Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study.

Helicobacter pylori (H. pylori) is a common bacterial infection linked to gastric malignancies. While H. pylori infection and gastric cancer rates are decreasing, antibiotic resistance varies greatly by community. Little is known about resistance rates among rural Indigenous populations in the United States. From 2018 to 2021, 396 endoscopy patients were recruited from a Northern Arizona clinic, where community H. pylori prevalence is near 60%. Gastric biopsy samples positive for H. pylori (n = 67) were sequenced for clarithromycin- and metronidazole-associated mutations, 23S ribosomal RNA (23S), and oxygen-insensitive NADPH nitroreductase (rdxA) regions. Medical record data were extracted for endoscopic findings and prior H. pylori history. Data analysis was restricted to individuals with no history of H. pylori infection. Of 49 individuals, representing 64 samples which amplified in the 23S region, a clarithromycin-associated mutation was present in 38.8%, with T2182C being the most common mutation at 90%. While the prevalence of metronidazole-resistance-associated mutations was higher at 93.9%, the mutations were more variable, with D95N being the most common followed by L62V. No statistically significant sex differences were observed for either antibiotic. Given the risk of treatment failure with antibiotic resistance, there is a need to consider resistance profile during treatment selection. The resistance rates in this population of American Indian patients undergoing endoscopy are similar to other high-risk populations. This is concerning given the high H. pylori prevalence and low rates of resistance testing in clinical settings. The mutations reported are associated with antibiotic resistance, but clinical resistance must be confirmed.

Emotional support for parents with premature children admitted to a neonatal intensive care unit: a qualitative phenomenological study.

BACKGROUND AND OBJECTIVES: Parents who have a premature child in neonatal intensive care units (NICUs) are in a stressful situation. The aim of this paper is to analyze the emotional support received by parents with premature children admitted to NICUs. METHODS: A phenomenological qualitative study with an explanatory and interpretative approach was employed. RESULTS: The findings are: 1) The experience and emotions of a premature delivery; showing sadness, guilt and despair, stress, anxiety, and uncertainty over the future of their child. 2) The emotional support received by the father/mother of the partner; discussion of how their partner is cared for, as well as the care given to the premature child and other children in the family; the stress that this causes them on not being able visit all at once. 3) The emotional support offered by the health professionals (doctors, nurses, etc.); parents indicate that they have received very strong support from the nurses, but also that they were not always asked about their feelings when in the NICU. 4) The informal emotional support of relatives and parents in the NICU. After talking with other support mothers, the mothers then felt less guilty. CONCLUSION: As regards premature birth, the mothers showed feelings of sadness and guilt, asked themselves where they had failed and what they had done wrong.

[Associations between cognitive performance in a dementia screening test (SKT) and an intelligence test (WAIS IV) : Which deficits in cognitive performance in old age indicate a possible pathological deterioration process?] / Zusammenhänge zwischen den kognitiven Leistungen in einem Demenzscreening (SKT) und in einem Intelligenztest (WAIS-IV) : Welche kognitiven Leistungseinbußen im Alter sprechen für einen möglichen pathologischen Abbauprozess?

BACKGROUND: Which deficits in cognitive performance indicate the onset of a pathological deterioration process in older persons? AIM AND OBJECTIVES: Based on an established dementia screening test in elderly adults, a differentiation can be made between healthy cognitive performance and the onset of pathological deficits in performance (in the sense of mild cognitive impairment). The aim of the study was to investigate whether cognitive decline assessed with a dementia screening instrument is reflected in an intelligence test for adults. The dementia screening measured disorders in memory and attention, the intelligence testing battery measured information processing, working memory, perceptual reasoning, logical thinking and verbal comprehension. MATERIAL AND METHODS: A total of 253 cognitively healthy, self-dependent and non-dementia persons (129 women and 124 men), aged between 60 and 91 years (M = 71.98 years; SD = ±7.13) were tested with the complete Wechsler adult intelligence scale (WAIS-IV) and the short performance test (SKT), based on the new normalization from 2015. The SKT enables an assessment of the degree of cognitive deterioration based on coloring codes of traffic lights. Green indicates normal aging, yellow mild cognitive impairment and red stands for abnormal cognitive aging. RESULTS AND CONCLUSION: There were significant correlations between the total SKT score as a measure of total cognitive impairment and the indices of the WAIS-IV, such as information processing, working memory and perceptual reasoning. No significant covariation was found for verbal comprehension. The results suggest that in old age cognitive deterioration starts with reduced speed of information processing and impairment in the working memory log before deficits in memory are present. This finding was reflected in significant mean differences between the subjects in the category green versus yellow in the indices information processing and working memory. Under these aspects there were medium effect strengths (d = 0.60) and the second largest (insignificant) differences were shown in working memory (d = 0.39).