Trends of intestinal parasites prevalence in the Gaza Strip, 1998-2007: the use of government health records

To evaluate the amount of intestinal parasite infections over a 10-year period in the Gaza Strip. Materials and methods: Data from the Epidemiology Department, Ministry of Health were collected and analyzed statistically. The prevalence of intestinal parasites was monitored and studied for the period 1998-2007. Results: The present study shows results including the records of 471,688 patients (all ages) who had every provided 1 stool specimen to the laboratories of primary health care centers in one of the 5 governorates of the Gaza Strip. It was found that 116,261 specimens were positive for intestinal parasites, representing an overall prevalence of 24.6%. Entamoeba histolytica and Giardia lamblia were the most frequently detected intestinal parasites; there is a clear variation in the prevalence of intestinal parasites due to season. Conclusion: Intestinal parasites still constitute a health problem and there were fluctuations in the prevalence from 1998 to 2007. It is recommended that there is a need for health authorities to review health records periodically and examination of stool specimens by one method should be reviewed

Safety of percutaneous tracheostomy in NeuroICU patients with intracranial pressure monitoring

We read with great interest the article by Scales and Cutherbertson on percutaneous dilatational tracheostomy in a previous issue of Critical Care. In particular, we appreciated their last comment: ‘Finally, we believe that some patient populations - for example, those with chronic respiratory conditions or underlying neurological injury - may have risk-benefit profiles that differ from general ICU patients, and this should be further explored’. We wholeheartedly agree with their statement about neurosciences intensive care unit (NeuroICU) patients in particular because patients with traumatic brain injury or poor-grade subarachnoid hemorrhage can develop global cerebral edema (GCE), which may peak within the first few days and can last up to 2 weeks - refractory intracranial pressure (ICP) - without advanced intervention or decompressive hemicraniectomy or both. We have found that GCE patients with refractory ICP may be better served by having earlier tracheostomy if the primary brain injury is survivable and the patients have a reasonable prognosis but that it may be wise to wait longer if the prognosis is indeterminate, as the authors mention the risks versus benefit. Finally, we have studied the ICP surge during the dilatational part of percutaneous tracheostomies in our NeuroICU with indwelling ICP monitors. For the most part, we safely managed ICP with mannitol or hypertonic saline or by opening the ventriculostomy drain to allow ventricular fluid out in order to lower ICP during the procedure. Prior to this study, we found little to no information about the safety of this procedure in this group of patients. Therefore, we agree with the authors that a specific risk-versus-benefit ratio of subsets of ICU patients should be analyzed with regard to this procedure

A 'spicy' encephalopathy: synthetic cannabinoids as cause of encephalopathy and seizure

Synthetic cannabinoids, often sold under labels such as 'spice', are a popular product sold in incense shops and on the internet. When inhaled, consumers often report experiences similar to marijuana use, thus making synthetic cannabinoids a popular street substitute for marijuana. With increasing use, the number of patients presenting to emergency departments due to the toxic effects of these products has increased. While many reported side effects, including anxiety, agitation, tachycardia, and hypertension, are transient and relatively mild, reports of more severe consequences, including psychosis and seizures, are increasing, with ICU admissions

Optimisation of electrophoretic deposition parameters for gas diffusion electrodes in high temperature polymer electrolyte membrane fuel cells

Electrophoretic deposition (EPD) method was used to fabricate gas diffusion electrodes (GDEs) for high temperature polymer electrolyte membrane fuel cells (HT PEMFC). Parameters related to the catalyst suspension and the EPD process were studied. Optimum suspension conditions are obtained when the catalyst particles are coated with Nafion® ionomer and the pH is adjusted to an alkaline range of about 8 e10. These suspensions yield good stability with sufficient conductivity to form highly porous catalyst layers on top of the gas diffusion layers (GDLs). GDEs were fabricated by applying various electric field strengths of which 100 V cm-1 yields the best membrane electrode assembly (MEA) performance. Compared to an MEA fabricated by the traditional hand sprayed (HS) method, the EPD MEA shows superior performance with a peak power increase of about 73% at similar platinum (Pt) loadings. Electrochemical Impedance Spectroscopy (EIS) analysis shows lower charge transfer resistance for the MEA fabricated via the EPD method compared to the HS MEA. The EPD GDE exhibits a greater total pore area (22.46 m2 g-1) compared to the HS GDE (13.43 m2 g-1) as well as better dispersion of the Pt particles within the catalyst layer (CL).Web of Scienc

Association Between Learning Environment Interventions and Medical Student Well-being: A Systematic Review

Importance: Concerns exist about the current quality of undergraduate medical education and its effect on students' well-being. Objective: To identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Data Sources: Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and ERIC from database inception dates to October 2016. Studies examined any intervention designed to promote medical students' emotional well-being in the setting of a US academic medical school, with an outcome defined as students' reports of well-being as assessed by surveys, semistructured interviews, or other quantitative methods. Data Extraction and Synthesis: Two investigators independently reviewed abstracts and full-text articles. Data were extracted into tables to summarize results. Study quality was assessed by the Medical Education Research Study Quality Instrument (MERQSI), which has a possible range of 5 to 18; higher scores indicate higher design and methods quality and a score of 14 or higher indicates a high-quality study. Findings: Twenty-eight articles including at least 8224 participants met eligibility criteria. Study designs included single-group cross-sectional or posttest only (n = 10), single-group pretest/posttest (n = 2), nonrandomized 2-group (n = 13), and randomized clinical trial (n = 3); 89.2% were conducted at a single site, and the mean MERSQI score for all studies was 10.3 (SD, 2.11; range, 5-13). Studies encompassed a variety of interventions, including those focused on pass/fail grading systems (n = 3; mean MERSQI score, 12.0), mental health programs (n = 4; mean MERSQI score, 11.9), mind-body skills programs (n = 7; mean MERSQI score, 11.3), curriculum structure (n = 3; mean MERSQI score, 9.5), multicomponent program reform (n = 5; mean MERSQI score, 9.4), wellness programs (n = 4; mean MERSQI score, 9.0), and advising/mentoring programs (n = 3; mean MERSQI score, 8.2). Conclusions and Relevance: In this systematic review, limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research

Polyanxanthone A, B and C, three xanthones from the wood trunk of Garcinia polyantha Oliv.

Three xanthones, polyanxanthone A (1), B (2) and C (3) have been isolated from the methanol extract of the wood trunk of Garcinia polyantha, along with five known xanthones: 1,3,5-trihydroxyxanthone (4); 1,5-dihydroxyxanthone (5); 1,3,6,7-tetrahydroxyxanthone (6); 1,6-dihydroxy-5-methoxyxanthone (7) and 1,3,5,6-tetrahydroxyxanthone (8). Their structures were determined by means of 1D- and 2D-NMR techniques. Some of the above compounds were screened for their anticholinesterase activity on acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) enzymes.info:eu-repo/semantics/publishedVersio

Clostridium Difficile Infection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention

Prevention of Clostridium difficile infection (CDI) in acute-care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, the ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. We included studies performed in acute-care hospitals. We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. Of 3,236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% according to the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand-hygiene practices were not effective for reducing CDI rates. Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates

New/emerging psychoactive substances and associated psychopathological consequences

Submitted 24 November 2018, Revised 18 June 2019, Accepted 26 June 2019, Published online 22 July 2019BackgroundThe present paper provides an updated review of both the large number of new/novel/emerging psychoactive substances (NPS) and their associated psychopathological consequences. Focus was here given on identification of those NPS being commented in specialised online sources and the related short-/long-term psychopathological and medical ill-health effects.MethodsNPS have been identified through an innovative crawling/navigating software, called the 'NPS.Finder®', created in order to facilitate the process of early recognition of NPS online. A range of information regarding NPS, including chemical and street names; chemical formula; three-dimensional image and anecdotally reported clinical/psychoactive effects, were here made available.ResultsUsing the 'NPS.Finder®' approach, a few thousand NPS were here preliminarily identified, a number which is about 4-fold higher than those figures suggested by European and international drug agencies. NPS most commonly associated with the onset of psychopathological consequences included here synthetic cannabinoids/cannabimimetics; new synthetic opioids; ketamine-like dissociatives; novel stimulants; novel psychedelics and several prescription and over-the-counter medicines.ConclusionsThe ever-increasing changes in terms of recreational psychotropics' availability represent a relatively new challenge for psychiatry, as the pharmacodynamics and pharmacokinetics of many NPS have not been thoroughly understood. Health/mental health professionals should be informed about the range of NPS; their intake modalities; their psychoactive sought-after effects; the idiosyncratic psychotropics' combinations and finally, their medical and psychopathological risks.Peer reviewe