Vitamin D3 Supplementation at 5000 IU Daily for the Prevention of Influenza-like Illness in Healthcare Workers: A Pragmatic Randomized Clinical Trial.

Vitamin D supplementation has been shown to reduce the incidence of acute respiratory infections in populations at risk. The COVID-19 pandemic has highlighted the importance of preventing viral infections in healthcare workers. The aim of this study was to assess the hypothesis that vitamin D3 supplementation at 5000 IU daily reduces influenza-like illness (ILI), including COVID-19, in healthcare workers. We conducted a prospective, controlled trial at a tertiary university hospital. A random group of healthcare workers was invited to receive 5000 IU daily vitamin D3 supplementation for nine months, while other random healthcare system workers served as controls. All healthcare workers were required to self-monitor and report to employee health for COVID-19 testing when experiencing symptoms of ILI. COVID-19 test results were retrieved. Incidence rates were compared between the vitamin D and control groups. Workers in the intervention group were included in the analysis if they completed at least 2 months of supplementation to ensure adequate vitamin D levels. The primary analysis compared the incidence rate of all ILI, while secondary analyses examined incidence rates of COVID-19 ILI and non-COVID-19 ILI. Between October 2020 and November 2021, 255 healthcare workers (age 47 ± 12 years, 199 women) completed at least two months of vitamin D3 supplementation. The control group consisted of 2827 workers. Vitamin D3 5000 IU supplementation was associated with a lower risk of ILI (incidence rate difference: -1.7 × 1

Комбинирана спинална / епидурална (КСЕ) и лесна општа анестезија при елективна операција на анеуризма на инфраренална аорта

КСЕ анестезија ја применуваме за да ги искористиме предностите на двете техники и да ги елиминираме нивните недостатоци. Цел ни е да ги согледаме резултатите од користење на КЦЕ при операции на абдомална аорта

Карактеристики на бактериските изолати Pseudomonas syringae pv. Syringae изолирани од лисните дамки кај пиперката во Македонија

Бактериската лисна дамкавост кај расадот на пиперката е ново заболување (Capsicum annuum - Куртовска капија) за прв пат е забележано во 1995 год. Како причинител на ова заболување е изолирана бактерија од родот Pseudomonas која припаѓа на групата Ia по LOPAT тестот. Симптомите добиени со вештачките инокулации се идентични со тие добиени во природата. Некои изолати произведуваат сyрингомyцин и ниеден од нив не е патоген кон јоргованот (lilac). Во нумеричката таксономска студија на пет наши изолати споредени со 58 патовари од бактеријата Pseudomonas syringae и 10 слични видови, сите пет изолати се групирани во еден фенон. Имајќи ги во обзир фенотипските, серолошките, патогените карактеристики, како и ДНК сличноста на изолатите, може да се каже дека припаѓаат на бактеријата Pseudomonas syringae pv. syringae

Characterization of Bacterial Strains of Pseudomonas Syringae pv. Syringae Isolated from Pepper Leaf Spot in Macedonia

A new bacterial leaf spot disease on pepper seedlings (Capsicum annuum cv. ´Kurtovska kapija`) was observed in 1995 in Macedonia. Pseudomonas bacteria were isolated, belonging to LOPAT group Ia. Symptoms similar to natural symptoms were reproduced following inoculation on pepper seedlings. Some isolates produced syringomycin and none of them were pathogenic to lilac. In a numerical taxonomic study of five pepper isolates in comparison with 58 pathovars of P. syringae and 10 related species, the five pepper isolates clustered in one phenon. Considering phenotypic characteristics, serology, DNA relatedness and pathogenicity tests, it was concluded that the pepper strains belong to Pseudomonas syringae pv. syringae

Time to Post-Anesthesia Neurological Evaluation and Hemodynamic Stability in Carotid Endarterectomy Comparing Three General Anesthetic Techniques Targeted to a Preset Bispectral Index Value: A Pilot Study

Carotid endarterectomy (CEA) has a 1-5% risk of periprocedural stroke. The ability to emerge patients from anesthesia quickly to detect neurological abnormalities immediately after surgery is vital in this patient population. The objective of this pilot study was to assess if any of three general anesthetic techniques for CEA are associated with a shorter time to a reliable postoperative neurological exam. Secondary objectives were to assess postoperative cognitive dysfunction (POCD), postoperative delirium (POD), and hemodynamic stability. Twenty-one patients undergoing CEA were enrolled and randomized to different combinations of inhalational and intravenous anesthesia: Group A: propofol, remifentanil, and desflurane; Group B: dexmedetomidine, remifentanil, and desflurane; Group C: remifentanil and desflurane. Anesthetic depth was titrated using a bispectral index (BIS) monitor to a goal of 50-60. Time was recorded from surgery end to first meaningful neurological exam. Neurocognitive testing was completed preoperatively and up to 1 week postoperatively to assess POD (3D-CAM) and POCD (Short Blessed Test). Time to first reliable neurological exam was 2 minutes longer in group A (9 min ± 4 min) compared to group B and group C (7 min ± 3 min; 7 min ± 4 min), although this was not statistically significant. In addition, extubation time was significantly longer in group A (11 min) compared to group B and group C (5 min; 6 min) (P = 0.03). 3D -CAM and Short Blessed Test data along with hemodynamics did not differ significantly between the groups. Time to first useful neurologic exam and hemodynamics did not differ between the groups. However, extubation time was significantly prolonged in patients who received propofol, but not dexmedetomidine, as part of their anesthetic for CEA. These findings are best verified in an adequately powered prospective randomized study

Medication non-adherence in inflammatory bowel diseases is associated with disability

Background/Aims: Medication non-adherence is common in inflammatory bowel diseases (IBD). The short-term consequences of non-adherence include increased disease relapse but the long-term impact upon patients in terms of daily functional impairment are less well characterized. Identifying negative outcomes, such as disability, may encourage adherence. Methods: Consecutive ambulatory IBD subjects completed the Medication Adherence Rating Scale (MARS; non-adherence defined as ≤16), Inflammatory Bowel Diseases Disability Index (IBD-DI; disability: < 3.5) and Beliefs about Medicines Questionnaire (high necessity/concerns: ≥16). The primary outcome was the association between medication non-adherence and disability. Secondary outcomes were the predictors of these outcomes. Results: A total of 173 subjects on IBD maintenance medications were recruited (98 Crohn's disease, 75 ulcerative colitis: median IBD-DI, -5.0; interquartile range [IQR], -14.0 to 4.0 and median MARS, 19.0; IQR, 18 to 20) of whom 24% were non-adherent. Disability correlated significantly with medication non-adherence (r=0.38, P < 0.0001). Median IBD-DI for non-adherers was significantly lower than adherers (-16.0 vs. -2.0, P < 0.0001). Predictors of disability included female sex (P=0.002), previous hospitalization (P=0.023), management in a referral hospital clinic (P=0.008) and medication concerns (P < 0.0001). Non-adherence was independently associated with difficulty managing bowel movements (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.50-9.16, P=0.005), rectal bleeding (OR, 2.69; 95% CI, 1.14-6.36; P=0.024) and arthralgia/arthritis (OR, 2.56; 95% CI, 1.11-5.92; P=0.028). Conclusions: Medication non-adherence was associated with significantly increased disability in IBD. Female gender, higher disease severity and medication concerns were additional predictors of disability