Abstract: The most well-known gastrointestinal pathogen and typical component of the microbiota in the human gut is Escherichia coli (E.coli). Enterotoxigenic, enteroinvasive, enteropathogenic, and enterohemorrhagic E.coli are some of the designated pathotypes that are used to categorize the many types of E. coli that cause diarrhea. Each pathotype's individual strains have a unique collection of virulence-related traits that influence the clinical, pathological, and epidemiological aspects of the illnesses they cause. In this succinct overview, we highlight the important characteristics that set the different pathotypes of diarrheagenic E. coli apart. The development of logical strategies for the management and prevention of E. coli-induced diarrhea has been facilitated by our growing understanding of the pathogenic processes of these bacteria. Investigations investigating the virulence of E. coli are also helping to provide light on the history and development of bacterial pathogens in general. This species also contains primary pathogens that are responsible for a number of different diarrheal illness syndromes. There are presently five unique kinds of diarrheagenic E. coli that exhibit diverse virulence traits, interact with the intestinal mucosa in various ways,induce different clinical syndromes, have different epidemiologies,and belong to different O: H serotypes. The most typical sickness among people who move from parts of the world with abundant resources to those with scarce resources is travelers' diarrhea. The anxiety of getting diarrhea Traveler's diarrhea (TD) episodes are almost always self-limiting and benign, but the dehydration that can exacerbate an episode can be severe and pose a greater health risk than the actual illness. The purpose of this study is to review travelers' diarrhea caused by E. coli bacteria.
Abstract: Introduction: Peiminine is an alkaloid extracted from the bulbs of Fritillaria thunbergii with deep pharmacological effects. However, there is no or limited information about the possible effect of the peiminine on the function of immune cells. This study was done to investigate the impact of oral administration of peiminine for one month on the function of peritoneal macrophages isolated from mice.Methods: The male Balb/c mice were randomly allocated to four equal groups (n=10) and treated orally with doses of 0, 1, 3 and 6 mg/kg of peiminine (dissolved in PBS) for one month. After 30 days, the peritoneal macrophages of the mice were isolated and their function was evaluated ex vivo. Results: Analysis of data indicated an increase in phagocytosis in macrophages obtained from mice treated with peiminine in a non-dose-dependent manner. NR uptake did not show any change between the vitality of macrophages isolated from different studding group. Also, receiving peiminine by mice in a dose-dependent manner has reduced the production of oxygen and nitrogen free radicals by macrophages. Ex vivo secretion of IL-12 by LPS-stimulated macrophage significantly down-regulated in a dose dependent manner compared to macrophages isolated from mice without treatment. Also, the production of IL-10 by LPS-stimulated macrophages isolated from mice received low to moderate doses of peiminine significantly increased compared to macrophages alone. Conclusion: These findings proposed that the macrophage isolated from mice orally received peiminine had an anti-inflammatory phenotype.
Abstract: Introduction: Extracorporeal membrane oxygenation (ECMO) has emerged as a major advancement in treatment of critically ill patients, and has shown to be truly life-saving in otherwise hopeless situations. This study aimed to clarify and define the point of “end of life” to help in decision-making for withdrawal or termination of treatment for patients undergoing ECMO treatment.Methods: Pubmed, Scopus, Web of Science and Google Scholar were searched from1980 to 2021. Primary studies with English texts conducted on ECMO were selected based on PRISMA guidelines. After quality assessments, the data were analyzed using the Walker and Avant methods. Results: Fourteen studies were selected: three studies were cross-sectional and eleven were retrospective or prospective cohort studies. Four key attributes were identified: brain death, failure to bridge from ECMO to transplantation, myocardial failure and multi-organ failure. Several antecedents were identified including age, lactate levels (pre-ECMO), creatinine and bilirubin levels, hematocrit level, mechanical ventilation parameters (pre-ECMO), arterial blood gas (pre-ECMO PaO2<70mmHg), renal function (need for continuous renal replacement therapy – CRRT - during ECMO), SOFA score before ECMO, multi-organ failure, complications on ECMO, duration of ECMO and time of weaning from ECMO, lower annual hospital volume of ECMO and experience with ECMO.Conclusion: The main concepts for description of end of life in ECMO patients are brain death and multi-organ failure. There still are however scientific and ethical limitations with any medical recommendations to precisely determine the end of life for ECMO patients.
Abstract: AbstractIntroduction: Recently, psychological therapies increasingly used as complementary treatment along with medication to help patients with multiple sclerosis (MS). This present study compared the effectiveness of gestalt therapy (GT) behavioral activation (BA) and placebo on the anxiety in women with MS.Methods: This study was a clinical trial (pre/posttest with control group and 3-month follow-up).Using the inclusion criteria and implementation of Beck's anxiety inventory (BAI),60 women with MS who had an active case in MS clinic of Rasool Hospital in Tehran, were randomly blocked and assigned into four equal groups including 3 interventional groups and a control group. The psychotherapy groups were received GT and BA intervention for 8 weekly sessions. During this period, in the placebo group, capsules containing rice flour were used once a day. The control group was placed on the waiting list. Again, at the end of interventions, all of participants were retested with BAI and 3-month after the post-test, follow-up test was performed. Data was analyzed using SPSS25 and the repeated measures ANOVA and Bonferroni's post hoc test. P-value less than 0.05 was considered statistically significant.Results: The results showed GT and BA in comparison with placebo and control groups decreased anxiety mean scores in post-test and follow-up stages (p=0.001). GT and BA had no significant difference.Conclusion: GT and BA are equally effective on anxiety reduction in women with MS. Placebo had no effect on reducing the anxiety of these women.
Abstract: Introduction: The demographic characteristics of women who become pregnant have changed dramatically over the past decade. Most women are overweight or obese during pregnancy, so the growing global trend of being overweight during pregnancy has been accompanied by a concomitant increase in pregnancy complications. This study will evaluate the effect of ear acupressure (auriculotherapy) on the weighting pattern of overweight women during pregnancy.
Methods: This study will be a single-blind randomized clinical trial with two intervention and control groups. A total of 130 eligible pregnant women will be selected by a purposeful sampling method and then divided into two groups of intervention and control by a random blocking method with quadruple blocks. In the intervention group, two seeds were placed in the left ear on the metabolism and stomach points, while two seeds were placed in the right ear on the mouth and appetite points. Participants in the intervention group must press the seeds 6 times a day, preferably 20 minutes before a meal. The seeds will be changed twice a week (once every three days) by the researcher. The total duration of the study will last for 5 weeks. For the control group, instead of the real seed, the Vaccaria seedless label (waterproof cloth adhesive) will be placed by the researcher at the same points as the intervention group.
Results: Primary results include weight gain during 5 weeks of intervention compared to baseline weight. Secondary results include weight gain at the end of the intervention, then 2 and 4 weeks after the intervention compared to baseline weight. Adverse events during treatment and follow-up periods, regardless of the relationship with the interventions, are documented, reported to the ethics committee, and treated with appropriate treatment.
Conclusion: This study is expected to support the effect of ear acupressure on the weight gain status of overweight women during pregnancy.
Abstract: Introduction: Medical tourism, one of the most profitable industries, has been growing rapidly in recent years. Especially Turkey, which has a high ranking among medical travel destinations, has some advantages that can become preferable for international patients. This study is among the first few studies which examine affecting factors in patients’ medical travel destination choices with Data Mining techniques. Methods: The data were obtained from patients who came to Ankara from abroad for treatment in May 2015 through a ques-tionnaire. Cross-industry Standard Process for data mining, known as the CRISP-DM method, is used in this study. After cleaning out the missing data, the models were created using classification algorithms. Results: Models including Generalized Linear Model, Deep Learning, Decision Tree, Random Forest, Gradient Boosted Trees, and Support Vector Machine (SVM) were compared, and SVM reached the best performance with 0.2% Relative Er-ror, 0.014 Root Mean Squared Error and 0.998 Correlation. As a result of the SVM model, effective attributes in patients’ satisfaction level include low price advantage, advertisement, doctors with high-quality education, trained assistant staff, relatives living in Turkey, and high technology of medical equipment, respectively. Conclusion: Special attention should be paid to these factors in developing plans and policies for the health tourism sector. However, the importance of related socio-demographic variables was indicated in detail. Eventually, some suggestions were presented to improve the weaknesses in the health tourism sector.
Abstract: Introduction: Mosquito-borne diseases have historically affected communities, especially in tropical areas where mosquitoes and illnesses are endemic. Globalization, climate change, and increased travel have created ideal conditions for outbreaks of mosquito-borne diseases that could threaten the American health system and place a burden on the national economy, especially in southern states.Methods: The study adopts a quantitative cross-sectional design with a retrospective survey carried out using the Pollfish platform in June 2022. The data were analyzed using descriptive statistics and hierarchical multiple regression to assess the three hypotheses: (H1) Chikungunya awareness is related to sociodemographic factors; (H2) Wearing long sleeves and pants is related to (a) Chikungunya awareness and (b) information-seeking behaviors, when controlling for sociodemographic variables; (H3) Use of insect repellents is related to (a) Chikungunya awareness and (b) information-seeking behaviors when controlling for sociodemographic variables.Results: The results highlight the relationships between chikungunya’s awareness, information-seeking behavior, and willingness to engage in protective behaviors. 45.91% of the participants mentioned not having heard about chikungunya, and 67.07% of respondents had sought information about mosquito-borne illnesses in the past, 55.9% have looked at the U.S. State Department’s website for mosquito-borne diseases, 38.32% have visited the U.S. CDC website for information specifically about chikungunya.Conclusions: The results of this study show that most American travelers are unaware of chikungunya and its mode of transmission. Travel could likely introduce the chikungunya virus to the United States. Despite increased health information-seeking behavior among U.S. residents after the Covid19 pandemic, Chikungunya awareness is low.
Abstract: In recent years, we have seen an increasing number of outbreak reports of various emerging and re-emerging infectious diseases. Africa continue to be plagued with infectious diseases like HIV/AIDS, malaria, tuberculosis, trachoma, Ebola, Lassa Fever, COVID-19 and monkeypox. It is therefore pertinent to draw lessons and insights from the most recent outbreaks to guide response strategies for the future. Stigmatization is a common challenge that has accompanied the outbreak of infectious diseases in time past. Antistigma framework should be incorporated into diseases outbreak preparedness and response across all countries to address the mental health consequences that accompany disease-related stigmatization. Furthermore, certain containment measures that have proven effective in mitigating against the spread of COVID-19 could be adopted for the prevention of other infectious diseases. The media plays an important role in the communication of health information during disease outbreaks and should be leveraged for disease prevention and control. It is high time we rose unitedly against the microbes who are ready to render the human race extinct.
Abstract: The onset of COVID- 19 pandemic has resulted in the transition from the conventional face to face health care strategies to computerized approaches, considering distances, the importance of quarantine, and early diagnosis and management. As far as the rapid management of the infection is concerned, telemedicine has been introduced as a beneficial approach. The use of telemedicine is thought to decrease the risk of cross contamination. Moreover, it provides the access to the health care for remote locations. The health care staff can use the computational analyses to get rapid access to the accurate epidemiological and laboratory data. The risk assessment provided by the mathematical models seems beneficial for decision-making in regards to the prognosis and management. We aimed to explore the breakthrough of telemedicine regarding the pandemic, also attempting to describe the related problems and challenges.
Abstract: Health is a multifaceted issue and providing and promoting all its dimensions is an interdisciplinary task. Examination of crisis conditions shows that the retention of health human resources is very important due to the high volume of work in these conditions. Due to the severity of the prevalence of COVID-19, the health system must have an acceptable plan for dealing with this disease. Therefore, the purpose of this study is to investigate the factors affecting the retention and stability of human resources in crises. We used a critical review method using specific keywords (“human resources retention”, “COVID-19”, and some other related keywords) in, Pubmed, Scopus, Google Scholar, and SID databases until September 2022 without time limitation. Reviewers screened founded studies separately and finally, we summarized the main results of 12 eligible articles.Four main strategies (Organizational management and leadership, risk reduction, improving the mental health of health workers, and financial and welfare support) are possible solutions to reduce healthcare workers' burnout and increase their resilience to this hard situation. It seems that planning, appropriate policy-making to implement the solutions found, division of tasks, and compilation of a national document on human resource protection in crises with the cooperation of people and officials can be very helpful.
Abstract: Introduction: Educational attainment is one of the main social determinants of health, however, based on a literature from the US, high educational attainment is associated with fewer health advantages for marginalized groups such as immigrants. A recent study has shown diminished returns of education on health. In the current study, built on the Marginalization-related Diminished Returns (MDRs) theory, the differential association between educational attainment and happiness in Europe by nativity status is tested.Methods: For this cross-sectional study, we borrowed data from European Social Survey 2020 (ESS 2020). Participants included 9560 individuals who identified as either native-born (n = 9052) or immigrant (n = 508) individuals who had worked in the past week and were residing in one of these ten countries: Bulgaria, Czechia, Estonia, Finland, France, Croatia, Hungary, Lithuania, Slovenia, and Slovakia. Age, sex, and self-rate health were control variables, while educational attainment was the independent variable. Happiness was the outcome. Linear regression was used for data analysis. Poisson regression was used for sensitivity analysis.Results: Overall, high educational attainment was associated with higher levels of happiness. We documented a statistical interaction between nativity status and education on happiness, indicating a weaker inverse association between educational attainment and happiness for immigrant than native-born individuals. The results remained similar using linear or Poisson regression models.Conclusion: Similar to the US, the link between educational attainment and happiness also depends on nativity in Europe. Countries of host undervalue the educational attainment of immigrants. Future research should explore the role of labor market discrimination and other racialization and xenophobia on reducing the return of education for immigrants. Given the existing MDRs, and because diminished returns are a mechanism behind disparities, policymakers should go beyond equal SDOH and equalize the return of SDOHs. Policies such as equal pay and additional enforcement of antidiscrimination may help. The results are important given the anti-immigrant sentiment and nationalist movements in Europe and around the world.
Abstract: Background: Although high socioeconomic status (SES) is known to be associated with low-risk behaviors, the effects of high family SES may be weaker for racial and ethnic minority than majority youth. Aim: We compared the association between family SES and peers’ tobacco use risk between majority and minority youth in the US.Methods: We used four years of follow up data from the Population Assessment of Tobacco and Health (PATH-Youth) study. All participants were 12 to 17 years old at baseline and were successfully followed for four years. 4652 Non-Latino and Latino White and Black youth were enrolled. Outcome was peers’ tobacco use risk at year four, treated as a continuous measure. Predictor was baseline parental SES, as a proxy of family SES. Moderator was racial and ethnic minority status. Covariates were age, gender, and family structure at baseline.Results: Our linear regressions in the pooled sample showed that higher family SES at baseline was associated with a lower level of peers’ tobacco use risk at year four, however this association was weaker for minority than majority youth. Our stratified models also showed that higher family SES was associated with a lower level of peers’ tobacco use risk for majority but not for ethnic minority youth.Conclusion: The presumed protective effect of high family SES against peers’ tobacco use risk varies between diverse ethnic groups of youth. Future research should test the role of school and neighborhood climate on weakening the protective effects of family SES for minority than majority youth. The role of high-risk schools and neighborhood environments and other contextual conditions should be tested in future multi-level research.
Abstract: Purpose: Telemedicine is a concept with a history of several decades, which means providing medical and therapeutic services remotely using information and communication technology. This issue requires the transfer and flow of medical and therapeutic knowledge from specialists to those in need, and in this context, the importance of knowledge logistics can be realized in order to identify the need and provide a solution in the telemedicine process. Therefore, the aim of the current research is to review the concepts of these two fields and identify their common points in order to identify the application of knowledge logistics in telemedicine.Methodology: The current research is of applied type and using Scientometric method. At First, a descriptive review of the available resources with related keywords such as logistics, knowledge logistics, medical knowledge logistics, telemedicine and knowledge logistics in telemedicine was done in Google, Google Scholar and Sid databases, and in the second part, to determine the relationship Between the two concepts, the terms knowledge logistics and telemedicine were searched in Scopus and PubMed databases on March 3, 2022, and the outputs of each database were discussed.Finding: The findings show that for nearly two decades and the upward trend of special resources in recent years, a major part of the United States has been in the production of resources, history and growth of resources related to two areas. Also, Anderson as the most prolific writer, the Journal of Internet Medical Research has a stronger relationship with BMC Medical Informatics and Decision Making. Finally, there is an occurrence of the keywords of logistic models in the resources related to the field of telemedicine, and knowledge has an important place in the resources related to the field of telemedicine.Conclusion: The results showed that the position of knowledge and knowledge management in the field of telemedicine, considering its little history, but the exponential growth during these years is very impressive, and since knowledge logistics models are related to the resources of this field, therefore It can be considered a new and practical concept in this field.
Abstract: Introduction: Millions of chronic hepatitis B virus (HBV) affected people live around the world. Although, the progress in vaccination and treatment has been changed the picture of hepatitis B . According, hepatitis b health-related stigma as a barrier for health service use, still shows its important role. The current study aimed to understand the social knowledge and stigma of HBV in a selected community of Iran.Method: Based on a well-defined study design and through the cross-sectional hospital-based study ,we recruited 860 hepatitis B affected people. After informing about the purpose of the research, each men or women that referred to these hospitals and were satisfied could enter the study. Interviews were carried out with individuals’ informed consent. Stigma and knowledge questionnaire need to be finished independently within a 20-minues. . We applied The EMIC stigma scale for evaluating the stigma. The mean , standard deviation and multiple linear regression models was used to analysis the data that carried out with SPSS 21 software.Result: The 860 participants (39.88% males ,60.11% females) were entered. The distribution of age among respondents were 32.43±8.1 years. The total mean score of stigma in this study was 3.86 that was greater than 2 represents a strong perception among participants. Also, in some domains such as the shame or embarrassment, worthless considering, believe in adverse effect on others, community avoidance and refuse to get patients home, disclosure and marriage, the score of stigma was apparently heavier than the other domains.Conclusion: A lot of health care promotions have been occurred in the area where the hepatitis B isn’t endemic area but stigma still a remained concern. This study showed that there is a relationship between the stigma, knowledge of people, being single, unemployment and younger age of affected people.
Abstract: The greatest Ebola virus disease (EVD) epidemic in recorded history is now occurring in West Africa. The Zaire Ebolavirus (EBOV), the virus responsible for this outbreak, is a member of the genus Ebolavirus, which combined with the genus Marburgvirus makes up the family of the Filoviridae. Among the viral hemorrhagic fevers, EBOV is one of the most aggressive viruses; case fatality rates of up to 90% have been documented. Multi-organ failure and serious bleeding problems are what cause death. The WHO recorded 5335 cases (confirmed, suspected, and probable) as of September 18th, 2014, with 2622 fatalities, yielding a case fatality rate of almost 50%. With a focus on pathophysiology, clinical symptoms, and therapeutic options, this review aims to provide an overview of EVD for clinicians.
Abstract: Parkinson disease is a progressive neurodegenerative disorder affecting the dopaminergic neurons of the basal ganglia, affecting approximately 1% of individuals over the age of 65. The travel health challenges of patients with Parkinson disease have not been adequately addressed in the medical literature. This perspective article discusses the barriers to healthy travel in this vulnerable population and considers mitigating measures. It focuses on difficulties with mobility, cognitive impairment, chronic medications, and medical devices.
Abstract: People living with cystic fibrosis (CF) are believed to perform poorly at high altitude. The advent of cystic fibrosis transmembrane conductance regulator (CFTR) modulators has transformed patient care, making high-altitude trekking an attainable goal for most patients living with CF. We consider how an amateur trekker with CF who wishes to climb a high mountain such as Kilimanjaro (5895m) should be advised. Since symptomatic pulmonary hypertension is a contraindication to high altitude travel, CF patients with pulmonary hypertension should use supplemental oxygen and take nifedipine for HAPE prophylaxis. There is no contraindication to the use of prophylactic acetazolamide in CF. With the success of CFTR modulators, it may no longer be necessary to optimise the CF patient’s clinical status with an inpatient course of intravenous antibiotics in advance of high-altitude travel. High-altitude trekkers with CF should use volumatic spacers with their inhalers and portable nebulisers. They should continue to take their regular medications, including mucolytic agents and prophylactic oral antibiotics. Monitoring oxygen saturation using a pulse oximeter may be useful. On the Kilimanjaro trek, a longer climbing route such as Lemosho is preferred as it allows more time for acclimatisation to hypoxia. A formal medical fitness-to-travel assessment by a respiratory physician may be mandated by insurance companies. Close liaison between respiratory and travel medicine specialists will best serve the needs of high-altitude trekkers with CF.
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