Wind-driven roof turbines' effectiveness in enhancing household ventilation: a potential tool to reduce tuberculosis infection

Background: South Africa's overburdened healthcare systems have led to criticism of its unsustainable tuberculosis management interventions. In 2011, the National Department of Health implemented an outpatient, decentralised care model, but this increased costs and jeopardised the long-term viability of prevention measures. Home confinement is now recognised as a viable intervention option, when combined with safety precautions such as ventilation and medical support. However, little is known about the risk of infection in this context. Objectives: To assess the effectiveness of wind-driven roof turbines in enhancing ventilation and their potential to lower the risk of Mycobacterium tuberculosis infection in a residential setting. Methods: Eight houses were selected and divided equally into intervention (wind turbines installed) and control groups, using a pairwise comparison method. The CO2 decay method was used as a proxy to determine ventilation in the houses. The wind-driven roof turbines' potential to lower the risk of Mycobacterium tuberculosis infection was stochastically evaluated using the Wells-Riley mathematical model. Results: During two seasons, installation of a roof turbine resulted in twofold ventilation rates compared to the control houses. Consequently, the WellsRiley model predicted a twofold reduction in the probability of infection in the intervention compared to the control households. Conclusion: Low-cost, low-maintenance wind-driven roof turbines are effective in increasing ventilation in houses, and should be considered as an additional layer of protection against Mycobacterium tuberculosis and other infections in residential settings.

Prediction model of early risk of limb infection secondary to trimersurus mucrosquamatus snakebite / 中华急诊医学杂志

Objective:To explore the method of early prediction of the risk of limb infection in patients bitten by trimersurus mucrosquamatus snake. Methods:Totally 108 inpatients with limbs bitten by trimersurus mucrosquamatus snake in Chongqing Emergency Medical Center from January 2019 to October 2020 were respectively collected. They were divided into the infection group (23 cases) and non infection group (85 cases) according to whether they had secondary infection in the course of the disease. The clinical characteristics and serum indexes before admission were compared between the two groups to screen out the risk factors of infection. By combining all the above methods, the risk factor score was screened out; and the prediction model was constructed according to the snake bite severity score (SSS) and appearance score. The differences of the three prediction models between the two groups of patients were compared, and the predictive value of the three prediction models for the risk of limb infection in patients bitten by trimersurus mucrosquamatus snake was evaluated through the receiver operating characteristic (ROC) curve. Results:There were significant differences in clinical characteristics and serum indexes before admission, injury time, hand and foot finger injury, edema score, tension blister, subcutaneous hemorrhage and admission platelet count between the two groups ( P<0.05). The scores of the three predictive models differed between the two groups ( P<0.05). The ROC curve was used to evaluate the predictive value of the three models for the risk of infection in the course of the disease. The predictive AUC value of the risk factors score was 0.830 (95% CI: 0.635-0.850), the cutoff value was 2.5, the sensitivity was 0.870 and the specificity was 0.671, which was the best in the three prediction models. Conclusions:The prediction model based on the risk factors can effectively predict the infection risk of snake bite patients. It indicates that the infection risk is high when the score of risk factors ≥3 points, which can be used as the basis for guiding clinical treatment plan and is worthy of promotion.

Consenso sobre riesgo de complicaciones infecciosas en pacientes usuarios de medicamentos biológicos seleccionados. Parte I / Consensus of infectious complications in patients treated with selected biological therapies: first Part

Resumen La incorporación de terapias biológicas ha significado un gran avance en el manejo de diversas patologías de origen autoinmune, neoplásico u otros. Si bien su uso ha implicado mejoras significativas en el pronóstico de estas enfermedades, no está exento de complicaciones, entre estas, las infecciosas. El objetivo de este consenso fue evaluar el perfil de seguridad, desde la mirada infectológica, de las terapias biológicas de uso más frecuente y dar recomendaciones para la prevención de infecciones en pacientes tratados con ellas, basándose en la evidencia de mayor calidad disponible para los biológicos seleccionados. El consenso cuenta de dos manuscritos. Esta primera parte detalla los riesgos de desarrollar complicaciones infecciosas dependiendo del tipo de biológico utilizado para determinada patología. La revisión incluyó búsqueda amplia en MEDLINE y Epistemonikos de revisiones sistemáticas y meta-análisis de estudios clínicos controlados y caso/control que examinaban infecciones posteriores al tratamiento con anti-TNF alfa, anti-CD20, anti-CD52, CTLA4-Ig y anti-integrinas. Esta búsqueda se complementó con revisión de cohortes multicéntricas de usuarios de biológicos, del MMWR del CDC, Atlanta, E.U.A. y de registros nacionales y/o de sociedades científicas en la que se hiciera mención a complicaciones infecciosas derivadas del uso de biológicos.

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of two manuscripts. This first part details the risks of developing infectious complications depending on the type of biological used for a certain pathology. This evaluation included a broad search in MEDLINE and Epistemonikos of systematic reviews and meta-analyzes of controlled clinical trials and casecontrol examining post-treatment infections with anti-TNF alpha, anti-CD20, anti-CD52, CTLA4-Ig and anti-integrins. The research was complemented by a review of: multicentre cohorts of biological users, the MMWR of the CDC, Atlanta, U.S.A., and national registers and scientific societies in which infectious complications derived from the use of biological therapies were mentioned.

Consenso sobre riesgo de complicaciones infecciosas en pacientes usuarios de medicamentos biológicos seleccionados. Parte II: Guía clínica chilena de Prevención de Infecciones Asociadas al Uso de Terapias Biológicas (PREVITEB) / Consensus of infectious complications in patients treated with selected biological therapies. Screening of hepatitis B in high risk Chilean and immigrant pregnant women: Management of mother to child transmission Second part: Chilean Guidelines for Prevention of Infections associated to use of Biological Therapies (PREVITEB)

Resumen La incorporación de terapias biológicas ha significado un gran avance en el manejo de diversas patologías de origen autoinmune, neoplásico u otros. Si bien su uso ha implicado mejoras significativas en el pronóstico de estas enfermedades, no está exento de complicaciones, entre éstas, las infecciosas. El objetivo de este consenso fue evaluar el perfil de seguridad, desde la mirada infectológica, de las terapias biológicas de uso más frecuente y dar recomendaciones para la prevención de infecciones en pacientes tratados con ellas, basándose en la evidencia de mayor calidad disponible para los biológicos seleccionados. El consenso cuenta de dos manuscritos. Esta segunda parte corresponde a la guía clínica que detalla estas recomendaciones mediante estrategias de cribado, terapias profilácticas e indicación de vacunas, según corresponde, para infecciones bacterianas, y por micobacterias en particular, virus, hongos y parásitos, tanto para adultos como para niños.

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of 2 manuscripts. This second part is a guideline that details these recommendations through screening strategies, prophylactic therapies and vaccines indications for bacterial, mycobacterial, viral, fungal and parasitic infections, both for adults and children.

Trichomonas vaginalis and HIV infection: relation and prevalence among women in southern Brazil

Trichomoniasis is a curable sexually transmitted infection (STI) that has been reported to be linked to exposure to human immunodeficiency virus (HIV), although few studies have described this association. The purpose of this study was to focus on the incidence of trichomoniasis in low-income women, its relation to HIV status, viral load levels and TCD4+cell counts, among other risk factors, using an in vitro culture as a diagnostic test. A cross-sectional study among 267 women (103 HIV-positive and 164 HIV-negative) was conducted in 2015. The overall prevalence of Trichomonas vaginalis (TV) infection was 6.4%. Among HIV-positive and HIV-negative women, the prevalence was 3.9% and 7.9%, respectively, yet these results were not statistically different (p=0.1878). The factors associated with TV infection were cigarette smoking (OR= 3.52), vaginal itching (OR=4.43) and bacterial vaginosis (BV) (OR= 5.29). HIV status, TCD4+ cell count and viral load were not associated with TV infection in this group. The prevalence rates found, lower than those observed in other studies, may be due to the fact that the women evaluated in the present study are part of a low-risk population as well as the limited sample size of HIV positive women

Characteristic analysis among MSM-users of the "Online HIV Acquisition Risk Assessment System" in Guangzhou / 中华流行病学杂志

Objective@#To analyze the characteristics of levels related to the risk through self-evaluation system, among MSM users in Guangzhou, between 2015 and 2017.@*Methods@#Between 2015 and 2017, data was collected from the users of a self-evaluation system network related to HIV infection, based on the previous 'HIV health risk appraisal model’. Information on risk factors was collected to calculate the scores and levels of risks and to estimate the incidence of HIV. Taking the reference of R value on risks as (R=0.9-1.1) in general population. The ones with very low risk, with low risk, moderate risk, high risk and very high risk were set as R≤0.5, 0.5<R≤0.9, 0.9<R≤1.1, 1.1< R≤2.0 and R>2.0, respectively. The scores of modifiable risk factors were compared with different subgroups of MSM.@*Results@#A total of 4 601 MSM were involved in this study, with the following features presented as: aged 16-64 (28.38±7.11) years, proportions of residence from Guangzhou, Guangdong province or other provinces as 38.6%(1 776/4 601)、35.4%(1 629/4 601) and 26.0%(1 197/4 601), 59.6%(2 742/4 601) received bachelor or above degrees. 81.3%(3 741/4 601) of them claimed as having homosexual orientation. R values of risk level on very low risk, low risk level, moderate risk, high risk and very high risk appeared as 12.9%(594/4 601), 50.9%(2 342/4 601), 17.0%(783/4 601), 14.8%(682/4 601) and 4.3%(200/4 601), respectively. Scores of modifiable risk factors decreased year by year (P<0.05), among MSM in this study. In either of the groups that experiencing insertive or receptive sex, the ones with heterosexual orientation presented the highest scores of modifiable risk factors (P<0.05).@*Conclusions@#The risk levels on HIV infections called for special attention among the users of the self-evaluation network system. Among the MSM that carrying either insertive or receptive sex role, the ones with heterosexual orientation had the highest risk levels and scores of modifiable risk factors in Guangzhou. Further study should be explored to better understand the causes of related risks.

Evaluation of HIV, STI and CD4 results among voluntary attendees at the HIV/AIDS program of Mexico City / Evaluación de resultados de VIH, ETS y CD4 en asistentes al programa de VIH/SIDA de la Ciudad de México

Abstract: Objective: To describe results of HIV, sexually transmitted diseases (STI) and CD4 counts at the HIV-specialized Condesa Clinic (CC) in Mexico City. Materials and methods: Individuals who requested voluntary counseling and testing at CC were studied. We identified antibodies against HIV, syphilis, hepatitis C, and hepatitis B HBsAg. CD4 cell counts and viral load of HIV positive individuals were also obtained. Late HIV infection diagnosis was established if CD4 counts were lower than 200 cells/μL. Results: Global seroprevalence of HIV, syphilis, HBsAg, and anti HCV markers was of 20.1, 6, 1 and 1, respectively. Men displayed higher seroprevalence of infection markers than women. Among men, HIV infection was related to age and with all STI markers. Late HIV diagnosis was 31.8%. The risk of late HIV diagnosis was higher among women and it increased as age increased. Conclusions: Differences between genders regarding HIV and STIs prevalence as well as risk factors for HIV infection and late HIV diagnosis were observed.

Resumen: Objetivo: Describir resultados del programa VIH/SIDA de la Clínica Especializada Condesa (CC). Material y métodos: Se identificaron anticuerpos contra VIH, sífilis y hepatitis C, así como HBsAg del virus de la hepatitis B. Se hizo un conteo de CD4 y carga viral en los positivos a VIH asistentes a la CC. El conteo CD4 menor a 200 células/μL definió el diagnóstico tardío de la infección por VIH. Resultados: La prevalencia de VIH, sífilis, HBsAg y virus de la hepatitis (HCV) fue de 20.1, 6, 1 y 1, respectivamente. Los hombres mostraron prevalencias mayores de infección que las mujeres y en ellos la infección por VIH estuvo relacionada con la edad y con los marcadores de ITS. El diagnóstico tardío de VIH fue de 31.8% y su riesgo fue mayor en las mujeres y se incrementó conforme la edad. Conclusión: Se encontraron diferencias de género en las prevalencias de VIH e ITS, en los riesgos de infección por VIH y en el diagnóstico tardío de esta infección.

Prevalência e fatores de risco para infecção de sítio cirúrgico em mielomengocele / Prevalence of and risk factors for surgical site infections in patients with myelomeningocele / Prevalencia y factores de riesgo para infección del sitio quirúrgico en mielomeningocele

Objetivo: Determinar a prevalência e os fatores de risco para infecção de sítio cirúrgico (ISC) no tratamento de mielomeningocele infantil. Métodos: Foram listados os prontuários de crianças que se submeteram ao procedimento e analisados apenas os casos positivos para ISC. Resultados: De 2005 a 2010, foram listados 155 prontuários, dos quais 123 (79,35%) foram localizados. Destes, 14 (9,03%) foram descartados, restando 109 (70,32%) para análise. Houve 33,94% de prevalência da ISC, e predominaram a localização lombossacral (32,43%) e lesões rotas (83,78%). A maioria (86,49%) das crianças reali-zou correção cirúrgica após 48 horas de vida. Em 11 (27,73%) casos se fez cultura de material proveniente da ferida operatória, todas (100%) positivas; pre-dominaram Klebsiella pneumoniae (46,66%) e Pseudomonas aeruginosa (26,67%). Conclusão: A taxa de prevalência de ISC neste estudo foi considerada alta quando comparada a outros tipos de cirurgia; no entanto, para cirurgias infectadas os níveis encontrados acordam com a literatura, que relata de 7 a 40%.

Objective: To determine the prevalence of and risk factors for surgical site infections (SSIs) in the treatment of children with myelomeningocele. Methods: The medical records of children who underwent the procedure were listed; only the cases that tested positive for SSI were analyzed. Results: From 2005 to 2010, 155 medical records were listed, 123 (79.35%) of which were found. Of these, 14 (9.03%) were discarded, and 109 (70.32%) remained for analysis. There was a 33.94% prevalence of SSIs; the lumbosacral localization (32.43%) and ruptured lesions (83.78%) are predominant. The majority (86.49%) of the children underwent surgical correction after 48 hours of life. In 11 (27.73%) cases, material from the surgical wound was cultured, all of them (100%) were positive; Klebsiella pneumoniae (46.66%) and Pseudomonas aeruginosa (26.67%) prevailed. Conclusion: The prevalence rate of SSIs in this study was high when compared to other types of surgery; for infected surgeries, however, the levels found are consistent with the literature, which reports from 7% to 40%.

Objetivo: Determinar la prevalencia y los factores de riesgo para infección del sitio quirúrgico (ISQ) en el tratamiento de mielomeningocele infantil. Método: Fueron listados los históricos de niños que se sometieron al procedimiento y analizados apenas los casos positivos para ISC. Resultados: De 2005 a 2010, fueron listados 155 históricos, de los cuales 123 (79,35%) fueron ubicados. De estos, 14 (9,03%) fueron descartados, restando 109 (70,32%) para análisis. Hubo un 33,94% de prevalencia de la ISC, y predominaron la ubicación lumbosacra (32,43%) y lesiones rotas (83,78%). La mayoría (86,49%) de los niños realizó corrección quirúrgica tras 48 horas de vida. En 11 (27,73%) casos se hizo cultivo de material proveniente de la herida operatoria, todas (100%) positivas; predominaron Klebsiella pneumoniae (46,66%) y Pseudomonas aeruginosa (26,67%). Conclusión: La tasa de prevalencia de ISQ en este estudio fue considerada alta cuando comparada a otros tipos de cirugía; sin embargo, para cirugías infectadas los niveles encontrados acuerdan con la literatura, que relata de un 7 a un 40%.

Effect of Risk Classifying Method on Prophylactic Application of Antibiotics in TypeⅠOrthopedic and Paren-chyma Incision / 中国药房

OBJECTIVE:To standardize periooperative prophylactic application of antibiotics. METHODS:According to the characteristics of orthopaedic and parenchyma surgery,classifying evaluation table of typeⅠincision infection risk was designed sci-entifically and rationally. The individual application of antibiotics in surgery patients had been achieved through infection risk evalua-tion. High risk typeⅠincision patients used antibiotics rationally and low risk patients seldom used or didn’t use at all. RESULTS:Through using infection risks classifying table,the rate of antibiotics prophylactic application in typeⅠincision drops from 74.10%to 28.68%,and and the per capita duration of antibiotics prophylactic application shortened from 4.23 d to 2.21 d. The postopera-tive infection rate remained the same. CONCLUSIONS:Through infection risk classifying evaluation,individual application of anti-biotics can be achieved in surgery patients,so as to promote rational use of antibiotics for prophylactic use,reduce antibiotics dos-age and antibiotics abuse under the condition of controllable surgery infection.

Status and Risk Factors of Nosocomial Infection in Cerebral Palsy Children / 中国康复理论与实践

@#Objective To investigate the risk factors of nosocomial infection in children with cerebral palsy(CP).Methods The clinical data including infection part,infection time,age,the length of hospitalization,feeding patterns of 1 646 CP children was retrospectively investigated.Results 556 CP children got nosocomial infection.The nosocomial infection rate was 33.78%,the most common infection site was respiratory tract(80.97%),and the age of the most children infected was <2 years.March,April,November and December were the seasons easy to occur nosocomial infection.Conclusion Hypoimmunity,more young,longer hospitalization,season change,more companion and ventilation obstructed indoor maybe the important risk factors which leading a higher nosocomial infection rate among the CP children.

HIV Infection among patients attending the Genitourinary Medicine Clinic, Hospital Kuala Lumpur

Background According to the Department of Public Health Malaysia, the total number of HIV patients up to December 2006 was 76,389. More than 90% were males with Malays being the majority. IVDU was the main mode of transmission followed by heterosexual contact. Objectives To determine the sociodemography, associated risk factors and clinical presentation of patients with HIV attending the Genitourinary Medicine (GUM) clinic. Method A retrospective study analyzing the data using a standard questionnaire. All HIV patients seen in the GUM clinic between 1/1/2000-31/12/2005 were recruited. Results A total of 191 patients with HIV were seen, with 84% being males and 16% females. This constituted 4.2% of the total number of patients seen in the clinic. 64% were Chinese, 18% Malays, 15% Indians and 2% other races. 90% were between 21-50 years of age. The major risk factors for males were sexual promiscuity (61%) and IVDU (14%). 41% frequented commercial sex workers. 74% were heterosexuals, 18% homosexuals and 8% bisexuals. The major risk factors for females were being sexual partners of HIV infected males (48%), IVDU (16%) and sex workers (6%). Majority reported no usage of condom. The main diagnoses at presentation were herpes genitalis (24%), genital warts (22%), gonorrhoea (10%) and syphilis (10%). Non venereal disease accounted for 23%. Conclusions The major risk factor for HIV transmission in patients attending the GUM clinic was exposure to sex workers, and the predominant race was Chinese. According to the national figure the main mode of HIV transmission was IVDU with Malays being the majority. The main diagnoses at presentation were herpes genitalis, genital warts, gonorrhoes and syphilis.

Risk factors and prevention of nosocomial infection in diabetic cerebral infarction / 中国康复理论与实践

@# ObjectiveTo investigate the clinical characteristics of patients,risk factors and preventive measures of nosocomial infection in diabetic cerebral infarction(DCI).MethodsThe clinical data of 124 DCI cases with nosocomial infection and 116 DCI cases without nosocomial infection were analyzed retrospectively.ResultsThe clinical characteristics of nosocomial infection in DCI patients were that large cerebral infarction and severity neurological deficits were very common.The patients always had long hospitalization days and poor prognosis.Invasive operation,antibiotic prophylaxis,severity neurological deficits,fasting plasma glucose,urinary albumin,size of cerebral infarction,albumin/globulin and hospitalization days were the risk factors for nosocomial infection in DCI.Among the patients,nosocomial lower respiratory tract infection was the highest(41.5%),the second one was urinary tract infection(28.1%).The case that both sites of infected was common(8.9%).Klebsiella pneumoniae(16.7%),Pseudomonas aeruginosa(15.9%),Candida albicans(12.1%) and Escherichia coli(12.1%) were the most frequent pathogens.ConclusionThe patient's condition of nosocomial infection in DCI is serious and has poor prognosis.Taking preventive measures according to the risk factors can reduce the infection rate.

Risk factors of nosocomial infection of patients with spinal cord injury / 中国康复理论与实践

@#ObjectiveTo analyze the risk factors of nosocomial infection of patients with spinal cord injury.MethodsRetrospective surveys of nosocomial infection including risk factors, pathogen analysis and drug sensitivity tests were carried out for 88 cases with spinal cord injury in our hospital from 1996 to 2002.ResultsIt showed that the rate of nosocomial infection was 90.91% with 46.59% of urinary tract infection and 32.95% of respiratory tract infection. Nosocomial infection was closely related with such factors as the disease of spinal cord, the use of antibiotics, invasive operation, age and disturbance of disease.ConclusionReducing risk factors and using antibiotics reasonably are effective measures to reduce nosocomial infection of patients with spinal cord injury.

Factors Associated with Fungal Infection Following Pancreatoduodenectomy / 中国普外基础与临床杂志

Objective To investigate the relevant factors for fungal infection following pancreatoduodenectomy and offer the theoretical foundation for preventing the emergence of complications after operation. Methods Medical records from 562 consecutive patients who underwent pancreatoduodenectomy in this hospital from 1995 to 2005 were retrospectively reviewed by using single factor and non-condition Logistic regression analyse. Results ①Seventy-eight patients (13.9%) developed invasive fungal infection. The most frequently isolated fungal were Candida albicans accounted for 67.0%, and followed by Candida glabrata, Candida papasilosis and Candida tropicalis and gastrointestinal tract was the most common infection site, followed by respiratory tract, abdominal cavity. ②Fungal infection occurred significantly more often in patients with the length of time in parenteral nutrition, antibiotic use or abdominal cavity complications. Conclusion The most common infection site and isolated fungal associated with pancreatoduodenectomy were gastrointestinal tract and Candida albicans. Abdominal cavity complications such as pancreatic fistula, biliary fistula and abdominal infection and extended use parenteral nutrition and antibiotic are the most important factors leading to invasive fungal infection after pancreatoduodenctomy. Eliminating the various risk factors will decrease the incidence of fungal infection.

Risk factors analysis for fungal infection in lupus nephritis patients / 中国实用内科杂志

Objective To investigate the fungal infection situation and the risk factors in lupus nephritis(LN)patients.Methods Infection states were investigated in 93 LN patients and 45episodes(about 48.4%) occurred the different kind and different degree of Hospital-acquired infections.The fungal infection rate was 22.6% and two patients directly died of it.Except fungi,the main pathogens were bacteria and virus.The main infection sites were urinary,gastrointestinal and respiratory tract.Results The infection causes were related to the use of corticosteroids,immunodepressive,antibiotic and the aggressive operation,renal failure ,the duration in hospital and so on.Conclusion Effective prevention and treatment for infection in LN patients is an important way to improve the prognosis of LN.