Virulence genes and antimicrobial resistance pattern in Proteus mirabilis strains isolated from patients attended with urinary infections to Tertiary Hospitals, in Iran

Background: Proteus mirabilis is a frequent reason for catheter-associated urinary tract infections (UTIs). The aim of this study was to identify virulence genes and antimicrobial resistance patterns in P. mirabilis strains isolated from patients whoattended a tertiary hospital in Iran. Methods: In this study, 100 P. mirabilis strains from urine samples were isolated. These isolated strains were identified by biochemical and PCR-based tests, and their antibiotic resistance was profiled through a standard procedure using 14 antibiotics.PCR assays were used to detect virulence-related genes in P. mirabilis strains. The biofilm formation of each P. mirabilis strain was examined. Results: Of the 100 P. mirabilis isolates, 16 (16%) were multidrug-resistant. High resistance was observed against cotrimoxazole (97%), nalidixic acid (93%), cefotaxime (77%), and amoxicillin (62%). Sixty of the 100 isolates showed resistance against extended-spectrum cephalosporins. The prevalence rates of the genes related to the virulence factors in this study were mrpH (100%), ucaA (91%), hpmA (94%), zapA (95%), ptaA (100%), ureG (100%), pmfA (100%), fliC (97%), and mrpA (90%) using PCR method. Strong biofilm formation was observed in 20% (5/25) of the strains isolated fromnon-catheterized samples and 80% (20/25) of strains isolated from catheterized samples. Conclusions: Resistance to antibiotics and the prevalence of pathogenicity genes are high in Proteus mirabilis strains iolated from UTIs. Keywords: Antibiotic resistance; Proteus mirabilis; biofilm; virulence factors

Association of Lipid Accumulation Product with Cardio-Metabolic Risk Factors in Postmenopausal Women

The lipid accumulation product is a novel, safe and inexpensive index of central lipid over accumulation based on waist circumference and fasting concentration of circulating triglycerides. This study was designed to investigate the ability of lipid accumulation product to predict Cardio-metabolic risk factors in postmenopausal women. In this Cross-sectional study, 264 postmenopausal women by using convenience sampling method were selected from menopause clinic in Tehran. Cardio-metabolic risk factors were measured, and lipid accumulation product (waist-58×triglycerides [nmol/L]) was calculated. Optimal cut-off point of lipid accumulation product for predicting metabolic syndrome was estimated by ROC (Receiver-operating characteristic) curve analysis. Metabolic syndrome was diagnosed in 41.2% of subjects. Optimal cut-off point of lipid accumulation product for predicting metabolic syndrome was 47.63 (sensitivity:75%; specificity:77.9%). High lipid accumulation product increases risk of all Cardio-metabolic risk factors except overweight, high Total Cholesterol, high Low Density Lipoprotein Cholesterol and high Fasting Blood Sugar in postmenopausal women. Our findings show that lipid accumulation product is associated with metabolic syndrome and some Cardio-metabolic risk factors Also lipid accumulation product may have been a useful tool for predicting cardiovascular disease and metabolic syndrome risk in postmenopausal women

The burden of neck pain among adults aged 70 years and older in Iran, 1990–2019

Abstract Background Neck pain is a complex musculoskeletal disorder that can result in substantial morbidity. The present article presents the neck pain burden in Iranians who were at least 70 years old, from 1990 to 2019, by sex, age group, and province. Methods Publicly available information on the prevalence, incidence, and years lived with disability (YLD) caused by neck pain was extracted from the Global Burden of Disease study 2019. The estimates were all provided as counts and age‐standardized rates (per 100,000), and included 95% uncertainty intervals. Results The point prevalence of neck pain in 2019 was 8710.6, while the incidence rate was 1334.7 per 100,000 population. That same year, there were number of 27.8 thousand YLDs and an YLD rate of 801.7 per 100,000. The prevalence, incidence, and YLD rates did not change substantially over the measurement period (1990–2019). The highest YLD rate was found in Tehran (960.9 per 100,000), while Kohgiluyeh and Boyer‐Ahmad had the lowest (730.5 per 100,000). Females had slightly higher prevalent cases, incident cases, and YLDs, as well as their corresponding rates in 2019. In 2019, the number of prevalent cases, incident cases, and YLDs peaked in the 70–74 age group, for both sexes, and in all cases they reduced with age. In both 1990 and 2019, Iran had a higher YLD rate than that found among elderly adults in the Middle East and North Africa region. Conclusions The burden of neck pain in Iran has decreased slightly over the last three decades, but it still imposes a substantial burden and is higher than that found in the rest of the region. Therefore, preventive programs should be initiated at a young age to reduce the attributable burden later in life

A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Nowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis

Additional file 8 of Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990–2019

Additional file 8: Supplementary Table S5. Countries with lowest QCI changes

Additional file 3 of Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990–2019

Additional file 3: Supplementary Figure S3. QCIs for the seven GBD super-regions in 1990 and 2019

Additional file 2 of Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990–2019

Additional file 2: Supplementary Figure S2. Age-standardized QCI by socio-demographic index

Additional file 4 of Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990–2019

Additional file 4: Supplementary Table S1. SDI values for different regions

Additional file 6 of Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990–2019

Additional file 6: Supplementary Table S3. QCIs of all countries from 1990 to 2019

Additional file 5 of Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990–2019

Additional file 5: Supplementary Table S2. Global and SDI-based regional epidemiologic indices of prostate cancer