Knowledge and Attitudes among Primary Healthcare Physicians Regarding Immediate Postpartum Contraception in Cairo, Egypt

Knowledge and Attitudes among Primary Healthcare Physicians Regarding Immediate Postpartum Contraception in Cairo, Egypt

Elhazek AA (a), Talib YMA (b), Amin GE (c), Eltaieb EM (d) and Allam MF (a)*
a. Family Medicine Department, Faculty of Medicine, Ain Shams University, Egypt
b. Professor of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Egypt
c. Assistant Professor of Public Health, Faculty of Medicine, Ain Shams University, Egypt
d. Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Egypt

Abstract
Background: Family planning has a great impact on maternal and child health. Postpartum contraception is defined as the prevention of unintended pregnancy and closely spaced pregnancies in the first 12 months following childbirth.
Purpose: To assess the level of knowledge and attitudes regarding immediate postpartum contraception among primary health care [PHC] physicians in Egypt.
Material and Methods: A pilot cross-sectional study conducted among 100 PHC physicians from 3 health districts in Cairo governorate, Egypt. The study was conducted between August and October 2017. Data were collected through a pre-designed validated self-administered questionnaire on sociodemographic characteristics and knowledge and attitude questions regarding postpartum contraception.
Results: The mean knowledge score was 31.75 ± 9.24; 72% of physicians had a poor knowledge score, and 9% had good knowledge scores. The mean attitude score was 76.92 ± 8.81, and 56% had a favorable attitude. There was no significant difference in knowledge and attitude scores in terms of gender, residence, marital status and PHC center. However, there was a significant difference in knowledge scores in terms of age and experience. There was a significant difference in total knowledge score and attitude when comparing scientific degrees, with higher scores among those with master’s degrees.
Conclusion: There was an unsatisfactory level of knowledge regarding immediate postpartum contraception; there were also a high percentage of favorable and neutral attitudes among the participating physicians. Thus, training courses should be designed for PHC physicians to maintain and improve their knowledge and skills regarding immediate postpartum contraception.

Keywords: Attitude; Knowledge; Physicians; Postpartum contraception.

Elhazek AA, Talib YMA, Amin GE, Eltaieb EM, Allam MF (2019). Knowledge and Attitudes among Primary Healthcare Physicians Regarding Immediate Postpartum Contraception in Cairo, Egypt . J Community Med Health Res 1(2): 108.

https://www.pubtexto.com/pdf/?knowledge-and-attitudes-among-primary-healthcare-physicians-regarding-immediate-postpartum-contraception-in-cairo-egypt

Normal Vitamin D Levels

Normal Vitamin D Levels

Maivel Emile Soby Gerges, Ghada Essam Aldin, Diaa Marzouk Abdel Hamid and Mohamed Farouk Allam*

Department of Family Medicine, Faculty of Medicine, Ain Shams University, Egypt

*Corresponding author: Mohamed Farouk Allam, Environmental and Occupational Med icine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Email: farouk.allam@med.asu.edu.eg

Public H Open Acc 2019, 3(2): 000138.
DOI: 10.23880/phoa-16000138

Mini Review

ABSTRACT
Vitamin D deficiency is a common public-health problem. Deficiency is more common in women than men, and the childbearing period is known to represent a particularly high-risk situation. High rates of poor vitamin D status are found among women during the childbearing period throughout the world. Women at reproductive age are a group that can be susceptible at earlier age for vitamin D deficiency and its complications as increase the risk of osteopenia, osteoporosis, muscle weakness, osteomalacia and pathological fractures and can worsen other chronic conditions, such as the polycystic ovary syndrome; it is also a risk factor for cardiovascular diseases, metabolic syndrome, some types of cancers and some autoimmune diseases. Several studies have identified a surprisingly high prevalence of vitamin D deficiency in all age groups such as in Europe after 14 population study, United States, Canada and Australia. Despite reported prevalence of vitamin D deficiency and insufficiency depend on the cut-off values used that vary between studies, an estimated 1 billion people worldwide have vitamin D deficiency or insufficiency or hypovitaminosis D. National surveys should be conducted in every country to determine normal levels of vitamin D in that country and the need for national screening programs for vitamin D deficiency.

Keywords: Vitamin D; Screening; Survey.

https://medwinpublishers.com/PHOA/PHOA16000138.pdf

The association between coffee consumption and bladder cancer in the bladder cancer epidemiology and nutritional determinants (BLEND) international pooled study

The association between coffee consumption and bladder cancer in the bladder cancer epidemiology and nutritional determinants (BLEND) international pooled study

Yu EY(1)(2), Wesselius A(3), van Osch F(3)(4), Stern MC(5), Jiang X(5), Kellen E(6), Lu CM(7), Pohlabeln H(8), Steineck G(9), Marshall J(10), Allam MF(11), La Vecchia C(12), Johnson KC(13), Benhamou S(14), Zhang ZF(15), Bosetti C(16), Taylor JA(17), Zeegers MP(3)(18).

Author information:

(1)NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Universiteitssingel 40 (Room C5.564), 6229 ER, Maastricht, The Netherlands. evan.yu@maastrichtuniversity.nl.

(2)CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands. evan.yu@maastrichtuniversity.nl.

(3)NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Universiteitssingel 40 (Room C5.564), 6229 ER, Maastricht, The Netherlands.

(4)Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.

(5)Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.

(6)Leuven University Centre for Cancer Prevention (LUCK), Louvain, Belgium.

(7)Department of Urology, Buddhist Dalin Tzu Chi General Hospital, Dalin Township, Chiayi County, Taiwan.

(8)Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.

(9)Clinical Cancer Epidemiology, Department of Oncology, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

(10)Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.

(11)Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy.

(12)Department of Clinical Medicine and Community Health, University of Milan, Milan, Italy.

(13)Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada.

(14)INSERM U946, Variabilite Genetique et Maladies Humaines, Fondation Jean Dausset/CEPH, Paris, France.

(15)Departments of Epidemiology, UCLA Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

(16)Laboratory of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milan, Italy.

(17)Epidemiology Branch and Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.

(18)CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands.

Cancer Causes Control. 2019 May 30. [Epub ahead of print] PubMed PMID: 31147895.

doi: 10.1007/s10552-019-01191-1.

BACKGROUND: Inconsistent results for coffee consumption and bladder cancer (BC) risk have been shown in epidemiological studies. This research aims to increase the understanding of the association between coffee consumption and BC risk by bringing together worldwide case-control studies on this topic.

METHODS: Data were collected from 13 case-control comprising of 5,911 cases and 16,172 controls. Pooled multivariate odds ratios (ORs), with corresponding 95% confidence intervals (CIs), were obtained using multilevel logistic regression models. Furthermore, linear dose-response relationships were examined using fractional polynomial models.

RESULTS: No association of BC risk was observed with coffee consumption among smokers. However, after adjustment for age, gender, and smoking, the risk was significantly increased for never smokers (ever vs. never coffee consumers: ORmodel2 1.30, 95% CI 1.06-1.59; heavy (> 4 cups/day) coffee consumers vs. never coffee consumers: ORmodel2 1.52, 95% CI 1.18-1.97, p trend = 0.23). In addition, dose-response analyses, in both the overall population and among never smokers, also showed a significant increased BC risk for coffee consumption of more than four cups per day. Among smokers, a significant increased BC risk was shown only after consumption of more than six cups per day.

CONCLUSION: This research suggests that positive associations between coffee consumption and BC among never smokers but not smokers.

Cancer Causes Control. 2019 May 30. [Epub ahead of print] PubMed PMID: 31147895.

https://link.springer.com/article/10.1007%2Fs10552-019-01191-1

EFFECT OF VITAMIN D SUPPLEMENTATION ON MUSCLE FUNCTION IN ELDERLY INDIVIDUALS: A META-ANALYSIS

EFFECT OF VITAMIN D SUPPLEMENTATION ON MUSCLE FUNCTION IN ELDERLY INDIVIDUALS: A META-ANALYSIS

Tomader Taha Abdel Rahman (1), Mohamed Shawky Khater (1), Mohamad Farouk Allam (2)

1 Geriatric Medicine & Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
2 Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University.

Egyptian Journal of Geriatrics and Gerontology 2018; 5(2): 32-40.

DOI: 10.21608/ejgg.2018.30912

ABSTRACT 

Background: Sarcopenia (the loss of muscle mass and strength) has estimated prevalence rates of 5-13% and 11-50% in the young-old and old-old, respectively. Recent studies have shown that vitamin D plays important roles in various systems, including the musculoskeletal system. Objective:
The aim of this meta-analysis was to determine the effects of vitamin D supplementation on muscle function in community‐dwelling elderly individuals.

Methods: We conducted systematic searches of PubMed, Medline, Egyptian Knowledge Bank, and the reference sections of previous reviews, and we discussed the topic with several experts in the field. Only randomized controlled trials that evaluated the effect of vitamin D supplementation on muscle function [muscle strength was evaluated by the hand grip strength (HGS) test, and physical performance was evaluated by the timed up-and-go (TUG) test] were included. Only studies published in English between January 2000 and June 2018 were considered.

Results: In total, 14 randomized controlled clinical trials (RCTs) met our inclusion criteria. The participants in these studies were all community-dwelling elderly individuals, who were generally in good health for their age. The pooled mean difference in HGS was higher in the vitamin D supplementation group than in the control group. The pooled mean difference in the TUG test was slightly lower in the vitamin D supplementation group than in the control group.

Conclusions: Our meta-analysis shows that vitamin D supplementation could improve muscle function in elderly individuals. Future studies should use standardized durations and doses of vitamin D supplementation.

Keywords: Vitamin D supplementation, Sarcopenia, Muscle function, Meta-analysis, Randomized controlled clinical trials, Systematic review.

Egyptian Journal of Geriatrics and Gerontology Volume 5, Issue 2, October 2018, Page 32-40.
https://ejgg.journals.ekb.eg/article_30912.html 

COMPARISON BETWEEN ANTRAL RESECTION IN LAPAROSCOPIC SLEEVE GASTRECTOMY AND CLASSICAL LAPAROSCOPIC SLEEVE GASTRECTOMY

COMPARISON BETWEEN ANTRAL RESECTION IN LAPAROSCOPIC SLEEVE GASTRECTOMY AND CLASSICAL LAPAROSCOPIC SLEEVE GASTRECTOMY

Ahmed Helmy M, Zakria Shaker H, Nafea A, Abo EL Naga M , Mahmoud Gabr A, Farouk Allam M* 

Department of General Surgery, * Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Egypt. *Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Spain 

REVISTA ESPAÑOLA DE INVESTIGACIONES QUIRÚRGICAS

Spanish Journal of Surgical Research

REIQ 2019 Vol XXII nº1 (11-14)

ABSTRACT Background: Laparoscopic sleeve gastrectomy (LSG) is essentially a restrictive bariatric operation. Weight loss is achieved by drastically reducing the gastric volume, which in turn leads to reduced food intake. In addition, a series of hormonal changes occurring postoperatively in bariatric patients, contribute to decreased appetite, reduced food intake and long-term weight loss. To date there is a lack of standardization regarding the surgical technique of LSG, which may affect the long-term outcome of the patients. Our study aimed to assess the difference in short and long- term weight loss and complications between antral resection in laparoscopic sleeve gastrectomy and classical laparoscopic sleeve gastrectomy with antral preservation. Patients and Methods: This is a controlled clinical trial held in Ain Shams University Hospital including 40 patients with BMI >30, of them 20 underwent antral resection in laparoscopic sleeve gastrectomy, and the other 20 patients underwent classical laparoscopic sleeve gastrectomy, with antral preservation. Results: Our study showed mild increase in weight loss and BMI reduction after 12 months in the antral resection group compared with the antral preservation group with mean weight loss 70.5kg in antral resection group versus 75.05kg in antral preservation group and mean BMI 27.7% in antral resection group versus 27.9% in antral preservation group, but did not reach statistical significant values. Conclusion: Our study showed that antral resection in laparoscopic sleeve gastrectomy resulted in non-significant better weight loss in the first postoperative year than classical laparoscopic sleeve gastrectomy. 

KEYWORDS Sleeve gastrectomy, Antral resection, Body mass index.

http://www.reiq.es/ESP/pdf/REIQ22.1.2019.pdf

Selenium supplements for asthma: a systematic review of clinical trials/ Suplementos de selenio para el asma: revisión sistemática de ensayos clínicos

Suplementos de selenio para el asma: revisión sistemática de ensayos clínicos

Alexandra Remón Love, Carmen Díaz Molina, Mohamed Farouk Allam*

Área de Medicina Preventiva y Salud Pública. Facultad de Medicina. Universidad de Córdoba. Córdoba

Medicina General y de Familia. 2018; 7(6): 245-251

Sociedad Española de Médicos Generales y de Familia

http://mgyf.org/suplementos-de-selenio-para-el-asma-revision-sistematica-de-ensayos-clinicos/

http://dx.doi.org/10.24038/mgyf.2018.069

Objetivo. El objetivo de este metanalisis es examinar distintos estudios experimentales para determinar si administrando suplementos de selenio (Se) a estos pacientes obtenemos una mejoría clínica del asma.

Material y métodos. Se realizó una búsqueda de ensayos controlados aleatorios, en los que se diera suplementos de Se, a ser posible comparado con administración de placebo. Los resultados analizados fueron la mejoría clínica, la función pulmonar, los niveles de Se y glutation‑peroxidasa Se‑dependiente antes y después del tratamiento, y la calidad de vida.

Resultados. Se localizaron 12 estudios; de ellos 6 cumplieron con los criterios de inclusión. Solo 3 estudios evaluaron los síntomas y la mejoría clínica; 2 estudios demostraron mejoría clínica y 1 estudio demostró menor uso de corticoesteriodes inhalados a partir de 24 semanas de suplementos de Se. Solo 2 estudios evaluaron las funciones pulmonares; un ensayo controlado aleatorio no demostró mejoría en la FEV1, mientras el otro ensayo clínico no controlado demostró mejoría en la FEV1 y la FVC. Solo 3 estudios evaluaron la calidad de vida de los asmáticos; todos utilizaron escalas distintas para evaluar la calidad de vida de los participantes. Los 2 ensayos clínicos no controlados demostraron mejoría en la calidad de vida, mientras el ensayo clínico controlado demostró mejoría en ambos grupos, aunque siendo la diferencia no fue estadísticamente significativa con respecto a placebo.

Conclusiones. A pesar de la heterogeneidad entre los estudios localizados, hay indicios de que los suplementos de Se podrían ser útiles para el tratamiento del asma.

Palabras clave: Selenio, Asma, Suplemento, Revisión sistemática, Estudio experimental.

Selenium supplements for asthma: a systematic review of clinical trials

Objective. Our goal is to analyze randomized controlled trials to determine whether giving selenium supplements improve asthmatic symptomatology or not.

Material and methods. We performed a research of randomized controlled trials in which selenium supplements were given to asthmatic patients, with a control group treated with placebo if possible. The analyzed results were clinical improvement, quality of life, selenium and selenium-dependent glutathione-peroxidase enzyme plasma levels before and after treatment.

Results. 12 studies were found, 6 of them met our inclusion criteria. Only 3 studies measured symptoms and clinical improvement; 2 proved that there was an improvement in the symptomatology of asthmatic patients and 1 showed a decrease in the dosage of inhaled corticosteroids after 24 weeks of taking selenium supplements. Only 2 studies evaluated pulmonary function; a controlled randomized trial found that the FEV1 hadn’t improved, while another non-controlled trial showed better results in the FEV1 and FVC. Only 3 studies analyzed quality of life (QoL) in asthmatics. Each of the 3 used different scales to evaluate the QoL of the participants. Both non-controlled clinical trials showed improvement, as did the controlled clinical trial in both groups although the difference between them was not significant.

Conclusions. Despite the heterogeneity between the studies we located, there is some evidence that selenium supplements could be useful for asthma treatments.

Keywords: Selenium, Asthma, Supplements, Systematic review, Controlled clinical trial

Surgical versus non-surgical management of obstructive sleep-disordered breathing in children: meta-analysis

Surgical versus non-surgical management of obstructive sleep-disordered breathing in children: meta-analysis

A.A. Afifi, A. Askoura, M. Shehata, M.F. Allam and D.M. Marzouk

From the Family Medicine Department, Faculty of Medicine, Ain Shams University

QJM: An International Journal of Medicine, Volume 111, Issue suppl 1, 1 December 2018, hcy200.050, https://doi.org/10.1093/qjmed/hcy200.050

Published: 13 December 2018

Background: Obstructive sleep disordered breathing (OSDB) includes a wide spectrum of clinical entities with variable severity of recurrent partial or complete upper airway obstruction. OSDB is common in children, adenotonsillar hypertrophy account for most cases in children. Adenotonsillectomy is widely considered an effective treatment for obstructive sleep disordered breathing in children.

Objectives: To compare effectiveness of surgical versus nonsurgical treatment of Obstructive sleep-disordered breathing in children in randomized controlled trials through a meta-analysis study.

Search methods: The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Google Scholar, Web of Science, were searched for available trials till August 2017.

Selection criteria: Clinical trials concerned in treatment of Obstructive sleep-disordered breathing in children aged 2 to 16 years.

Outcome measured: Apnea/Hypopnea Index, behavioral outcomes, neurocognitive performance, executive functions, health care utilization, disease specific quality of life and adverse events of treatment.

Results: Seven trials met the inclusion criteria. As regard disease- specific quality of life Four studies evaluated this outcome there was significant clinical improvement in the surgical group (REM: SMD = -1.013, 95% CI = -1.584 to -0.441, P-value = 0.001), while Only one study measures health care utilization which states that Adenotonsillectomy significantly reduces health care utilization. As regard Apnea/Hypopnea Index, three studies present their data as continuous data evaluated the change in AHI among children with OSDB by pooling of these three studies there is no statistically significant difference between both management strategies surgical and non-surgical (REM: SMD = -0.248, 95% CI = -0.701 to 0.205, P-value = 0.283), Two other studies present their data as dichotomous data by pooling of these two studies there is no statistically significant difference between both management strategies (FEM: Odds ratio = 0.881, 95% CI = 0.304 to 2.557, P-value = 0.816). Regarding behavioral out comes two studies evaluated the change in behavior by pooling of these 2 studies there was no difference between both management strategies (REM: SMD = -0.514, 95% CI = -2.145 to 1.117, P-value = 0.537). Two studies evaluated the changes in executive functions by pooling these 2 studies there was no statistically significant difference between surgical and non-surgical management (REM: SMD = 0.151, 95% CI = -0.037 to 0.340, P-value = 0.116). Two studies evaluated adverse events that occurred among children by pooling these 2 studies there was no difference between both management strategies (FEM: Odds ratio = 0.834, 95% CI = 0.317 to 2.193, P-value = 0.713). Only one study measures neurocognitive outcome, no inference on neurocognitive outcome can be elicited.

Conclusion: the current meta-analysis reported significant clinical improvement in the surgical group as compared with the non-surgical group, in terms of disease specific quality of life, Health care utilization. However, there were no significant changes in other outcomes.

Delusional disorder and suicidal behavior: descriptive study of 26 cases/ Trastorno delirante y conducta suicida: estudio descriptivo de 26 casos.

Delusional disorder and suicidal behavior: descriptive study of 26 cases/ Trastorno delirante y conducta suicida: estudio descriptivo de 26 casos.

Francisco Mármol Bernal (1), Rogelio Luque Luque (2), Mohamed Farouk Allam (3,4), Rafael Fernández-Crehuet Navajas (3)

1. Delegación Territorial de Salud, Córdoba, España.

2. Hospital Universitario Reina Sofía. Universidad de Córdoba, Córdoba, España.

3. Área de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Córdoba, Córdoba, España.

4. Department of Community, Environmental and Occupational Medicine, Faculty of 

Medicine, Ain Shams University, Cairo, Egypt.

Rev Chil Neuro-Psiquiat 2018; 56 (4): 228-240

http://dx.doi.org/10.4067/s0717-922720180004002228

Resumen

Introducción / antecedentes. La conducta suicida en el trastorno delirante (TD) ha sido esca­samente estudiada.

Objetivo. Profundizar en el conocimiento de las características demográ­ficas, ambientales, psicosociales y clínicas del suicido en un gru­po de pacientes con TD con la finalidad de contribuir a generar y sugerir estrategias que contribuyan a realizar nuevos estudios de mayor nivel explicativo.

Método. Estudio epidemiológico descriptivo retrospectivo de Registro de Casos en el Dispensario de Psiquiatría e Higiene Mental de Córdoba sobre pacientes con TD según criterios DSM-IV-TR. Aquellos pacientes que cumplieron con los criterios de inclusión definidos constituyeron nuestra muestra final de 261 casos, de ellos 26 casos presentaron evidencias de intento de suicidio. Las variables sobre las que se recogió información en base a protocolos, fueron agrupadas con el orden siguiente: I. Socio­demográficos y generales. II. Factores de riesgo del TD (fami­liares y personales). III. Cuadro Clínico y el Diagnóstico del TD (Presentación, Sintomatología, Funcionalidad y Discapacidad, utilización de los recursos sanitarios, tratamiento, problemas psicosociales, evolución y curso) y medios letales utilizados.

Resultados. La edad media de los pacientes fue de 47 años y el 60% fue­ron hombres. Los datos sociodemográficos muestran que los pacientes con intento de suicidio residían en núcleos rurales (46,2%), no tenían estudios en un 15,4%, un 57,7% no traba­jaba y un 26,9% recibía una pensión por enfermedad o jubi­lación laboral. El subtipo persecutorio con 8 casos, fue el más frecuente, seguido de los subtipos de grandiosidad (6 casos) y celotípico (6 casos), mixto (3 casos), erotomaníaco (2 casos) y somático (1 caso).

Discusión y conclusión. Son necesarios futuros estudios prospectivos para investigar los factores de protección, de riesgo y/o asociados al suicidio en el TD.

Palabras clave: Trastorno delirante, paranoia, conducta suici­da, series de casos.

Delusional disorder and suicidal behavior: descriptive study of 26 cases.

Summary

Introduction / background. Suicidal behavior in delusional disorder (DD) patients has been poorly studied.

Objective. Investigate the demographic, environmental, psychosocial and clinical characteristics of the suicidal behavior in a group of patients with DD.

Method. Retrospective descriptive study of DD cases registered at Psychiatry and Mental Hygiene Clinic of Cordoba according to DSM-IV criteria was conducted. We obtained a sample of 261 DD patients who met the inclusion criteria, of them 26 cases presented evidence of suicidal behavior. Data and variables co­llected were divided into 4 groups: I. Socio-demographic and general data. II. DD risk factors (personal and family). III. DD clinical picture and diagnosis (presentation, symptoms, disabi­lity, use of health care resources, treatment, and evolution) and lethal methods used.

Results. The mean age of the patients was 47 years old and 60% were males. Socio-demographic data show that 46.2% of patients with suicidal behavior lived in rural areas, only 15,4% were analphabet, 57,7% were unemployed, and 26.9% were recei­ving a pension because of illness or retirement. The persecu­tory subtype with 8 cases was the most frequent presentation, followed by grandiose (6 cases) and jealous (6 cases), mixed (3 cases), erotomanic (2 cases) and somatic (1 case) subtypes.

Discussion and conclusion. It is necessary to conduct future prospective studies to investi­gate the protective and risks factors associated with the suici­dal behavior in DD patients.

Key words: delusional disorder, paranoia, suicidal behavior, case series.

Rev Chil Neuro-Psiquiat 2018; 56 (4): 228-240

https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-92272018000400228

Is selenium deficiency a risk factor for the development of asthma? ¿La deficiencia de selenio es un factor riesgo para el desarrollo del asma?

¿La deficiencia de selenio es un factor riesgo para el desarrollo del asma?

Arantxa Domínguez-Jiménez (1), José Luis Barranco Quintana (1), Mohamed Farouk Allama (1,2)

1. Área de Medicina Preventiva y Salud Pública. Facultad de Medicina, Universidad de Córdoba.
2. Department of Community, Environmental and Occupational Medicine. Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Medicina General y de Familia. 2018; 7(5): 202-207
Sociedad Española de Médicos Generales y de Familia

http://mgyf.org/la-deficiencia-de-selenio-es-un-factor-riesgo-para-el-desarrollo-del-asma/
http://dx.doi.org/10.24038/mgyf.2018.059

Objetivo. El objetivo de esta revisión sistemática es examinar la asociación entre los niveles de selenio (Se) y el riesgo de asma.
Material y métodos. Se realizó una búsqueda de estudios observacionales publicados hasta enero de 2016, en los que se investigó específicamente la asociación entre los niveles de Se y el riesgo de asma. Se extrajo o calculó el riesgo estimado (riesgo relativo u odds ratio), con su intervalo de confianza al 95 % (IC95 %), de los estudios encontrados, si era factible. Cuando la estimación de riesgo y su IC95 % no estaban disponibles en el artículo, calculamos valores no ajustados de los datos publicados en el artículo.
Resultados. Se localizaron 28 estudios; de ellos 6 estudios de casos y controles cumplieron con los criterios de inclusión. Los 6 estudios fueron publicados entre 1989 y 2012. Los resultados del metaanálisis no demostraron ninguna asociación positiva entre los niveles bajos de selenio y el riesgo de asma, y los IC95 % de 5 de los 6 estudios superaban la unidad. También se localizaron 10 estudios de casos y controles que midieron los niveles de Se en asmáticos y en controles sanos. De los 10 estudios, 5 demostraron niveles más bajos de Se en los asmáticos, con diferencias estadísticamente significativas.
Conclusiones. Nuestros resultados sugieren que el selenio sérico es menor en pacientes asmáticos que en no asmáticos. Son necesarios futuros estudios prospectivos que integren criterios homogéneos para investigar la asociación entre los niveles de selenio y el riesgo asma.

Palabras clave: Asma, Selenio, Metaanálisis, Revisión sistemática, Estudios observacionales.


Is selenium deficiency a risk factor for the development of asthma?

Objective. The objective of this systematic revision is to evaluate the association between plasma selenium (Se) levels and asthma risk.
Material and methods. Observational studies published before January 2016 that specifically investigated the association between plasma Se levels and asthma risk were reviewed. Odds ratios and 95% confidence intervals (95%CI) of these studies were extracted, when data were available. If odds ratio and its 95% CI were not published in the article, we calculated unadjusted parameters.
Results. From among the 28 localized studies, 6 case-controls studies met our inclusion criteria. The 6 studies were published between 1989 and 2012. The results of the meta-analysis did not show a positive association between low plasma Se levels and asthma risk, and 95%CI of 5 of the 6 studies overlapped unity. In addition, we localized 10 case-control studies that measured Se levels in asthmatics and controls. In 5 of them, differences in plasmatic Se levels of the asthmatic group were statistically significant.
Conclusions. Our results suggest an association between low plasmatic Se levels and asthma risk. Future prospective studies with similar homogenous criteria are required to investigate association between Se and asthma.

Keywords: Asthma, Selenium, Meta-analysis, Systematic review, Observational studies. 

Incidence Of Central Line-associated Bloodstream Infections In Intensive Care Units In A Private Hospital (Cairo, Egypt)

Incidence Of Central Line-associated Bloodstream Infections In Intensive Care Units In A Private Hospital (Cairo, Egypt)

Amira M. Malek, Hasnaa A. Abouseif, Khaled M. Abd Elaziz, Mohamed F. Allam* and Hoda I. Fahim

Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

The Open Public Health Journal, 2018, Volume 11, Page 562-571

DOI: 10.2174/1874944501811010562

Abstract:

Objective: The study aimed to measure the incidence, risk factors and most frequent causative organisms of central line-associated bloodstream infections (CLA-BSI) in the Medical/Coronary and Surgical Intensive Care Units (ICUs) at a private hospital.

Methods: This prospective study included 499 patients and was conducted between April 2014 and September 2014 in the Medical/Coronary ICU and Surgical ICU of a private hospital in Cairo, Egypt.

Results: Approximately 44% of all the patients admitted to the ICUs underwent Central Venous Catheter (CVC) insertion. The overall incidence density rate of CLA-BSI was 6 cases per 1000 central line-days. The central line utilization rate was 0.94 per 1000 patientdays. The mortality rate among cases with CLA-BSI was 16.8% (95% CI: 13.6% – 20.4%) during the study period. Risk factors for CLA-BSI were detected by univariate analysis and included associated co-morbidities such as heart failure, APACHE II scores of >15, an ICU stay of 5 days or more, duration of CVC placement, subclavian insertion of CVCs, and mechanical ventilation. Additionally, logistic regression analysis identified a long ICU stay of 5 days or more, mechanical ventilation and the presence of heart failure as the only significant predictors. Gram-negative bacteria, especially Enterobacter (36.8%: 95% CI: 16.3%– 61.6%), Pseudomonas aeruginosa (21.1%: 95% CI: 16.0% - 45.5%) were the predominant organisms detected in CLA-BSI cases.

Conclusion: CLA-BSI is an important cause of mortality in ICU patients. The infection rate is considerably higher than that in recent studies from developed counties, but it is still lower than the rates reported in comparable published studies in Egypt. Strict adherence to the standard infection prevention practices for critically ill patients is highly recommended.

Keywords: Adults, Central Line-Associated Blood Stream Infection, Cohort study, Intensive Care Unit, Incidence density rate, Risk factors.