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The International Journal on Drug Policy Jun 2024People who inject drugs (PWID) are at high risk of developing injection-related infections, including abscesses. Access to water, sanitation, and hygiene (WASH) are key...
INTRODUCTION
People who inject drugs (PWID) are at high risk of developing injection-related infections, including abscesses. Access to water, sanitation, and hygiene (WASH) are key human rights and services; yet these services have been underexplored as predictors of abscesses among PWID.
METHODS
Longitudinal analysis was employed among a cohort of PWID to determine if WASH insecurity (lack of access) was associated with abscess incidence in the Tijuana, Mexico and San Diego, United States metropolitan area during 24-months of follow-up survey data from 2020 to 2023. We calculated abscess prevalence at baseline and tracked the incidence of new abscesses among individuals without an abscess during the previous visit. Time dependent Cox regression modeling was employed with variance clustered by participant to characterize the relationship between WASH insecurity and abscess incidence.
RESULTS
At baseline, hand hygiene insecurity, bathing insecurity in the previous six months and open defecation in the last week, were reported by 60 %, 54 % and 38 % of participants, respectively; 21 % reported an abscess in the last six months. The incidence of abscesses was 24.4 (95 %CI: 21.1-27.6) per 100 person-years. After adjusting for covariates, the hazard of developing an abscess remained significantly elevated among individuals using non-improved (with risk of contamination) water sources (e.g., surface water) for preparing drugs (adjusted HR [adjHR]: 1.49 [95 %CI: 1.01-2.21], experiencing bathing insecurity (adjHR: 1.59 [95 %CI: 1.12-2.24]) and open defecation (adjHR: 1.65 [95 %CI: 1.16-2.35]).
CONCLUSIONS
PWID in the Tijuana-San Diego metropolitan area reported facing high rates of insecurity accessing WASH services. Abscess incidence was higher (four to nine times) than observed rate among PWID cohorts in other settings. Access to continuously available toilet facilities, bathing infrastructure, and safe water sources for preparing drugs for injection could prevent abscesses among PWID. Accessible WASH infrastructure should be ensured among PWID communities and promoted as a key component of harm reduction infrastructure.
PubMed: 38901113
DOI: 10.1016/j.drugpo.2024.104485 -
Revista Brasileira de Parasitologia... 2024The saffron finch, Sicalis flaveola, a passerine bird, can be found in nearly all Brazilian territory and is also raised in captivity. The objective of this work was to...
The saffron finch, Sicalis flaveola, a passerine bird, can be found in nearly all Brazilian territory and is also raised in captivity. The objective of this work was to determine the prevalence and load of oocysts in captive saffron finches in the municipality of Campos dos Goytacazes, state of Rio de Janeiro and in free-living saffron finches in the municipality of Eugenopolis, state of Minas Gerais. In this analysis, 30 captive and 30 wild birds were assessed. Feces eliminated in a 24-hour period were collected and weighed to determine the number of oocysts per gram of feces (OoPG). Statistical analyses were performed using Microsoft Excel and GraphPad Prism Software. All birds in the present study were positive for one or more species of coccidia. Captive birds had a mean total oocyst count higher than that of wild birds. No significant differences in OoPG counts were observed when comparing males and females or captive and wild birds. We can conclude that due to the fact that birds both eat and defecate in their cages, it is essential to keep them as clean as possible, since captive birds have a higher prevalence of coccidia.
Topics: Animals; Finches; Prevalence; Female; Male; Brazil; Bird Diseases; Oocysts; Animals, Wild; Parasite Load; Animals, Zoo; Feces
PubMed: 38896754
DOI: 10.1590/S1984-29612024029 -
SAGE Open Nursing 2024Urinary tract infection is the single most common bacterial infection of mankind.
BACKGROUND
Urinary tract infection is the single most common bacterial infection of mankind.
OBJECTIVE
To assess the risk factors and prevalence of Urinary tract infection among pregnant women attending antenatal care at Wachemo University Comprehensive Specialized Hospital, Central Ethiopia, 2023.
METHODS
An institutional-based cross-sectional study design was conducted from 2 October to 29 December 2023. The total sample size was 405 and a systematic random sampling technique was used. Data were entered using the Epi-data 3.1 version and exported to SPSS 25 for analysis. Multicollinearity was checked. The goodness of fit test was done using the Hosmer-Lemeshow goodness of fit test. Binary logistic regression analysis was done, and variables with a -value of <0.25 in the bivariable analysis were taken into the multivariable analysis. Statistical significance was declared at a -value of <0.05 with an adjusted odds ratio and 95% confidence interval.
RESULT
The prevalence of urinary tract infection was 40.7% with 95%CI [36.5-45.2]. Rural resident [AOR: 2.32, 95% CI: 1.36-3.96], educational status of husband no formal education [AOR: 3.38, 95% CI: 1.24-9.21], educational status of husband primary level [AOR: 2.94, 95% CI: 1.06-8.18], having vaginal bleeding [AOR: 3.89, 95%CI: 1.78-8.47], having female genital mutation [AOR: 2.98, 95%CI: 1.83-4.84], itchiness around genitalia [AOR: 3.82, 95%CI: 1.14-12.82], and using water for cleaning after defecation [AOR: 0.46, 95%CI: 0.22-0.97] were significantly associated.
CONCLUSION
Four in ten pregnant women attending antenatal care had urinary tract infections. Residence, educational status of the husband, vaginal bleeding, female genital mutation, itchiness around genitalia, and mode of cleaning after defecation were significantly associated. Therefore, creating awareness for rural women, improving the educational status of husbands`, treatment of vaginal bleeding, avoiding female genital mutation, screening and treating itchiness around genitalia, and using water for cleaning after defecation might reduce the burden.
PubMed: 38895654
DOI: 10.1177/23779608241264172 -
Journal of Clinical Medicine May 2024Constipation causes substantial morbidity worldwide. This survey assessed constipation-related factors in Japan using the Japanese version of the Irritable Bowel...
Constipation causes substantial morbidity worldwide. This survey assessed constipation-related factors in Japan using the Japanese version of the Irritable Bowel Syndrome Quality of Life (IBS-QOL-J) instrument. We also examined the relationship among laxative type, Bristol Stool Form Scale (BSFS) scores, and treatment cost. Finally, we examined differences in satisfaction scores according to laxative type, treatment type, treatment cost, and BSFS score. IBS-QOL-J was higher among those taking salt and/or irritation laxatives. Those paying >JPY 5000 (USD 50.00) had the lowest IBS-QOL-J. IBS-QOL-J was significantly lower among those with a BSFS score of 1 or 2 (severe constipation). This study's findings suggest that a variety of factors, including treatment type and cost, are associated with defecation satisfaction. Those who had hard stools, used multiple laxatives, or spent more on treatment were less satisfied. Future strategies should target therapies that do not require multiple laxatives with lower treatment costs. Adequate defecation with a small number of appropriate laxatives at minimal cost appears to improve defecation satisfaction. It is desirable to identify appropriate laxatives and improve dietary habits and exercise routines. It is also necessary to stop blindly increasing laxative usage and properly diagnose constipation disorders such as anatomical abnormalities other than functional constipation.
PubMed: 38892926
DOI: 10.3390/jcm13113216 -
Frontiers in Surgery 2024About one-third of patients experience postoperative ileus (POI) after abdominal surgery, which can cause various complications and has not been treated well in clinical...
BACKGROUND
About one-third of patients experience postoperative ileus (POI) after abdominal surgery, which can cause various complications and has not been treated well in clinical practice. The comprehensive treatment offered by traditional Chinese medicine may be a good choice for promoting intestinal mobility. Therefore, the aim of this study protocol is to observe the effectiveness of acupuncture combined with auricular acupressure in decreasing the incidence and related symptoms of POI.
METHODS
This is a single-center, assessor-blinded, randomized controlled trial. A total of 160 participants are supposed to recruit at Shanghai Tenth People's Hospital and randomly divided into two parallel groups in a 1:1 ratio. The intervention group are planned to receive manual acupuncture combined with auricular acupressure, while the control group are planned to receive regular enhanced recovery after surgery treatment. The primary outcome is the time to first defecation and first flatus after surgery. The secondary outcomes include the length of postoperative hospital stay, intensity of postoperative abdominal pain and distension, severity of postoperative nausea and vomiting, time to tolerate diet, inflammatory index, and incidence of prolonged postoperative ileus.
DISCUSSION
The results of this research will provide substantial evidence regarding the efficacy of comprehensive traditional Chinese treatment, specifically auricular acupressure and manual acupuncture, in treating and preventing POI.
TRIAL REGISTRATION
ClinicalTrials.gov, Identifier: ChiCTR2300075983, registered on September 21, 2023.
PubMed: 38887315
DOI: 10.3389/fsurg.2024.1349975 -
BMC Surgery Jun 2024Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women that substantially...
Early safety and efficiency outcomes of a novel interdisciplinary laparoscopic resection rectopexy combined with sacrocolpopexy for women with obstructive defecation syndrome and pelvic organ prolapse: a single center study.
BACKGROUND
Obstructive defecation syndrome (ODS) defines a disturbed defecation process frequently associated with pelvic organ prolapse (POP) in women that substantially compromises quality of life. Conservative management offers limited relief and a surgical intervention may be required. This is characterized by individual approaches. AIM OF THE STUDY: This retrospective single center study evaluated the surgical and clinical short-term outcome of a novel interdisciplinary laparoscopic resection rectopexy (L-RRP) with mesh- sacrocolpopexy (L-SCP) for women suffering from ODS and POP.
METHODS
The study participants underwent surgery in an interdisciplinary laparoscopic approach. Safety was the primary endpoint, assessed via postoperative morbidity classified by Clavien-Dindo scale. Secondary outcomes included evaluation of bowel function, fecal and urinary incontinence and pelvic organ prolapse status at 12 months follow-up. Additionally, a biological mesh (BM) was offered to women, who asked for an alternative to synthetic mesh material (SM).
RESULTS
Of the 44 consecutive patients requiring surgery for ODS and POP, 36 patients underwent the interdisciplinary surgical approach; 28 patients with SM and 8 patients with BM. In total 5 complications occurred, four of them were classified as minor. One minor complication was observed in the BM group. One anastomotic leakage occurred in the SM group. The two ODS scores, the bowel dysfunction score, and the incontinence score improved significantly (p = 0.006, p = 0.003, p < 0.001, and p = 0.0035, respectively). Pelvic floor anatomy was fully restored (POP-Q 0) for 29 (80%) patients after surgery. 17 patients (47%) suffered from urinary incontinence before surgery, which was restored in 13 patients (76.5%).
CONCLUSIONS
The interdisciplinary approach with L-RRP and L-SCP and the use of a BM in a small subgroup were technically feasible, safe, and effective in this single center setting. The study's retrospective design, the small sample size and the lack of comparators limit the generalizability of the findings requiring future randomized trials.
TRIAL REGISTRATION
Retrospectively registered at clinicaltrials.gov, trial number NCT05910021, date of registration 06/10/2023.
Topics: Humans; Female; Retrospective Studies; Pelvic Organ Prolapse; Laparoscopy; Middle Aged; Aged; Surgical Mesh; Treatment Outcome; Vagina; Rectum; Defecation; Postoperative Complications; Gynecologic Surgical Procedures; Syndrome; Constipation
PubMed: 38877450
DOI: 10.1186/s12893-024-02474-4 -
Alternative Therapies in Health and... Jun 2024To evaluate the effectiveness of perioperative empathic care for patients with cervical cancer and its impact on their postoperative recovery and psychological...
OBJECTIVE
To evaluate the effectiveness of perioperative empathic care for patients with cervical cancer and its impact on their postoperative recovery and psychological well-being.
METHODS
A total of 196 patients diagnosed with cervical cancer and treated at our hospital between December 2019 and January 2021 were recruited and assigned via random number table method to receive either conventional nursing care (conventional group) or empathic care (experimental group), with 98 cases in each group. The inclusion criteria for cervical cancer patients were FIGO stage I-III, aged 18-65 years, and no prior cancer treatment. The empathic care provided to the experimental group involved enhanced communication, emotional support, and shared decision-making. Outcome measures included postoperative recovery indices, numeric rating scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS) scores, Hamilton depression scale (HAMD) scores, and Strategies Used by People to Promote Health (SUPPH) scores.
RESULTS
Independent t tests were used to analyze the differences in postoperative recovery indices between the two groups. Patients in the experimental group who received empathic care had significantly shorter mean time to passing gas (2.35 ± 0.61 days vs. 3.41 ± 0.56 days, P < .05), shorter mean time to postoperative defecation (3.28 ± 0.71 days vs. 4.75 ± 0.63 days, P < .05), and shorter mean length of hospital stay (7.18 ± 1.04 days vs. 11.52 ± 1.25 days, P < .05) compared to the conventional group.Before the nursing intervention, there were no significant differences between the two groups in NRS scores, PSQI scores, SAS scores, HAMD scores, and SUPPH scores (all P > .05). After the nursing intervention, ANOVA was used to analyze the differences. Patients in the experimental group had lower mean NRS scores (2.96 ± 0.84 vs. 4.36 ± 1.02, P < .05), lower mean PSQI scores (8.45 ± 1.11 vs. 12.15 ± 1.52, P < .05), lower mean SAS scores (33.08 ± 3.35 vs. 47.65 ± 4.32, P < .05), and lower mean HAMD scores (30.44 ± 3.37 vs. 41.82 ± 4.05, P < .05) compared to the conventional group.
CONCLUSION
This study demonstrates that perioperative empathic care can significantly improve postoperative recovery and psychological well-being in patients with cervical cancer. Patients receiving empathic care exhibited faster return of gastrointestinal function, shorter hospital stays, and better outcomes on measures of pain, sleep quality, anxiety, and depression. These findings suggest that incorporating empathic care into standard oncology nursing practice could have a positive impact on patient experience and clinical outcomes. Beyond the benefits for individual patients, widespread adoption of empathic care approaches has the potential to enhance the overall quality of cancer care, improve resource utilization, and contribute to more holistic, patient-centered models of healthcare delivery. Further research is warranted to evaluate the long-term effects of empathic care and its applicability across diverse oncology populations.
PubMed: 38870495
DOI: No ID Found -
Iranian Journal of Pathology 2024The occurrence of rectosigmoid junction inflammatory myofibroblastic tumor (IMT) is uncommon in children. This is a rare form of mesenchymal tumor, belonging to the...
The occurrence of rectosigmoid junction inflammatory myofibroblastic tumor (IMT) is uncommon in children. This is a rare form of mesenchymal tumor, belonging to the category of soft tissue tumors, and can be found at any anatomical site from the central nervous system to the gastrointestinal tract. Our patient was a 10-year-old male subject complaining of lack of defecation and constipation. The patient had decreased the frequency of defecation and constipation about two weeks before his referral and had not improved despite the use of laxatives. The abdomen was completely distended and there was no tenderness or guarding in the examination. Several airfluid levels are shown on the abdominal X-ray. In the ultrasound, free fluid was reported in the interlobular and pelvic spaces. The patient was transferred into the operating room. A tumor of the rectosigmoid junction was detected. Histopathologic studies showed evidence of IMT. IMT is a rare neoplasm of unknown origin, which may occur in various sites of the body. Complete surgical removal is usually curative, but early detection of recurrence is required. Treatment options include chemotherapy, radiation therapy, and immunotherapy. Further investigations are needed to improve the understanding and management of this rare tumor.
PubMed: 38864087
DOI: 10.30699/ijp.2024.2003653.3122 -
Cureus May 2024Background After anterior resection (AR), one of the most debilitating complications is low anterior resection syndrome (LARS) seen in about 64% of patients. The...
Background After anterior resection (AR), one of the most debilitating complications is low anterior resection syndrome (LARS) seen in about 64% of patients. The severity of the LARS score was significantly correlated with neoadjuvant treatment, the extent of rectal surgery, complication by the anastomotic leak, female gender, and age < 64 years. In this study, we analyzed the impact of various clinical factors on LARS and also the various domains of quality of life (QoL). Purpose To assess the incidence of LARS in patients undergoing sphincter-sparing surgery for rectal cancer after the patient starts long-term defecating per anus, change in the QoL, and relation to LARS and factors affecting it. Methods One year before, 72 patients who had undergone AR in the Regional Cancer Centre were interviewed by a trained interviewer and data was collected from the file. The questionnaires used were the Wexner Incontinence score, LARS Malayalam Questionnaire, and European Organisation For Research and Treatment of Cancer (EORTC) QLQ C30 Malayalam translations. Statistical measures The LARS score was used to categorize patients into three grades. The scores were compared with clinical and social factors using the χ2 test for association. Continuous variables were compared by the Spearman Rho test. Results Details of patients were studied (male: 55.6% (40) and female: 44.4% (32)). Fifty patients underwent low anterior resection (LAR). The mean LARS score was 25.61, with 47.2% of patients having severe LARS score. The mean Wexner score was 6.84. The relation with type of surgery, approach (laparoscopic vs open), or type of neoadjuvant therapy was not found to be significant. A higher LARS score did not impact overall QoL as assessed by FACT-C. Insomnia and diarrhea symptoms scores were significantly worsened. The pain score was worse for those undergoing stapler anastomosis. Wexner's score was worse for those who had received adjuvant chemotherapy. Role functioning score was better for AR compared to low anterior resection (LAR). Only distance from the anal verge was found to be a significant cause of LARS and was negatively correlated. Discussion LARS of severe degrees were seen in most patients. No modifiable risk factors were significantly found to affect the chance of LARS. However, LARS did not have a significant impact on QoL, neither did the type of surgery. So sphincter preservation can be offered to the patients, but all patients undergoing LAR should be counseled well about the risk of LARS before surgery.
PubMed: 38860066
DOI: 10.7759/cureus.60059