Abstract The aim of the study was to determine predictive factors influencing the acceptance of the 2009 A(H1N1) influenza vaccination among hospital workers (HW) in two French cancer centers. A ...standardized, anonymous, self-administered questionnaire was sent to HW of two cancer centers. The survey response rate was 26.2% ( n = 506). Main reasons for A(H1N1) vaccination acceptance were “to protect my relatives” (30.3%), “to protect myself” (30.3%). Main reasons for A(H1N1) vaccination refusal were the fear of side effects (43.1%), doubt about the vaccine's efficacy (25.8%). Vaccinated HW were more influenced by the institutional campaign ( p < 0.001) or colleagues’ advice ( p < 0.001) whereas non-vaccinated HW were influenced by their family physician's advice ( p = 0.03), personal conviction ( p < 0.001) or the media ( p < 0.001). A multivariate analysis revealed age (>35 vs ≤35), prior seasonal influenza vaccination, professional category and source of information to be predictive factors of vaccination. Future vaccination campaigns will need to focus on young HW (≤35-year old), with no prior influenza vaccination and HW who are in contact with patients and who reported low seasonal influenza vaccination rates.
In the context of the SARS-CoV-2 pandemic, patients may have been dissuaded from seeking consultation, thus exposing themselves to a risk of loss of chance. This guide aims to define how ...teleconsultation can assist in assessing vertiginous adults or children, and to gather the information needed to provide quick medical care.
These recommendations rely on the authors’ experience as well as on literature. A survey on otoneurologic approach via telemedicine has been conducted based on a literature search until March 2020.
The first clinical assessment of the vertiginous patient via teleconsultation can only be successful if the following conditions are met: initial contact to verify the feasibility of the assessment at a distance, the presence of a caregiver in order to assist the patient, the possibility of making video recordings. Medical history via telemedicine, as in a face-to-face assessment, allows to assess the characteristics, duration, frequency, and potential triggering factors of the vertigo, in both children and adults. During teleconsultation, the following tests can be carried out: oculomotricity evaluation, assessment of balance, simple neurological tests, checking for positional vertigo/nystagmus and, eventually to perform canalith-repositioning procedures. In children, the following should be searched for: history of hearing or visual impairment, a context of fever or trauma, otorrhea, signs of meningeal irritation.
The neurotologic telemedicine relies on the accuracy of the clinical assessment, which is based on history taking and a few simple tests, encouraging the development of a decision-making algorithm adapted for teleconsultation. However, the latter has its limitations during an emergency examination of a new patient presenting vertigo, and, at least in some cases, cannot replace a face-to-face consultation. Teleconsultation is often adapted for follow-up consultations of previously selected vertiginous patients during face-to-face assessment.
Aims/hypothesis Defects in pancreatic beta cell turnover are implicated in the pathogenesis of type 2 diabetes by genetic markers for diabetes. Decreased beta cell neogenesis could contribute to ...diabetes. The longevity and turnover of human beta cells is unknown; in rodents <1 year old, a half-life of 30 days is estimated. Intracellular lipofuscin body (LB) accumulation is a hallmark of ageing in neurons. To estimate the lifespan of human beta cells, we measured beta cell LB accumulation in individuals aged 1-81 years. Methods LB content was determined by electron microscopical morphometry in sections of beta cells from human (non-diabetic, n = 45; type 2 diabetic, n = 10) and non-human primates (n = 10; 5-30 years) and from 15 mice aged 10-99 weeks. Total cellular LB content was estimated by three-dimensional (3D) mathematical modelling. Results LB area proportion was significantly correlated with age in human and non-human primates. The proportion of human LB-positive beta cells was significantly related to age, with no apparent differences in type 2 diabetes or obesity. LB content was low in human insulinomas (n = 5) and alpha cells and in mouse beta cells (LB content in mouse <10% human). Using 3D electron microscopy and 3D mathematical modelling, the LB-positive human beta cells (representing aged cells) increased from ≥90% (<10 years) to ≥97% (>20 years) and remained constant thereafter. Conclusions/interpretation Human beta cells, unlike those of young rodents, are long-lived. LB proportions in type 2 diabetes and obesity suggest that little adaptive change occurs in the adult human beta cell population, which is largely established by age 20 years.
Despite the increased use of rescue medical therapies for steroid refractory acute severe ulcerative colitis, mortality related to this entity still remains high. We aimed to assess the mortality and ...morbidity related to colectomy and their predictive factors in steroid refractory acute severe ulcerative colitis, and to evaluate the changes in mortality rates, complications, indications of colectomy, and the use of rescue therapy over time.
We performed a multicenter observational study of patients with steroid refractory acute severe ulcerative colitis requiring colectomy, admitted to 23 Spanish hospitals included in the ENEIDA registry (GETECCU) from 1989 to 2014. Independent predictive factors of mortality were assessed by binary logistic regression analysis. Mortality along the study was calculated using the age-standardized rate.
During the study period, 429 patients underwent colectomy, presenting an overall mortality rate of 6.3% (range, 0-30%). The main causes of death were infections and post-operative complications. Independent predictive factors of mortality were: age ≥50 years (OR 23.34; 95% CI: 6.46-84.311; p < 0.0001), undergoing surgery in a secondary care hospital (OR 3.07; 95% CI: 1.01-9.35; p = 0.047), and in an emergency setting (OR 10.47; 95% CI: 1.26-86.55; p = 0.029). Neither the use of rescue medical treatment nor the type of surgical technique used (laparoscopy vs. open laparotomy) influenced mortality. The proportion of patients undergoing surgery in an emergency setting decreased over time (p < 0.0001), whereas the use of rescue medical therapy prior to colectomy progressively increased (p > 0.001).
The mortality rate related to colectomy in steroid refractory acute severe ulcerative colitis varies greatly among hospitals, reinforcing the need for a continuous audit to achieve quality standards. The increasing use of rescue therapy is not associated with a worse outcome and may contribute to reducing emergency surgical interventions and improve outcomes.
The objective was to investigate the immune status against tetanus and diphtheria of healthcare workers in Catalonia. A cross-sectional multicentre study was conducted in seven health centres. Blood ...samples were obtained, and demographic and clinical variables collected.
509 health workers were included. The prevalence of protective antibodies against tetanus was 94.7% (95% CI: 92.3–96.4) overall and 85.1% (95% CI: 74.5–92.0) in workers aged ≥55 years. The prevalence of protective antibodies against diphtheria was 68.6% (95% CI: 64.3–72.5%) overall and 29.7% (95% CI: 19.9–41.6) in workers aged ≥55 years.
Protection against tetanus in healthcare workers is high, but should be improved in workers aged ≥55 years. Protection against diphtheria has improved in healthcare workers over the past decade (68.6% vs 46.5%) but should be improved in all ages, especially in workers aged ≥55 years.
We sought to determine factors associated with opportunistic infections (OI) in infliximab-treated patients. A retrospective study cohort (1999–2004) was examined. Nine OI were diagnosed in 94 ...infliximab-treated patients: tuberculosis (four), visceral leishmaniasis (one), pyogenic muscular abscess (one
Salmonella
spp. and one
Streptococcus pneumoniae
), and two viral infections (hepatitis B virus HBV and zoster ophthalmicus). The risk for OI was significantly higher in the first year of treatment (odds ratio OR 8; 95% confidence interval CI 2–50). Previous treatment with more than two immunosuppressive drugs was the only factor related to OI (OR 8.686; 95% CI 1.889–39.943). We identified the subset of patients treated with infliximab who had a higher risk for OI. The screening of latent infections is key to diminishing the incidence of these infections.
Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to ...evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs.
Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period.
We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs.
We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.
The aim of this work was to study the effect of different parameters on the accumulation of volatile oak compounds and ethylphenols in red barrel-aged wines. For this, 510 wines, from four different ...geographic zones and aged for various times in different oak barrel types were analysed. The results of the statistical analysis showed that the compounds were in four groups, accounting for 82.99% of the variance. The enological parameters did not present correlation with any of these four groups. The wines that remained longer in oak barrels presented, in general, higher concentrations of the studied compounds. Three of the four geographic zones were similar to each other. The oak barrel type affected the value of the ratio
cis/
trans, but it did not affect the accumulation of any of the volatile oak compounds or ethylphenols.
The practice of mathematics underwent a major transformation in the seventeenth century due to new procedures and concepts that also showed their utility for military architecture. The circulation of ...this knowledge can be found in several works. In this paper, we focus on an early work on Portuguese fortifications, Methodo Lusitanico de Desenhar as Fortificaçoens das Praças Regulares & Irregulares (Lusitanic Method of Drawing Fortifications of Regular and Irregular Military Posts), published posthumously in 1680, the author of which was the leading Portuguese Chief Cosmographer and Chief Engineer, Luis Serrão Pimentel (1613-1679). Methodo Lusitanico was a novel work containing the author's own theoretical explorations of the art and science of fortification in Portugal arising from the theoretical investigations and military education sponsored by the Portuguese Crown. The aim of our contribution is to show the European influences on Portuguese science in the seventeenth century through the analysis of an early work on modern fortifications written in the Portuguese language and by a Portuguese scholar. As far as the contents of the book are concerned, we show that Serrão Pimentel analyzes and reviews the published methods of fortification, and modifies them by introducing new procedures to improve the use of mathematics in the teaching of engineers. Our analysis also shows that Serrão Pimentel was a leading mathematician and a skillful teacher who had read the main mathematical works published at his time, such as Stevin's decimal arithmetic, and used them in practice.
The application of pulsed electric fields (PEF) is one of the new non-thermal technologies being studied to evaluate their potential as alternative or complementary processes to thermal ...pasteurization. “Horchata de chufa” (tiger nut milk or earth almond milk) is of high nutritional quality and therefore has great potential in the food market, limited by its very short shelf-life. The present work studies whether PEF can be used to obtain a quality horchata and increase its shelf-life while maintaining its organoleptic characteristics. In order to do so we determined pH, total fat, peroxide index, thiobarbituric acid-reactive substances index, formol index, and peroxidase activity in natural (untreated) horchata and horchata subjected to various PEF treatments and studied their stability during refrigerated storage (2–4 °C). After PEF treatment, only peroxidase activity decreased significantly (
p
<
0.05). This parameter and pH varied during the shelf-life of the horchata, and a negative correlation was obtained between pH and peroxidase activity.
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