Impact of COVID-19 on the degree of compliance with hand hygiene: a repeated cross-sectional study.

Hand hygiene (HH) is the paramount measure used to prevent healthcare-associated infections. A repeated cross-sectional study was undertaken with direct observation of the degree of compliance on HH of healthcare personnel during the SARS-CoV-2 pandemic. Between, 2018-2019, 9,083 HH opportunities were considered, and 5,821 in 2020-2022. Chi squared tests were used to identify associations. The crude and adjusted odds ratios were used along with a logistic regression model for statistical analyses. Compliance on HH increased significantly (p < 0.001) from 54.5% (95% CI: 53.5, 55.5) to 70.1% (95% CI: 68.9, 71.2) during the COVID-19 pandemic. This increase was observed in four of the five key moments of HH established by the World Health Organization (WHO) (p < 0.05), except at moment 4. The factors that were significantly and independently associated with compliance were the time period considered, type of healthcare-personnel, attendance at training sessions, knowledge of HH and WHO guidelines, and availability of hand disinfectant alcoholic solution in pocket format. Highest HH compliance occurred during the COVID-19 pandemic, reflecting a positive change in healthcare-personnel's behaviour regarding HH recommendations.

Efectividad de la vacuna antigripal para prevenir casos graves de gripe. Temporada 2022/2023 / Effectiveness of influenza vaccine in preventing severe cases of influenza: Season 2022/2023

Introducción: La gripe supone una importante carga en términos de morbimortalidad, siendo la vacunación una de las medidas más efectivas para su prevención. Por lo que el objetivo de este estudio es conocer la efectividad de la vacuna antigripal para prevenir casos de gripe grave en los pacientes ingresados en un hospital de tercer nivel durante la temporada 2022/23. Metodología: Estudio de casos y controles. Se incluyeron todos los pacientes hospitalizados con resultado positivo en una RT-PCR de gripe. Se consideró caso a aquellos que cumplieron criterio de caso grave (neumonía, sepsis, fallo multiorgánico, ingreso en la UCI o exitus). Quienes no los cumplían se consideraron controles. Se calculó la efectividad vacunal (EV) para prevenir los casos graves y su intervalo de confianza al 95%. Resultados: Un total de 403 pacientes ingresaron con gripe confirmada. Noventa y ocho (24,3%) de ellos desarrollaron gripe grave. Del total, el 50,6% fueron varones y el 47,1% fueron mayores de 65 años. La EV ajustada por tipo de gripe, edad y ciertas comorbilidades fue del 40,6% (−21,9-71,1). En un análisis segmentado, la vacuna de la gripe resultó efectiva para la prevención de los casos graves en todas las categorías. Resultó especialmente relevante en el grupo de 65 años o más (EVa=60,9%; −2,0-85,0) y en los pacientes con gripe A (EVa=56,7%; 1,5-80,9). Conclusiones: La vacunación antigripal redujo notablemente la aparición de casos graves de gripe en los pacientes hospitalizados, por tanto, sigue siendo la principal estrategia para reducir la morbimortalidad y los costes asociados.(AU)

Introduction: Influenza poses a significant burden in terms of morbidity and mortality, with vaccination being one of the most effective measures for its prevention. Therefore, the aim of this study is to determine the effectiveness of the influenza vaccine in preventing cases of severe influenza in patients admitted to a tertiary hospital during the 2022/23 season. Methods: Case-control study. All hospitalised patients with a positive result in an RT-PCR for influenza were included. Those who met the criteria for a severe case (pneumonia, sepsis, multi-organ failure, admission to ICU or exitus) were considered cases. Those who did not meet these criteria were considered controls. Vaccine effectiveness (VE) to prevent severe cases and its 95% confidence interval were calculated. Results: A total of 403 patients were admitted with confirmed influenza. Of these, 98 (24.3%) developed severe influenza. Of the total, 50.6% were men and 47.1% were over 65 years of age. VE adjusted for influenza type, age and certain comorbidities was 40.6% (−21.9 to 71.1). In a segmented analysis, influenza vaccine was effective in preventing severe cases in all categories. It was particularly relevant in the 65+ age group (VEa=60.9%; −2.0 to 85.0) and in patients with influenza A (VEa=56.7%; 1.580.9). Conclusion: Influenza vaccination markedly reduced the occurrence of severe cases of influenza in hospitalised patients, therefore, it remains the main strategy to reduce morbidity and mortality and associated costs.(AU)

Effectiveness of influenza vaccine in preventing severe cases of influenza: Season 2022/2023.

INTRODUCTION: Influenza poses a significant burden in terms of morbidity and mortality, with vaccination being one of the most effective measures for its prevention. Therefore, the aim of this study is to determine the effectiveness of the influenza vaccine in preventing cases of severe influenza in patients admitted to a tertiary hospital during the 2022/23 season. METHODS: Case-control study. All hospitalised patients with a positive result in an RT-PCR for influenza were included. Those who met the criteria for a severe case (pneumonia, sepsis, multi-organ failure, admission to ICU or exitus) were considered cases. Those who did not meet these criteria were considered controls. Vaccine effectiveness (VE) to prevent severe cases and its 95% confidence interval were calculated. RESULTS: A total of 403 patients were admitted with confirmed influenza. Of these, 98 (24.3%) developed severe influenza. Of the total, 50.6% were men and 47.1% were over 65 years of age. VE adjusted for influenza type, age and certain comorbidities was 40.6% (-21.9 to 71.1). In a segmented analysis, influenza vaccine was effective in preventing severe cases in all categories. It was particularly relevant in the 65+ age group (VEa = 60.9%; -2.0 to 85.0) and in patients with influenza A (VEa = 56.7%; 1.5-80.9). CONCLUSION: Influenza vaccination markedly reduced the occurrence of severe cases of influenza in hospitalised patients, therefore, it remains the main strategy to reduce morbidity and mortality and associated costs.

Unraveling the Phase Transition Behavior of MgMn2O4 Electrodes for Their Use in Rechargeable Magnesium Batteries.

Rechargeable magnesium batteries are an attractive alternative to lithium batteries because of their higher safety and lower cost, being spinel-type materials promising candidates for their positive electrode. Herein, MgMn2O4 with a tetragonal structure is synthesized via a simple, low-cost Pechini methodology and tested in aqueous media. Electrochemical measurements combined with in-situ Raman spectroscopy and other ex-situ physicochemical characterization techniques show that, in aqueous media, the charge/discharge process occurs through the co-intercalation of Mg2+ and water molecules. A progressive structure evolution from a well-defined spinel to a birnessite-type arrangement occurs during the first cycles, provoking capacity activation. The concomitant towering morphological change induces poor cycling performance, probably due to partial delamination and loss of electrical contact between the active film and the substrate. Interestingly, both MgMn2O4 capacity retention and cyclability can be increased by doping with nickel. This work provides insights into the positive electrode processes in aqueous media, which is vital for understanding the charge storage mechanism and the correlated performance of spinel-type host materials.

Maladaptive personality traits in patients with recent-onset psychosis: A case-control study using the Personality Inventory for the DSM-5 (PID-5).

BACKGROUND: The relationship between maladaptive personality traits and psychotic disorders in the early stages of disease has not been thoroughly investigated, even though it is essential for developing prevention and early intervention strategies. METHODS: The five domains and the 25 facets of the Personality Inventory for DSM-5 (PID-5) were compared between 102 patients with recent-onset psychosis (ROP) and 116 community subjects (C) with a general linear model including age and sex in the analyses. In addition, multiple linear regression models were used to identify which factors associated with the PID-5 domains in ROP, and correlation analyses were used to explore the relationship between personality traits. RESULTS: Patients with ROP, compared to C, exhibited higher scores in four out of the five domains with medium effect sizes (Cohen's f2 ≥ 0.15) in two of them: negative affect (NA, p = 0.013, f2 = 0.04), detachment (DET, p < 0.001, f2 = 0.15), disinhibition (DIS, p < 0.001, f2 = 0.14) and psychoticism (PSY, p < 0.001, f2 = 0.16). Significant group differences were observed in 15 of the 25 facets and the largest effects were observed in the facets of withdrawal (p ≤ 0.001, f2 = 0.20), irresponsibility (p < 0.001, f2 = 0.23) and unusual beliefs (p = 0.001, f2 = 0.22). Interestingly, being on antidepressants and high scores on the positive subscale of the Positive and Negative Syndrome Scale (PANSS) were associated with high scores of NA, antagonism (ANT) and PSY. CONCLUSIONS: Maladaptive personality traits were prominent in persons with ROP. These findings suggest that personality traits might play a role in vulnerability to psychosis and highlight the importance of evaluating personality in the early stages of psychosis.

Risk factors for metabolic syndrome in individuals with recent-onset psychosis at disease onset and after 1-year follow-up.

Metabolic syndrome (MetS) is a cluster of parameters encompassing the most dangerous heart attack risk factors, associated with increased morbidity and mortality. It is highly prevalent in recent-onset psychosis (ROP) patients. In this pilot study, we evaluated MetS parameters (fasting glucose, high-density lipoprotein (HDL) cholesterol (HDL-c), fasting triglycerides, waist circumference, and systolic and diastolic blood pressure), clinical symptoms, pharmacological treatment, lifestyle, and inflammatory markers in 69 patients with ROP and 61 healthy controls (HCs). At baseline, waist circumference (p = 0.005) and fasting triglycerides (p = 0.007) were higher in patients with ROP than in HCs. At the 1-year follow-up, patients showed clinical improvement, with a reduction in the positive and negative syndrome scale (PANSS) score (p < 0.001), dietary intake (p = 0.001), and antipsychotic medication dose (p < 0.001); however, fasting glucose (p = 0.011), HDL-c (p = 0.013) and waist circumference worsened (p < 0.001). We identified sex, age, BMI, dietary intake, physical activity, daily tobacco use, daily cannabis use, and antipsychotic doses as risk factors contributing to baseline MetS parameters. After 1-year follow-up, those factors plus the PANSS and Calgary Depression Scale for Schizophrenia (CDSS) scores were associated with MetS parameters. Further studies are needed to understand the contributions of the studied risk factors in patients with ROP at onset and during disease progression.

Development and validation of the INCREMENT-ESBL predictive score for mortality in patients with bloodstream infections due to extended-spectrum-ß-lactamase-producing Enterobacteriaceae.

Background: Bloodstream infections (BSIs) due to ESBL-producing Enterobacteriaceae (ESBL-E) are frequent yet outcome prediction rules for clinical use have not been developed. The objective was to define and validate a predictive risk score for 30 day mortality. Methods: A multinational retrospective cohort study including consecutive episodes of BSI due to ESBL-E was performed; cases were randomly assigned to a derivation cohort (DC) or a validation cohort (VC). The main outcome variable was all-cause 30 day mortality. A predictive score was developed using logistic regression coefficients for the DC, then tested in the VC. Results: The DC and VC included 622 and 328 episodes, respectively. The final multivariate logistic regression model for mortality in the DC included age >50 years (OR = 2.63; 95% CI: 1.18-5.85; 3 points), infection due to Klebsiella spp. (OR = 2.08; 95% CI: 1.21-3.58; 2 points), source other than urinary tract (OR = 3.6; 95% CI: 2.02-6.44; 3 points), fatal underlying disease (OR = 3.91; 95% CI: 2.24-6.80; 4 points), Pitt score >3 (OR = 3.04; 95 CI: 1.69-5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72-8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58-4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of < 11 and ≥11 were 5.6% and 45.9%, respectively, in the DC, and 5.4% and 34.8% in the VC. Conclusions: We developed and validated an easy-to-collect predictive scoring model for all-cause 30 day mortality useful for identifying patients at high and low risk of mortality.

Personality dimensions of schizophrenia patients compared to control subjects by gender and the relationship with illness severity.

BACKGROUND: Personality traits and schizophrenia present gender differences; however, gender has not been considered in most studies on personality and schizophrenia. This study aims to identify the different personality dimensions of schizophrenia patients and healthy control subjects by gender and to explore the relationship between personality dimensions and illness severity variables by analyzing data for males and females separately. METHODS: Temperament and Character Inventory-Revised dimensions were compared by gender between 161 schizophrenia patients and 214 healthy controls from a population-based sample using independent t-tests. We then investigated whether personality dimensions are related to illness severity variables using correlation analyses and bivariate logistic regression, also by gender. RESULTS: The patients had significantly higher scores for harm avoidance (HA) and self-transcendence (ST) and lower scores for reward dependence (RD), cooperativeness (C), and self-directedness (SD) than the controls. Similar results were obtained when the sample was stratified by gender, however the differences were higher and more significant for HA among males and for RD among females. The number of admissions to a psychiatric hospital positively correlated with novelty seeking (NS) in males and negatively with SD in females. In males, SD and ST negatively correlated with the number of suicide attempts. CONCLUSIONS: Male and female patients present difficulties for regulating and adapting behavior to achieve goals (SD) and for identifying and accepting others (C), as well as a great sense of spirituality and universe identification (ST). However, male patients are more characterized by being fearful, doubtful and easily fatigued (HA), while female patients are characterized by presenting difficulties maintaining and pursuing associated reward behaviors (RD). Furthermore, male and female patients who are frequently admitted to psychiatric hospitals and male patients who attempt suicide should be evaluated regarding their personality dimensions. Future studies assessing the relationship between personality dimensions and the clinical features of schizophrenia should consider gender differences.

New evidence for the involvement of mitochondrial inheritance in schizophrenia: results from a cross-sectional study evaluating the risk of illness in relatives of schizophrenia patients.

OBJECTIVE: One of the hypotheses about the genetic factors that contribute to schizophrenia involves mitochondrial DNA (mtDNA), an approximately 16,569-base pair molecule inherited only from the mother. If this hypothesis were true, one would expect a higher frequency of schizophrenia among matrilineal relatives who share mtDNA with a schizophrenia patient than among relatives who do not. This article reports the risk of presenting with schizophrenia, other psychiatric disorders, and conditions related to mitochondrial disorders in relatives who share mtDNA with a schizophrenia patient versus those who do not. METHOD: We interviewed 100 schizophrenia patients (DSM-IV criteria) and 147 of their first-degree relatives from November 2007 to November 2009 to collect clinical data from patients and from both sides of each patient's pedigree. The study was conducted at of a psychiatric teaching hospital in Reus, Spain. Contingency tables were established, and odds ratios were calculated to estimate relative risk. RESULTS: Relatives who shared mtDNA with a schizophrenia patient had a higher risk of presenting with schizophrenia than those who did not share mtDNA (odds ratio [OR] = 3.05; 95% CI, 1.65-5.72; P < .001). Female but not male relatives who shared mtDNA with a schizophrenia patient also had a higher risk of unipolar depression (OR =10.19; 95% CI, 4.07-32.80; P < .001), panic attack (OR = 15.52; 95% CI, 2.41-643.6; P < .001), and other anxiety disorders (OR = 4.14; 95% CI, 1.84-9.71; P < .001). Some conditions frequently associated with mitochondrial disorders were also more frequent among female relatives who shared mtDNA with a schizophrenia patient than among those who did not. CONCLUSIONS: The results of this study support the hypothesis that mtDNA may be involved in schizophrenia. In females, mtDNA could also be involved in the development of other psychiatric and nonpsychiatric conditions. Further studies are needed to confirm the role of mtDNA in psychiatric disorders.

Characteristics of meningitis caused by Ibuprofen: report of 2 cases with recurrent episodes and review of the literature.

Ibuprofen is a common nonsteroidal antiinflammatory drug that is the most frequent cause of aseptic meningitis induced by drugs. The incidence of this type of aseptic meningitis is increasing, mainly among patients with underlying autoimmune connective tissue disorder, but also among healthy people. We report 2 patients with recurrent meningitis caused by ibuprofen mimicking bacterial meningitis: the first patient a woman with dermatomyositis and the second patient a previously healthy woman who developed autoimmune thyroiditis a few months later. We then review 71 episodes of ibuprofen-related meningitis in 36 patients reported in the literature. Twenty-two patients (61%) presented with an autoimmune connective tissue disorder, mainly systemic lupus erythematosus, and 22 (61%) had recurrent episodes. Most episodes consisted of an acute meningeal syndrome with a predominance of neutrophils in cerebrospinal fluid (CSF) in 72.2% of episodes and elevated protein in the CSF, so the clinical presentation of this type of aseptic meningitis may be quite similar to that of acute bacterial meningitis. CSF glucose levels are usually normal, which may help to differentiate between these 2 types of meningitis. In some cases the clinical presentation is that of meningoencephalitis with neurologic focal deficits. Although based on the close relation between the administration of ibuprofen and the onset of symptoms, especially if previous episodes have occurred, the diagnosis of ibuprofen-induced aseptic meningitis is a diagnosis by exclusion. If the clinical picture is compatible with bacterial meningitis, empirical antibiotic therapy must be administered until negativity of cultures and other microbiologic tests is determined. Rechallenge to ibuprofen reproduces the symptoms and confirms the diagnosis, but is usually not advised. Whatever the clinical presentation, physicians must consider the possibility of ibuprofen-related meningitis or meningoencephalitis in patients taking ibuprofen, especially if they are suffering from an autoimmune connective tissue disorder. On the other hand, we think it would be appropriate to screen for autoimmune disease in previously healthy patients diagnosed with ibuprofen-related meningitis or meningoencephalitis. Finally, we propose that meningitis due to ibuprofen be included in the list of causes of recurrent aseptic meningitis.

(Mu-oxalato-O1,O2:O1',O2')bis[aqua(diethylenetriamine)nickel(II)] bis(hexafluorophosphate) dihydrate.

The title compound, [Ni(2)(C(2)O(4))(C(4)H(13)N(3))(2)(H(2)O)(2)](PF(6))(2).2H(2)O, contains a dinuclear oxalato-bridged nickel(II) complex cation. The structure determination reveals the presence of a centrosymmetric binuclear complex where the oxalate ligand is coordinated in a bis-bidentate mode to the Ni atoms. The distorted octahedral environment of each Ni atom is completed by the three N atoms of the diethylenetriamine ligand in a fac arrangement and by one O atom from a water molecule. PF(6)(-) acts as counter-anion. A two-dimensional network of hydrogen bonds links the cations and anions and stabilizes the structure.

Influence of the Peripheral Ligand Atoms on the Exchange Interaction in Oxalato-Bridged Nickel(II) Complexes: An Orbital Model. Crystal Structures and Magnetic Properties of (H(3)dien)(2)[Ni(2)(ox)(5)].12H(2)O and [Ni(2)(dien)(2)(H(2)O)(2)(ox)]Cl(2).

Two nickel(II) complexes of formula (H(3)dien)(2)[Ni(2)(ox)(5)].12H(2)O (1) and [Ni(2)(dien)(2)(H(2)O)(2)(ox)]Cl(2) (2) (dien = diethylenetriamine and ox = oxalate dianion) have been synthesized and characterized by single-crystal X-ray diffraction. 1 crystallizes in the orthorhombic system, space group Abnn, with a = 15.386(4) Å, b = 15.710(4) Å, c = 17.071(4) Å, and Z = 4. 2 crystallizes in the monoclinic system, space group P2(1)/c, with a = 10.579(1) Å, b = 7.258(1) Å, c = 13.326(1) Å, beta = 93.52(3) degrees, and Z = 2. The structures of 1 and 2 consist of dinuclear oxalato-bridged nickel(II) units which contain bidentate oxalate (1) and tridentate dien in the fac-conformation (2) as terminal ligands. Both features, oxalato as a peripheral ligand and dien in the fac-conformation (instead of its usual mer-conformation), are unprecedented in the coordination chemistry of nickel(II). The nickel atom is six-coordinated in both compounds, the chromophores being NiO(6) (1) and NiN(3)O(3) (2). The Ni-O(ox) bond distances at the bridge (2.072(4) Å in 1 and 2.11(1) and 2.125(9) Å in 2) are somewhat longer than those concerning the terminal oxalate (2.037(5) and 2.035(3) Å in 1). Magnetic susceptibility data of 1 and 2 in the temperature range 4.2-300 K show the occurrence of intramolecular antiferromagnetic coupling with J = -22.8 (1) and -28.8 (2) cm(-)(1) (J being the parameter of the exchange Hamiltonian H = -JS(A).S(B)). The observed value of -J in the investigated oxalato-bridged nickel(II) complexes, which can vary from 22 to 39 cm(-)(1), is strongly dependent on the nature of the donor atoms from the peripheral ligands. This influence has been analyzed and rationalized through extended Hückel calculations.