Abstract: Background: Risk factors of COVID-19 infection in people vaccinated with the 4th dose of mRNA COVID-19 vaccine remain the subject of debate.Objective: To identify risk and protective factors of COVID-19 in vaccinated people with 4th dose of bivalent mRNA vaccines.Location: General Practitioner consultation in Toledo (Spain).Methodology: Longitudinal and prospective study of cases and controls of adult patients with or without COVID-19 infection in vaccinated people with 4th dose of bivalent mRNA vaccines, from October 1, 2022, to February 28, 2023.Results: Five cases of COVID-19 infections in vaccinated people with 4th dose were included, which were compared with 52 controls (with 4th dose and without COVID-19 after the booster). The risk factors for COVID-19 infection with the 4th dose were: Women (RR = 1.67), Socio-Health Care Workers (RR = 10.39; p = 0.0349), Chronic Diseases of the blood (RR = 6.9. p = 0.0322), Chronic Diseases of Endocrine (RR = 2.72. p = 0.039425), and Chronic Diseases of Circulatory system (RR = 1.87).Conclusion: In the general practice setting in Toledo, Spain, being a socio-health care worker and having chronic diseases presumably associated with immunosuppression were statistically significant risk factors for COVID-19 infection in people vaccinated with the 4th dose of bivalent mRNA vaccines. The most exposed or immunosuppressed people continue to be at risk of becoming infected with SARS-CoV-2 despite having received the 4th dose of the mRNA COVID-19 vaccine, so other preventive methods in these groups are advisable. PubDate: 30 May, 2023
Abstract: Introduction: The vascular system has a high frequency of variations, which are of interest to both anatomists and clinicians, as well as surgeons. The renal vasculature is quite variable and given the significant number of variations, the latter has proven difficult to classify. The conflicting terminology is often the cause of a poor understanding of the clinical implications of the presence of such variations. We present a case of bilateral accessory arteries, which can be classified as polar and extrahilar.Background: Variants of the renal artery are a common finding with additional vessels in up to 30% of cases. The supernumerary arteries are of end type and often enter the kidney outside the hilum. The arteries that enter the kidney in its upper or lower pole are referred to as polar arteries. Case report: During a routine dissection of a 73-year-old, female, formalin-fixed cadaver at the department of Anatomy, Histology and Embryology at the Medical University of Sofia, we discovered a right inferior polar artery and a left extrahilar renal artery, both originating from the abdominal aorta. The right kidney was located at the level of L1- L2. Conclusion: Accessory renal vessels have been an object of multiple cadaveric and in vivo studies. The terminology and classification of such variations in regard to their origin, course, and site of entrance in the kidney are conflicting and often prove inadequate to convey the clinical and surgical importance of their presence. Knowledge of such variants is of great significance when performing an explorative laparotomy, kidney transplantation, and assessing kidney injury. Such vessels are as well associated with cases of hypertension, hydronephrosis and other conditions. PubDate: 27 Jan, 2023
Abstract: Inappropriate antimicrobial prescriptions are among the highest contributing factors to Antimicrobial Resistance (AMR). Most low and middle-income (LMICS) countries with high AMR burdens like Cameroon, seldom document information on prescription patterns, whereas this information is crucial in addressing inappropriate antimicrobial prescriptions. This study was therefore designed to elucidate antimicrobial prescription patterns in order to tailor interventions to mitigate AMR in Cameroon. The study adopted a multicentre cross-sectional design. Information on antimicrobial prescriptions was collected from four hospitals within the Deido Health District, between October 2019 and March 2020. Of the 1398 participants that were enrolled in the study, the most presented age group were participants aged 15-45 years 913(65.3%) and prescriptions were higher amongst females (923,53.6%). The highest number of antimicrobial prescriptions was made in the outpatient department 592(42.3%) followed by the pediatric unit, 344(24.6%). Most of the prescriptions were for patients with respiratory tract infections 436 (31.2%), followed by those with digestive tract infections 248 (17.7%). The most frequently prescribed class of drugs were the Penicillins 690 (40.3%, 37.8 – 42.6), with Amoxicillin clavulanic acid accounting for 27.8% of the overall prescriptions followed by Cephalosporins 392 (22.7, 20.6 – 24.7), with Ceftriaxone being the most prescribed in the class (13.3%). The need for prescription was mainly determined by clinical judgement (61.1%), while only 9.5% of prescriptions were based on antimicrobial sensitivity test. In the struggle to mitigate AMR, there is a great need to exploit data on prescription patterns and develop stewardship programs in order to optimise antimicrobial use in Cameroon. We emphasize in this communication the potential benefits and outcomes of foresight thinking, such as improved resilience, better resource allocation, and effective response strategies. PubDate: 24 Jun, 2023
Abstract: Prospective studies have evolved towards a more integrated, complex, and diachronic way of thinking about the future. What is the future' It is a set of possibilities, delimited by what we think is impossible (limits of plausibility) and by the difficulty of estimating the degree of plausibility of an event in a V.U.C.A. period. The term V.U.C.A. refers to the four characteristics that reflect the world according to military thinking: Volatility; Uncertainty; Complexity; Ambiguity. The COVID-19 crisis is an example of V.U.C.A with an uncertain situation. Foresight is a discipline that allows us to understand the forces at work in the construction of the future. Resolutely oriented towards action, it aims to enlighten the choices of the present by exploring possible futures. Strongly linked to strategy, it allows the determination of a desirable future, a vision, and the implementation of the means to achieve it. Foresight is exploratory (of possible futures), normative (creating a chosen future), quantitative (using statistical data), and qualitative (using survey data). Foresight does not foresee, it anticipates. Prospective approaches could be used more in particular in the field of health to define more or less pessimistic scenarios in order to define strategies of anticipation of futures that we do not want to see happen. The foresight for pandemics and epidemics initiatives can create a space for dialogue and bring together diverse perspectives and lived experiences. We emphasize in this communication the potential benefits and outcomes of foresight thinking, such as improved resilience, better resource allocation, and effective response strategies. PubDate: 23 Jun, 2023
Abstract: Osteoporosis is a skeletal disease caused by changes in the structure of the human skeleton, resulting in fragile and easily fractured bones. Because it is more common in postmenopausal women or the elderly, fractures may cause disability in the elderly, resulting in reduced quality of life, bedridden, or increased mortality. Therefore, the treatment of osteoporosis is one of the important issues in today’s aging society. In addition, diseases such as bone metastasis of cancer and multiple myeloma also need to be paid attention to. Drugs for the treatment of osteoporosis have been widely used in the prevention and treatment of osteoporosis because of their inhibitory effect on osteoclast activity, and even become the first-choice drug for bone metastases of some malignant tumors. Drugs for the treatment or prevention of osteoporosis can inhibit osteoclasts, and can also be used to treat hypercalcemia complications of malignant tumors or bone-related systemic diseases. For example, bisphosphonates or monoclonal antibody preparations (eg: Denosumab, Romosozumab, etc.) can resist bone resorption. However, in recent years, the literature pointed out that patients using anti-bone resorption drugs may have adverse reactions to maxillofacial osteonecrosis. Medication-Related Osteonecrosis of the Jaw (MRONJ) may occur in patients with osteoporosis and tumors. Bisphosphonates or synthetic human monoclonal antibodies can inhibit bone resorption and are currently the most commonly used drugs for the treatment of osteoporosis in the world. The literature for nearly 20 years has shown that long-term use of such antiresorptive drugs increases the risk of osteonecrosis of the jaw in the oral cavity. Therefore, MRONJ is still a complication that we must pay attention to. Once MRONJ occurs, it is recommended to refer to an oral surgeon immediately; the current clinical treatment methods include the use of antibacterial mouthwash and drugs to control pain in mild cases, and antibiotics for infection control in moderate cases. PubDate: 21 Feb, 2023
Abstract: Affected by human activities, the living environment of aquatic wildlife in Bohai Bay and Huanghai Bay of our country is deteriorating day by day. In accordance with the animal protection law and other relevant laws and regulations, our country has formulated an action plan and an action plan for the protection of leopard seals. The Action Plan is based on the multi-dimensional vision of the natural environment, the balance of nature, sustainable development and human care, in 2021, the Leopard Seal is listed as a first-class protected animal in the country. This paper expounds on the survival status of the spotted seal population by searching the judgments of criminal cases, administrative cases and on-the-spot investigation on the judgment network, this paper analyzes the main reasons for the endangered population of spotted seal and puts forward the corresponding protection countermeasures. PubDate: 18 Feb, 2023
Abstract: A simple setup for rehabilitation training was established in 2007 in a rural area of Shanxi Province, China. It made use of an underused facility created for elderly people’s leisure time. Simple equipment for rehabilitation training was provided free for the users, and instructions were given by rehab experts, Traditional medical doctors, and social workers.This rural Service Station must be the first of its kind in rural China and deserves scrutinizes for its unique nature. After 5 years of service, a service evaluation of its service nature, service providers, users, and special orientations was completed. It is hoped that this Service Station could be taken as a model of similar rural development in China. PubDate: 05 Apr, 2023
Abstract: Aim: In this study, it was aimed to determine the thoughts and attitudes of young adults about HPV and HPV vaccines.Methods: This study was planned as a cross-sectional study to determine the knowledge levels and attitudes of young people living in a settlement in the middle of Turkey about the HPV vaccine. The research was conducted with 870 young adults between 1-30 November 2022.Results: The average age of the young people participating in the study was 20.49 ± 2.15 years, 60.9% of them were male. 61% have not heard of the PAP-Smear test before, 51.3% do not know what HPV is, only 17.7% have HPV by vaccination, 8% have HPV vaccine, 24.75% 37.9% of them stated that they wanted to have the HPV vaccine and that the HPV vaccine should be free of charge.Conclusion: It was determined that the knowledge level of young adults about HPV and HPV vaccine, in general, was very low, only one out of four people wanted to be vaccinated against HPV, and the rate of vaccination was very low. Even if the vaccine is free in our country, it is thought that the vaccination rates will be low. PubDate: 03 Feb, 2023
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