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Chronic rhinosinusitis is a common nasal disorder in children that is prone to recurrence. This study investigated the prevention of chronic rhinosinusitis recurrence with bacteria lysate in children.
Bacteria lysate was administered 10 days per month for 3 months to children with chronic rhinosinusitis, who had just entered a remission phase. Visual analogue score, nasal symptoms scores, rhinitis attack frequency and antibiotic use were assessed at three months and one year.
At one year of follow up, the visual analogue score, nasal discharge and obstruction scores, number of days with rhinitis attacks per month and number of days with antibiotic use per month were significantly decreased in the prevention group versus the control group (p < 0.05).
Bacterial lysate used in the remission period of rhinosinusitis in children was shown to provide long-term prophylaxis. Bacterial lysate can effectively reduce the frequency of rhinosinusitis attacks and ameliorate attack symptoms.
Repeat rectal chlamydia infection is common in men who have sex with men (MSM) following treatment with 1 g azithromycin. This study describes the association between organism load and repeat rectal chlamydia infection, genovar distribution, and efficacy of azithromycin in asymptomatic MSM. Stored rectal chlamydia-positive samples from MSM were analysed for organism load and genotyped to assist differentiation between reinfection and treatment failure. Included men had follow-up tests within 100 days of index infection. Lymphogranuloma venereum and proctitis diagnosed symptomatically were excluded. Factors associated with repeat infection, treatment failure and reinfection were investigated. In total, 227 MSM were included – 64 with repeat infections [28·2%, 95% confidence interval (CI) 22·4–34·5]. Repeat positivity was associated with increased pre-treatment organism load [odds ratio (OR) 1·7, 95% CI 1·4–2·2]. Of 64 repeat infections, 29 (12·8%, 95% CI 8·7–17·8) were treatment failures and 35 (15·4%, 95% CI 11·0–20·8) were reinfections, 11 (17·2%, 95% CI 8·9–28·7) of which were definite reinfections. Treatment failure and reinfection were both associated with increased load (OR 2·0, 95% CI 1·4–2·7 and 1·6, 95% CI 1·2–2·2, respectively). The most prevalent genovars were G, D and J. Treatment efficacy for 1 g azithromycin was 83·6% (95% CI 77·2–88·8). Repeat positivity was associated with high pre-treatment organism load. Randomized controlled trials are urgently needed to evaluate azithromycin's efficacy and whether extended doses can overcome rectal infections with high organism load.
The West African 2014 Ebola outbreak has highlighted the need for a better information network. Hybrid information networks, an integration of both hierarchical and formalized command control-driven and community-based, or ad hoc emerging networks, could assist in improving public health responses. By filling the missing gaps with social media use, the public health response could be more proactive rather than reactive in responding to such an outbreak of global concern. This article provides a review of the current social media use specifically in this outbreak by systematically collecting data from ProQuest Newsstand, Dow Jones Factiva, Program for Monitoring Emerging Diseases (ProMED) as well as Google Trends. The period studied is from 19 March 2014 (first request for information on ProMED) to 15 October 2014, a total of 31 weeks. The term ‘Ebola’ was used in the search for media reports. The outcome of the review shows positive results for social media use in effective surveillance response mechanisms – for improving the detection, preparedness and response of the outbreak – as a complement to traditional, filed, work-based surveillance approach.
Virtual reality surgical simulation of mastoidectomy is a promising training tool for novices. Final-product analysis for assessing novice mastoidectomy performance could be limited by a peak or ceiling effect. These may be countered by simulator-integrated tutoring.
Twenty-two participants completed a single session of self-directed practice of the mastoidectomy procedure in a virtual reality simulator. Participants were randomised for additional simulator-integrated tutoring. Performances were assessed at 10-minute intervals using final-product analysis.
In all, 45.5 per cent of participants peaked before the 60-minute time limit. None of the participants achieved the maximum score, suggesting a ceiling effect. The tutored group performed better than the non-tutored group but tutoring did not eliminate the peak or ceiling effects.
Timing and adequate instruction is important when using final-product analysis to assess novice mastoidectomy performance. Improved real-time feedback and tutoring could address the limitations of final product based assessment.
The North American Free Trade Agreement (NAFTA) and its companion agreement, the North American Agreement on Environmental Cooperation (NAAEC), provide important and often underappreciated protection for the environmental laws of the Party states: Canada, Mexico, and the United States. On the twentieth anniversary of NAFTA's ratification, this book assesses the current state of environmental protection under those agreements. Bringing together scholars, practitioners, and regulators from all three Party states, it outlines the scope and process of NAFTA and NAAEC, their impact on specific environmental issues, and paths to reform. It includes analyses of the impact of the agreements on such matters as bioengineered crops in Mexico, assessment of marine environmental effects, potential lessons for China, climate change, and indigenous rights. Together, the chapters of this book represent an important contribution to the global conversation concerning international trade agreements and sustainable development.
The paper studied the effect of an array of hemispherical substance-units (HSUs) immersed in inviscid and incompressible liquid on resonance frequency of a quartz crystal resonator (QCR) under the thickness-shear mode (TSM) vibrations. A dynamic model of the compound QCR system, consisting of a QCR and HSUs, was established in advance. The frequency equation of the compound QCR system including the liquid-solid coupling was derived subsequently. Numerical results showed the frequency-shift characteristics of the compound system. The obtained results are useful in resonator design and applications.
Few studies have investigated the impact of lifestyle interventions during pregnancy on post-partum weight retention and infant growth. Thirty seven previously non-exercising, overweight or obese pregnant women were randomly assigned to a walking intervention or non-intervention control. For the follow-up study, weight of the mother and weight, length and body composition of the infant were collected at 1 month post-partum (n=37) and 6 months post-partum (n=33). Analysis of variance and linear regression were conducted to determine the differences and association in maternal post-partum weight retention and child outcomes. At 6 months post-partum, weight retention of obese women in the intervention group (Int-OB) was −0.10±8.11 kg; while, obese women in the control group (Con-OB) was 6.35±7.47 kg. A significantly higher percentage of Con-OB women retained more than 5 kg at 6 months post-partum (P=0.046). Even though statistically non-significant between the groups, the growth trend observed among offspring of obese women in the control group was consistently higher than the offspring of obese women in the intervention group from birth to 6-months. Third trimester gestational weight gain rate significantly predicted 6-m weight-for-length z-score after controlling for birth weight, treatment group and pre-pregnancy body mass index (r2=0.31, β=1.75, P=0.03). The reduced post-partum weight retention observed among the obese women in the intervention group may be explained in part by the lifestyle modification during pregnancy.
The impact of vanB vancomycin-resistant enterococci (VRE) bacteraemia on length of stay (LOS) in hospital, after adjusting for the time-varying nature of enterococcal bacteraemia (variable onset of bacteraemia post-admission), is unknown. Survival analyses (time-varying Cox and competing risks regression) were performed on vanB VRE bacteraemia patients, matched 1:1 with vancomycin-susceptible enterococci bacteraemia patients to determine the factors associated with LOS in these patients. In Cox regression analysis, vanB VRE bacteraemia, intensive-care-unit admission, Charlson co-morbidity index score ⩾4, and an increase in the time to receive appropriate antibiotics were associated with prolonged LOS. Competing risks regression which accounts for the influence of in-patient mortality on the ability to observe the event discharge alive from hospital suggests that, vanB VRE bacteraemia was not significantly associated with prolonged LOS. For the first time, the rate of discharge from hospital in patients with vanB VRE bacteraemia has been quantified.
The present study assessed the impact of the 2009 food packages mandated by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on dietary intake and home food availability in low-income African-American and Hispanic parent/child dyads.
A natural experiment was conducted to assess if the revised WIC food package altered dietary intake, home food availability, weight and various lifestyle measures immediately (6 months) following policy implementation.
Twelve WIC clinics in Chicago, IL, USA.
Two hundred and seventy-three Hispanic and African-American children aged 2–3 years, enrolled in WIC, and their mothers.
Six months after the WIC food package revisions were implemented, we observed modest changes in dietary intake. Fruit consumption increased among Hispanic mothers (mean = 0·33 servings/d, P = 0·04) and low-fat dairy intake increased among Hispanic mothers (0·21 servings/d, P = 0·02), Hispanic children (0·34 servings/d, P < 0·001) and African-American children (0·24 servings/d, P = 0·02). Home food availability of low-fat dairy and whole grains also increased. Dietary changes, however, varied by racial/ethnic group. Changes in home food availability were not significantly correlated with changes in diet.
The WIC food package revisions are one of the first efforts to modify the nutrition guidelines that govern foods provided in a federal food and nutrition assistance programme. It will be important to examine the longer-term impact of these changes on dietary intake and weight status.
Convergent studies provide support for abnormalities in the structure and functioning of the prefrontal cortex (PFC) and the amygdala, the key components of the neural system that subserves emotional processing in major depressive disorder (MDD). We used resting-state functional magnetic resonance imaging (fMRI) to examine potential amygdala–PFC functional connectivity abnormalities in treatment-naive subjects with MDD.
Resting-state fMRI data were acquired from 28 individuals with MDD and 30 healthy control (HC) subjects. Amygdala–PFC functional connectivity was compared between the MDD and HC groups.
Decreased functional connectivity to the left ventral PFC (VPFC) from the left and right amygdala was observed in the MDD group, compared with the HC group (p < 0.05, corrected).
The treatment-naive subjects with MDD showed decreased functional connectivity from the amygdala to the VPFC, especially to the left VPFC. This suggests that these connections may play an important role in the neuropathophysiology of MDD at its onset.