The issue of drug resistance (DR) among patients with tuberculosis (TB) has occurred since the introduction of streptomycin and becomes a priority for TB control programs worldwide. Based on Portugal National Tuberculosis Surveillance System (SVIG-TB) and regional drug sensitivity testing (DST) database, a 10 year-epidemiological survey described retrospectively the impact of DR phenomenon on TB trend in Algarve, Portugal, from 01 January 2004 to 31 December 2014. Study sample included 106 patients with male (78%) and youth predominance. The most important risk factor for DR-TB consisted in immigration (31.13%). RezumatProblema chimiorezistenței, la pacienții cu tuberculoză (TB), a apărut odată cu introducerea streptomicinei și a devenit o prioritate a programelor de control al TB în întreaga lume. Pe baza datelor statistice oferite de Programul Național de Supraveghere a TB din Portugalia și de Registrul regional de investigare a sensibilității tulpinilor de micobacterii TB din regiunea Algarve la medicamentele anti-TB, s-a evaluat impactul rezistenței medicamentoase asupra evoluției endemiei TB, din această regiune, pe o perioadă de 10 ani (01 ianuarie 2004 până în 31 decembrie 2014). Eșantionul a inclus 106 pacienți, cu predominanța bărbaților (78%) și a adulților tineri. Cel mai important factor de risc al TB-DR a fost migrația (31,13%).
Over the last thirty years, the pathogenesis of obstructive sleep apnea syndrome (OSAS) has begun to be elucidated worldwide due to the presence of standardized diagnostic and treatment. In adults, the clinical diagnosis may be suggestive of OSAS when symptoms like fatigue, lack of concentration, poor work performance, absenteeism, daytime sleepiness, insomnia, snoring, nocturnal respiratory distress or apnea episodes witnessed by others are present. Some medical conditions found in employees’ personal history such as craniofacial abnormalities, some endocrine diseases, arterial hypertension, especially resistant arterial hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, stroke, obesity, diabetes mellitus, cognitive dysfunction or mental disorders may be the alarm signal for OSAS. The assessment of all risk factors, clinical presentation and diagnosis must become an important part of occupational medical examinations and performed in all workers due to its major public health potential and impact on survival. The early identification of OSAS among workers performed by the occupational physician can potentially reduce the risk of work injuries and fatalities. In conclusion, OSAS is a complex entity and an important public health problem. The delay in diagnosis and treatment contributes to the increase of healthcare services demand and implicitly to general mortality.
To understand the contribution of the work-related and extra-professional factors on the risk of insomnia during the COVID-19 pandemic. The survey was prepared on a GoogleDrive form. The questionnaire was distributed online and collected data from 769 responders. The dependent variable was the presence or absence of insomnia. Non parametric tests and correlations were used to find the main predictors linked with a greater chance of developing insomnia. The onset or the aggravation of the insomnia was reported by 41.01% of responders. The maximum rate was in healthcare workers (42.01%). Significant direct correlations were found between insomnia and work load, fear for the inefficiency of the personal protective equipment, changes in workplace, procedures and working schedule, belonging to a vulnerable health group, general psycho-social strain and lack of social recognition. A significant occupational stressor related to insomnia was represented by the contact with COVID-19 patients followed by fear of developing infection at work. The personal perception of risk was found a composite indicator and it was the only non-occupational factor related to insomnia. The best identified predictors for insomnia consisted in work overload (OR=2.13, CI=1.7-2.5, p=0.03), occupations supposing contact with COVID-19 patients (OR=2.04, CI =1.7-2.3, p=0.01), belonging to a vulnerable health group (OR=1.53, CI=1.1-2.3, p=0.001), personal perception of risk (OR=1.26, CI =1.2-1.3, p=0.001) and lack of social recognition (OR=1.21, CI =1-1.3, p=0.02). The study highlights the main risk factors that should be avoided in order or to reduce the occurrence of insomnia and its consequences.
A 74 year old Caucasian man, presents with a 6 week history of right sided chest pain including traumatic related painful right shoulder. Shoulder minor contusion was diagnosed and partial managed by symptomatic treatment associated to rehabilitation. The pain was initially eased with nonsteroidal anti-inflammatory drug (NSAID) use and finally changed worsening. He has evidence of moderate COPD on spirometry and has been commenced on inhalers. An invasive primitive adenocarcinoma lung cancer was confirmed by chest CT scan and lymphnode biopsy through mediastinoscopy
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