLUSION
PRO data at CIBMTR aims to provide the foundation for future large scale, population-level evaluations to determine areas for improvement, emerging disparities in access and health outcomes (eg, by age, race, and ethnicity), and new therapies that may impact current treatment guidelines. Continuing to collect and grow the PRO data is critical for understanding these changes and identifying methods for improving patient quality of life.
PubMed: 38944153
DOI: 10.1016/j.jtct.2024.06.021 -
Food and Chemical Toxicology : An... Jun 2024
PubMed: 38944143
DOI: 10.1016/j.fct.2024.114836 -
The Lancet. Rheumatology Jun 2024
PubMed: 38944052
DOI: 10.1016/S2665-9913(24)00166-8 -
Journal of Psychiatric Research Jun 2024Numerous studies on post-COVID syndrome (PCS) describe persisting symptoms of cognitive impairment. Previous studies, however, often investigated small samples or did...
Numerous studies on post-COVID syndrome (PCS) describe persisting symptoms of cognitive impairment. Previous studies, however, often investigated small samples or did not assess covariates possibly linked to cognitive performance. We aimed to describe 1) global and domain-specific cognitive performance in adults with PCS, controls with previous SARS-CoV-2 infection and healthy controls, 2) associations of sociodemographics, depressive symptoms, anxiety, fatigue, somatic symptoms and stress with cognitive performance and subjective cognitive decline (SCD), using data of the LIFE-Long-COVID-Study from Leipzig, Germany. Group differences in cognitive performance and associations with sociodemographic and neuropsychiatric covariates were assessed using multivariable regression analyses. Our study included n = 561 adults (M: 48.8, SD: 12.7; % female: 70.6). Adults with PCS (n = 410) performed worse in tests on episodic memory (b = -1.07, 95 % CI: -1.66, -0.48) and visuospatial abilities (b = -3.92, 95 % CI: -6.01, -1.83) compared to healthy controls (n = 64). No impairments were detected for executive function, verbal fluency, and global cognitive performance. Odds of SCD were not higher in PCS. A previous SARS-CoV-2 infection without PCS (n = 87) was not linked to cognitive impairment. Higher age and higher levels of stress and fatigue were linked to worse performance in several cognitive domains. Routine administration of tests for episodic memory and visuospatial abilities might aid in the identification of individuals at risk for cognitive impairment when reporting symptoms of PCS. Low numbers of participants with severe COVID-19 infections possibly limit generalizability of our findings.
PubMed: 38944016
DOI: 10.1016/j.jpsychires.2024.06.036 -
International Immunopharmacology Jun 2024Silicosis is a progressive disease characterized by interstitial fibrosis resulting from inhalation of silica particles, and currently lacks specific treatment. Hydrogen...
Hydrogen combined with tetrandrine attenuates silica-induced pulmonary fibrosis via suppressing NF-kappaB/NLRP3 signaling pathway-mediated epithelial mesenchymal transition and inflammation.
Silicosis is a progressive disease characterized by interstitial fibrosis resulting from inhalation of silica particles, and currently lacks specific treatment. Hydrogen (H) has demonstrated antioxidative, anti-inflammatory, and anti-fibrotic properties, yet its efficacy in treating silicosis remains unexplored. In this study, rats exposed to silica were administered interventions of H combined with tetrandrine, and euthanized at 14, 28, and 56 days post-intervention. Lung tissues and serum samples were collected for analysis. Histological examination, MDA assay, enzyme-linked immunosorbent assay, hydroxyproline assay, and Western blotting were employed to assess the impact of H combined with tetrandrine on pulmonary fibrosis. The results revealed that this combination significantly alleviated inflammation in silicosis-afflicted rats, effectively suppressed levels of MDA, TNF-α, and IL-1β expression, and inhibited epithelial-mesenchymal transition (EMT), thereby ameliorating pulmonary fibrosis. Notably, protein expression level of E-cadherin was increased,however protein expression levels of vimentin and α-SMA were reduced, and TGF-β were reduced, alongside a significant decrease in hydroxyproline content. Furthermore, H combined with tetrandrine downregulated protein expression of NF-κB p65, NF-κB p-p65, Caspase-1, ASC, and NLRP3. These findings substantiate the hypothesis that H combined with tetrandrine mitigates inflammation associated with silicosis and suppresses the EMT process to ameliorate fibrosis via the NF-κB/NLRP3 signaling pathway. However, the pressure of airway opening was not assessed in this study and dynamic readings of lung physiological function were not obtained, which is a major limitation of this study.
PubMed: 38943976
DOI: 10.1016/j.intimp.2024.112563 -
American Journal of Industrial Medicine Jun 2024In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the...
OBJECTIVES
In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the dose-response between asbestos exposure and asbestosis mortality across a pool of Italian occupational cohorts, taking into account the presence of competing risks.
METHODS
Cohorts were followed for vital status and the cause of death was ascertained by a linkage with mortality registers. Cause-specific (CS) Cox-regression models were used to evaluate the dose-exposure relationship between asbestosis mortality and the time-dependent cumulative exposure index (CEI) to asbestos. Fine and Gray regression models were computed to assess the effect of competing risks of death.
RESULTS
The cohort included 12,963 asbestos cement workers. During the follow-up period (1960-2012), of a total of 6961 deaths, we observed 416 deaths attributed to asbestosis, 879 to lung cancer, 400 to primary pleural cancer, 135 to peritoneal cancer, and 1825 to diseases of the circulatory system. The CS model showed a strong association between CEI and asbestosis mortality. Dose-response models estimated an increasing trend in mortality even below a CEI of 25 ff/mL-years. Lung cancer and circulatory diseases were the main competing causes of death.
CONCLUSIONS
Asbestos exposure among Italian asbestos-cement workers has led to a very high number of deaths from asbestosis and asbestos-related diseases. The increasing risk trend associated with excess deaths, even at low exposure levels, suggests that the proposed limit values would not have been adequate to prevent disability and mortality from asbestosis.
PubMed: 38943482
DOI: 10.1002/ajim.23629 -
Work (Reading, Mass.) Jun 2024Nurses are among high-risk occupational groups during the outbreak of epidemics. Therefore, these people are required to use personal protective equipment (PPE)....
BACKGROUND
Nurses are among high-risk occupational groups during the outbreak of epidemics. Therefore, these people are required to use personal protective equipment (PPE). Previous studies have shown that the use of personal protective equipment can affect people's thermal strain and mental workload.
OBJECTIVE
The present study was conducted with the aim of objectively and subjectively evaluating the use of protective clothing on the thermal strain and mental workload of nurses during the covid-19 pandemic.
METHODS
This cross-sectional study was divided into two groups with a sample size of 300 people who were selected by systematic random method. In the first group, 120 people were objectively evaluated (use of protective clothing). In the second group, 180 people only completed the questionnaire of mental workload, feeling of heat and sweating and other information related to the type of clothing and the duration of its use, etc. Measurements were done in August and September of 2021 and in the morning shift of hospitals. Data were analyzed using SPSS version 21 software and chi-square, independent T-test and linear regression tests.
RESULTS
The average age and average working hours per month of the participants in the study were 33.51±7.88 years, 187.91±35.37 hours, respectively. The results showed that the predicted average vote (PMV) index and the predicted percentage of dissatisfied (PPD), moisture felt on the skin surface, the feeling of desirability and pleasantness of the temperature, the weight of sweat and the humidity inside the clothes between the two groups of people using insulated clothes There is a significant difference between medicine and dressing (P < 0.05). There was a significant relationship between mental workload and type of clothing, average working hours per month.
CONCLUSIONS
The use of medical isolation clothes causes a high heat load on nurses and can increase their mental workload. On the other hand, people using normal gowns suffer from a high mental workload due to the fear of disease due to the uncertainty of high-level protection. In addition, medical isolation clothes increase the humidity of the skin due to their impermeability, which causes skin complications.
PubMed: 38943418
DOI: 10.3233/WOR-230396 -
Work (Reading, Mass.) Jun 2024Low back pain (LBP) is a common public health problem resulting in workforce loss.
BACKGROUND
Low back pain (LBP) is a common public health problem resulting in workforce loss.
OBJECTIVE
This study aims to evaluate the LBP status and its affecting factors among drivers in a city in southeast Turkey.
METHODS
This cross-sectional questionnaire survey study was conducted among 323 drivers. The chi-square test and logistic regression analysis were used to analyze the data.
RESULTS
The mean age of the drivers was 41.7±11.5 years (min: 19, max: 70), and 83.9% were married, and all were men. LBP was found in 59.4% of drivers. It was significantly higher in drivers with poor socioeconomic status, dissatisfied with their life, having a chronic illness, physically inactive, having sleep disorders, exposed to bad road conditions, prolonged vibration, high physical- psychological workload, and a family history of LBP (p < 0.05). There was no significant association between age, education level, and BMI with LBP (p > 0.05).
CONCLUSION
There is limited study on this subject in Turkey. Further studies can raise awareness about this issue and create an educational plan.
PubMed: 38943415
DOI: 10.3233/WOR-230059