Effectiveness of SMS reminders on improving follow-up rate of hypertensive patients during COVID-19 pandemic: An interim analysis of randomized controlled trial

Background@#Non-communicable diseases are a challenge to manage, more so during the COVID-19 pandemic. SMS-text messaging can be part of the solution, although more studies are needed.@*Objective@#Researchers evaluated the effectiveness of sending SMS reminders on different time intervals from the scheduled follow-up among hypertensive patients during the COVID-19 pandemic.@*Methods@#This is an interim analysis using a multi-clinic, three-armed, blinded, randomized controlled trial. 65 participants from two primary care facilities were recruited. Group A and B were sent SMS reminders three days and one day prior to their follow up appointment, respectively. Participants randomized to group C were not sent SMS reminders. Primary outcome measured was the difference between the follow-up rates of the three study arms. Intention to treat analysis was done.@*Results@#Follow-up rates for groups A, B, and C were 23.81%, 6.25%, and 19.05% respectively. Compared to the control group, participants in group A were likely to follow-up, while group B were less likely to follow-up (RR= 0.94 and 1.16 respectively). Comparing the two treatment arms, group A showed 19% risk reduction in non-attendance compared to group B (RR=0.81). The researchers failed to demonstrate statistical significance (p = 0.361024) between the three study arms.@*Conclusion@#This interim analysis shows a possible benefit of sending SMS reminders three days before scheduled follow-up. More robust conclusion can be made once more participants are added to the study. Longer time interval for sending SMS reminders, longer follow-up schedule, and broader inclusion criteria are recommended for future studies.

Degree Of burnout and its association with depression, anxiety and stress among health care workers in a tertiary hospital in Mandaue City during the COVID-19 pandemic

Background@#On top of adjusting to the societal shifts and emotional stressors faced by everyone, health care workers are also confronted by stressors such as an increased risk of exposure, extreme workloads, moral dilemmas, and a dynamic practice environment that differs greatly from what was familiar. These can lead to burnout, a state of physical, emotional, and mental exhaustion that results from long-term involvement in work situations that are emotionally demanding. @*General Objective@#This is a descriptive cross-sectional study that intends to measure the degree of burnout and determine its association with depression, anxiety, and stress among health care workers in Chong Hua Hospital Mandaue during the COVID-19 pandemic. @*Methodology@#The data collection process entailed the researchers’ physical and online administration of a questionnaire which included the health care workers’ socio-demographic data and questions lifted from both the Copenhagen Burnout Inventory (CBI) and Depression, Anxiety, Stress Scales (DASS) 42-item. Also included was an open-ended questionnaire to enumerate outbreak-specific contributors to burnout. @*Results@#222 health care workers were surveyed. Almost half (98, 44.2%) of the health care workers registered moderate to high overall burnout scores on the CBI but none of them had severe burnout. The degree of burnout was determined to be moderately associated with all three negative emotional states using the Cramer’s V coefficient: depression (V = .448), anxiety (V = .378), and stress (V = .415). The foremost factor identified to be a contributor to burnout was the high workload which was exacerbated by the onset of the pandemic. @*Conclusion@#The study showed that burnout and the negative psychological states of depression, anxiety, and stress, are prevalent in health care providers with results comparable to other global studies. The contributors to burnout identified by the respondents were either present pre-pandemic but were aggravated by it and those which were outbreak-specific.

Consumo de tabaco y condición de empleo en una región del eje cafetero colombiano / Smoking and employment conditions in a department of the coffee-triangle region of Colombia

RESUMEN Objetivos Estimar la prevalencia del consumo de tabaco en una región del eje cafetero y su asociación con la condición de empleo. Métodos Este estudio fue del tipo corte transversal. Los participantes fueron hombres y mujeres mayores de 15 años residentes de los municipios de Risaralda que aceptaron ser encuestados sobre las características del consumo de tabaco en 2017. Resultados Se evaluaron 4 157 registros de personas y se obtuvo una prevalencia de consumo de tabaco en Risaralda del 11,5%. En subempleados hubo una asociación significativa por fumar (p<0,05) (OR=1,51 IC95%: 1,18-1,94) cuando se ajustó el consumo de cigarrillo por edad y sexo, mientras que en desempleados el odds ratio reportado fue mayor (OR=3,10 IC95%: 2,03-4,73). Conclusiones Se encontró que el subempleo es un factor de riesgo para el consumo de tabaco que debe ser considerado en el desarrollo de políticas para el control de consumo de tabaco en la región en población vulnerable. La condición de empleo puede explicar las limitaciones de una política de control de consumo de tabaco en la población.

ABSTRACT Objective To estimate the links between smoking and employment conditions in a department of the coffee-triangle region. Methods This was a cross-sectional study. Participants were men and women older than 15 years residing in the municipalities of Risaralda. They agreed to complete a survey asking about the characteristics of tobacco consumption and socioeconomic status, in 2017. Results A total of 4 157 participants were surveyed. The smoking prevalence in Risaralda was 11,5%. Underemployment had a significant association with smoking (p<0,05 OR:1,51 CI95%: 1,18-1,94). Statistical significance was found when adjusting smoking by age and sex, whereas unemployment had over three times greater odds for smoking (OR:3,10, CI95%: 2,03-4,73). Conclusion This study finds that underemployment is a risk factor for smoking. This statement should be considered to the future assessment of the tobacco control policies in the region, particularly for vulnerable population. The employment conditions could explain the boundaries at the tobacco control policies in the population.

Gender-specific risk factors for gout: a systematic review of cohort studies

Abstract Background: Though gout is more prevalent in men than women, it remains unclear whether gender influences risk factors for incident gout. We aimed to systematically review all cohort studies examining risk factors for the development of gout by gender. Methods: MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched from inception to March 2019. Risk factors for gout examined were: age, ethnicity, consumption of alcohol, meat, seafood, dairy products, purine-rich vegetables, coffee and fructose, vitamin C intake, the Dietary Approaches to Stop Hypertension (DASH) diet, metabolic syndrome, BMI, waist and chest circumference, waist-to-hip ratio, weight change, diabetes mellitus, dyslipidaemias, renal disease, psoriasis, hypertension, diuretic use and anti-diabetic medication. Cohort studies were included if examining (at least) one of these risk factors for gout in either gender in the general population or primary care. Sample characteristics from included articles and their reported risk estimates were described using narrative synthesis. Results: Thirty-three articles were included, 20 (60.6%)directly compared risk factors by gender, 10 (30.3%) used men-only samples, 3 (9.1%) used women-only samples. Articles comparing risk across genders found similar increases in most risk factors. However, in men, metabolic syndrome (Hazard Ratio (95% CI) 1.37(1.20-1.58)) presented a risk of incident gout compared to none in women (> 50 years 1.15(0.85-1.54); ≤50 years 1.29(0.76-2.17)). Compared to men, women showed greater associated risk with higher consumption of fish and shellfish (HR (95% CI) Men: 1.02 (0.86-1.22); Women 1.36 (1.12-1.65)). Conclusions: Risk factors for developing gout did not typically differ between genders and therefore similar preventative advice can be provided. Exceptions were metabolic syndrome in men and excessive seafood consumption in women, but these singular articles need further examination and in general more research into the risk factors for gout which includes women is required.

Identification of enteric viruses circulating in a dog population with low vaccine coverage

ABSTRACT Although the use of vaccines has controlled enteric diseases in dogs in many developed countries, vaccine coverage is still under optimal situation in Brazil. There is a large population of nonimmunized dogs and few studies about the identification of the viruses associated with diarrhea. To address this situation, stool samples from 325 dogs were analyzed by polymerase chain reaction for the detection of common enteric viruses such as Canine adenovirus (CAdV), Canine coronavirus (CCoV), Canine distemper virus (CDV), Canine rotavirus (CRV) and Carnivorous protoparvovirus 1 (canine parvovirus 2; CPV-2). At least one of these species was detected in 56.6% (184/325) of the samples. The viruses detected most frequently in either diarrheic or nondiarrheic dog feces were CPV-2 (54.3% of the positive samples), CDV (45.1%) and CCoV (30.4%), followed by CRV (8.2%) and CAdV (4.9%). Only one agent was detected in the majority of the positive samples (63%), but co-infections were present in 37% of the positive samples and mainly included CDV and CPV-2. The data presented herein can improve the clinical knowledge in regions with low vaccine coverage and highlight the need to improve the methods used to control these infectious diseases in domestic dogs.

Detection and genetic characterization of Mamastrovirus 5 from Brazilian dogs

Abstract Mamastrovirus 5 (MAstV5), belonging to the Astroviridae (AstV) family, previously known as canine astrovirus or astrovirus-like particles, has been reported in several countries to be associated with viral enteric disease in dogs since the 1980s. Astroviruses have been detected in fecal samples from a wide variety of mammals and birds that are associated with gastroenteritis and extra enteric manifestations. In the present study, RT-PCR was used to investigate the presence of MAstV5 in 269 dog fecal samples. MAstV5 was detected in 26% (71/269) of the samples. Interestingly, all MAstV5-positive samples derived from dogs displaying clinical signs suggestive of gastroenteritis, other enteric viruses were simultaneously detected (canine parvovirus, canine distemper virus, canine coronavirus, canine adenovirus and canine rotavirus). Based on genomic sequence analysis of MAstV5 a novel classification of the species into four genotypes, MAstV5a-MAstV5d, is proposed. Phylogenetic analyses based on the ORF2 amino acid sequences, samples described herein grouped into the putative genotype 'a' closed related with Chinese samples. Other studies are required to attempt the clinical and antigenic implications of these astrovirus genotypes in dogs.

Effects of terrestrial runoff on the coral communities in Santiago Bay, Colima, Mexican Pacific Coast

Abstract:Coral reef ecosystems are under stress of different origins, from factors including sedimentation, fragmentation, overfishing, and tourism, depending on their geographical location, depth, and proximity to recreation areas. In this study of Juluapan Lagoon, we examined the relationship between various water-quality attributes and the status indicators of the coral community at La Boquita reef. During 2011 (12 months of sampling), six monitoring stations in the Juluapan lagoon were established in order to observe the gradient of the distribution of the physicochemical parameters: three stations on the upper part, or BI, (S4 to S6) and three more in the lower part, or BII, (S1 to S3). A control station (CS) was located in the coral reef close to the lagoon channel, and where dissolved inorganic nutrients and cellular carbon content were determined. Additionally, we considered the monitoring of three of the eight largest coral structures/headlands of this community: the first was the station closest to the channel communicating with Juluapan lagoon (C1), the second was in the intermediate region with respect to that lagoon (C2), and the third was farthest from the channel (C3). Three line intercept transects (LIT) 30 m in length and perpendicular to the coast provenance were established in each station, and the parameters indicative of the status of corals were evaluated in an area of 60 m2 on each transect (180 m2 by the station). Turbidity, evidence of fishing, signs of settling, algal coverage, abundance of fish, rate of sediment, and coral health records (as for CoralWach chart) were determined in situ and from digital photographs and videos. Considering various community status indicators used in the reef area, we could recognize a state of general deterioration, which was reflected in the loss of 17% of coral coverage. The main anthropogenic disturbances in adjacent areas to La Boquita reef included wastewater discharges into the lagoon, tourist developments in the coastal zone, deforestation and erosion resulting from inappropriate development, and the runoff of nutrients from agricultural lands nearby the lagoon. All these significantly contributed to the nutrient-enriched waters of the lagoon, especially in summer, with negative effects on the coral community. Continued exposure to these factors, coupled with the lack of control over other anthropogenic components, has promoted the maintenance of a chronic stress state in the studied coral community. Our findings highlight the need for the development of appropriate coastal management and conservation policies for the coral reefs of the Mexican Pacific Coast. Rev. Biol. Trop. 64 (3): 1185-1200. Epub 2016 September 01.

ResumenDependiendo de la ubicación geográfica, la profundidad, y la proximidad a zonas de recreo, algunos arrecifes de coral están bajo estrés por factores que incluyen la sedimentación, la fragmentación, la sobrepesca y el turismo. En la presente investigación, se estudian los diferentes atributos de calidad de agua de la Laguna Juluapan e indicadores del estatus de la comunidad coralina La Boquita. Durante 2011 (12 meses de muestreo), seis estaciones de monitoreo fueron establecidas dentro de la laguna de Juluapan, a fin de observar el gradiente de distribución de los parámetros fisicoquímicos: tres estaciones en la parte interna ó B1, (S4 a S6), y tres en la parte más externa, ó B2 (S1 a S3); una estación control (CS) fue ubicada en la zona coralina cercana a la comunicación con la Laguna de Juluapan, fueron determinados nutrientes inorgánicos disueltos y contenido de carbono celular. Adicionalmente se realizó el monitoreo de tres de los ocho cabezales coralinos que conforman esta comunidad. El primero de ellos fue localizado en la cercanía de la intercomunicación con la Laguna Juluapan (C1), el segundo en la región intermedia respecto a la proximidad de dicho cuerpo lagunar (C2), y el tercero totalmente alejado respeto a la intercomunicación (C3). En cada estación fueron colocadas, tres líneas de transectos de intersección (LIT) de 30 m de longitud de forma perpendicular al perfil de la costa, a partir de ello, fueron evaluados diversos parámetros de la condición coralina, cubriendo un área de 60 m2 en cada transecto (180 m2 por estación). En cada área de transecto fue evaluada la turbidez, evidencias de daños por pesca, daños por sedimentación, cobertura de algas, abundancia de peces, tasa de sedimentación, además de obtenerse registros de la salud coralina usando como indicador la tarjeta CoralWatch in situ, a partir de tomas fotográficas y videos. Considerando los diferentes indicadores del estatus de la comunidad coralina estudiada, nosotros pudimos reconocer un estado general de deterioro, reflejado en la pérdida del 17% de la cobertura de coral. Las principales alteraciones antropogénicas en las zonas adyacentes al arrecife La Boquita corresponde a descargas de aguas residuales en la laguna, desarrollos turísticos en la zona costera, la deforestación y efecto erosivo asociado al desarrollo urbano inadecuado, así como el escurrimiento de nutrientes de tierras agrícolas alrededor de la laguna. Estos factores contribuyen de manera significativa al enriquecimiento de nutrientes a la laguna, sobre todo en verano, con efectos negativos sobre la comunidad de coral. La exposición continua a estos factores, junto con la falta de control sobre otros componentes antropogénicos, promueve la existencia de un estado de estrés crónico en la comunidad coralina estudiada. Nuestros resultados destacan la necesidad de implementar políticas apropiadas de conservación para los arrecifes coralinos de la costa del Pacífico mexicano.

Funny turns in an elderly man

A 74-year old man presented with recurrent attacks of altered sensorium, sometimes with abrupt falls, against the background of a long history of chronic obstructive airways disease and ischaemic heart disease. Investigations revealed evidence of significant cardiac conduction abnormalities and this led to the insertion of a permanent pacemaker. However, he continued to have recurrent 'syncopal'attacks. He was hospitalized to clarify the nature and aetiology of these attacks. Multiple stereotyped events were observed by different medical personnel, lasting up to two hours in duration. An attack was terminated by the administration of intravenous diazepam. Subsequent initiation of anti-epileptic drugs led to the complete abolition of these episodes. He has remained event-free since then ie two years. Because of multiple co-morbidities, the elderly present a greater diagnostic challenge in the evaluation of paroxysmal alterations in sensorium. It is essential that epilepsy, particularly with non-convulsive seizures, be included in the differential diagnosis whenever evaluating these patients.

Achados laparoscópicos na infertilidade / Infertility and laparoscopic finding

O objetivo deste trabalho é rever retropectivamente os achados laparoscópicos em mulheres infertéis. Entre 1990 e 1997 foram realizadas 115 laparoscopias em mulheres com queixa de infertilidade, seguidas no ambulatório de Esterelidade da Faculdade de Medicina de Londrina/UEL. Deste total, 100 mulheres foram analisadas quanto a idade, paridade, tipos de partos e abortos anteriores, presença de prenhez ectópica anteiror ao procedimento laparóscopico, história prévia de doença inflamatória pélvica (DIP) e dismenorréia. A seguir as pacientes foram avaliadas quanto ao achado laparoscópio, sendo os mais freqüentes endometriose (54 por cento) e aderências pélvicas (49 por cento). Ainda foram encontradas 22 pacientes com laqueadura tubária prévia e nove pacientes com mioma. Deste universo de pacientes 39 tiveram cromotubagens positivas, 34 cromotubagens negativas, 20 cromotubagens positiva uniteralmente e sete inconclusivas

Sindrome de transfusäo feto-fetal / Twin-to-twin transfusion syndrome

Os autores realizaram uma revisÝo bibliográfica abragendo conceitos atuais sobre definiçÝo, fisiopatologia, diagnóstico, seguimento, tratamento e complicaçSes na Sindrome de transfusÝo feto-fetal. Eles confrontam as várias polêmicas sobre a eficácia e benefícios dos modernos métodos de diagnóstico e sua contribuiçÝo nos resultados neonatais