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.

Breastfeeding of mothers attending the outpatient clinic of Reina Sofia University Hospital (Cordoba, Spain)

Breastfeeding of mothers attending the outpatient clinic of Reina Sofia University Hospital (Cordoba, Spain)

Mohamed Farouk Allam (1,2)
1. Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
2. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (7), Page 4815-4820
DOI: 10.12816/ejhm.2018.10140

ABSTRACT
Background: Although the beneficial effects of breastfeeding are well-known, the prevalence of breastfeeding in many developed countries is quite low. Objective: The objective of this study was to estimate the prevalence of breastfeeding in the catchment area of Reina Sofia University Hospital of Cordoba (Spain). Materials and Methods: A cross sectional study was conducted for mothers attending the outpatient clinic of Reina Sofia University Hospital of Cordoba, for follow-up after 6 weeks of delivery. All mothers attending the outpatient clinic over 3 months accepted to participate in the study. Finally, we had a sample of 91 mothers. Study variables were age, educational level, gestational weeks, type of delivery, gender and weight of the new born, type of feeding for the baby over the first 6 weeks of his/her life, motives for abandoning breastfeeding, and motives for selecting the artificial formula. The information was collected through a previously validated interview questionnaire. Results: The mean age of the mothers was 31.8 (SD 3.13) years old. About 67% of mothers selected exclusive breastfeeding and 4.39% selected the combination of breastfeeding with the artificial formula. More than 28% of mothers selected the artificial formula. The reasons for selecting the artificial formula were own decision (46.15%), medical recommendation (11.53%), lack of breast milk (3.84%). The remaining 23.1% of mothers who selected the artificial formula refused to answer this question. Conclusions: Our results show that only two-third of mothers adopted breastfeeding in the first 6 weeks after delivery. Health education and promotion programmes for breastfeeding are urgently needed.

Keywords: Breastfeeding, Artificial Formula, Cross sectional, Cordoba, Spain.

The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (7), Page 4815-4820
http://ejhm.journals.ekb.eg/article_10140.html

Inflammatory Bowel Disease in Systemic Lupus Erythematosus Patients: A Meta-analysis

Inflammatory Bowel Disease in Systemic Lupus Erythematosus Patients: A Meta-analysis

Howaida El Sayed Mansour (1), Mohamed Farouk Allam (2), Sherin Mohamed Hosny (1), Amira Ibrahim Abdu (1)
1. Departments of Internal Medicine and Rheumatology, and 2. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain-shams University

The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (8), Page 5116-5121

DOI: 10.12816/EJHM.2018.10580

ABSTRACT
Background: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with features of multisystem involvement, relapsing and remitting course. Gastrointestinal system affection is common in Lupus patients but coexistence of the inflammatory bowel disease (IBD) and SLE is rare. The coexistence of signs and symptoms of both diseases in the same patient represents a diagnostic challenge. Diagnoses of both diseases is difficult as both may share the same gastrointestinal features. Some of the therapies used in IBD may induce lupus. Aim of the study: To detect the presence of IBD in SLE patients. Methods: Only19 studies investigating the coexistence of IBD in SLE patients were published from January 2000 to March 2017 searching the Medline, PubMed, Ovid, Trip and Cochrane database. We excluded 16 studies (case reports) as they lacked the inclusion criteria for the meta-analysis. Only three studies were included in this systematic review. The prevalence/frequency and its 95% CI are included or estimated whenever possible. Results: Most of the studies that detected a statistical association between both diseases were case series and case control study that revealed the presence of IBD in some lupus patients. Criteria for the diagnosis of SLE cases and IBD cases were clearly explained in these studies, and same stratified results according to gender. The pooled results of all cases with SLE were (total 6665) showed that, there were IBD cases (total 79) associated with lupus with a frequency (95% CI) is 1.19% (0.96-1.48). Conclusion: The prevalence of IBD in SLE patients is rare however, the coexistence of both diseases in the same patient could occur.

Keywords: Systemic lupus erythematosus, inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, coexistence, gastrointestinal symptoms.

The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (8), Page 5116-5121
http://ejhm.journals.ekb.eg/article_10580.html

Decline of Tobacco Smoking Among Medical Specialists at A Spanish University Hospital

Decline of Tobacco Smoking Among Medical Specialists at A Spanish University Hospital

Alberto Molina Cabildo (1), Carmen Díaz Molina (1), Mohamed Farouk Allam (1,2)

1. Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
2. Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (6), Page 4697-4701

DOI: 10.12816/EJHM.2018.9843

ABSTRACT
Background: Several epidemiological studies have shown that the prevalence of tobacco smoking in the Spanish healthcare centres is relatively high. Objective: to assess the current situation of tobacco smoking among medical specialists of Reina Sofia University Hospital (Cordoba, Spain). As a secondary objective we intended to calculate the indirect costs of smoking among medical specialists during the working hours. Materials and Methods: Descriptive cross-sectional study of the medical specialists of Reina Sofia University Hospital. Our survey was conducted using an interview questionnaire that included the following variables: age, sex, medical specialty, smoking habits, tobacco smoking during work hours, time spent on each cigarette, intention to quit smoking and the possibility to participate in a smoking cessation program. Results: A total of 143 medical specialists; 64 women and 79 men were interviewed. About 14% of participants were former smokers and 10.5% were current smokers, of whom 67% wanted to quit smoking. About 73% of smokers consumed tobacco during the working hours. Most of smokers consumed 2 cigarettes during the working hours. About 60% of smokers would use a permanent aid program to quit smoking. The hours lost by the smoking habits of medical specialists cause an annual loss of 143.512,96 euros. Conclusions: The study results show that currently there is an increasing awareness of health professionals about the harmful effects of smoking: former smokers have increased, and most of smokers want to quit. Also, they would use a permanent aid program to quit smoking.

Keywords: Prevalence, Tobacco, Medical specialist, Reina Sofia University Hospital, Cordoba, quit smoking.

The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (6), Page 4697-4701
http://ejhm.journals.ekb.eg/article_9843.html

SITUACIÓN ACTUAL DEL TABAQUISMO ENTRE LOS FACULTATIVOS ESPECIALISTAS DE ÁREA DE UN HOSPITAL UNIVERSITARIO

RESUMEN

Objetivo: Conocer la situación actual ante el consumo del tabaco de los Facultativos Especialistas de Área (FEAs) del Hospital Universitario Reina Sofía de Córdoba. Como objetivo secundario pretendemos calcular el coste indirecto del hábito tabáquico en los FEAs durante la jornada laboral. Materiales y métodos: Estudio transversal en los FEAs del Hospital Universitario Reina Sofía de Córdoba. El estudio se realizó mediante una encuesta de preguntas cerradas para estudiar las siguientes variables: edad, sexo, especialidad, hábito tabáquico, consumo de tabaco en horario laboral, tiempo empleado en cada cigarrillo, intención de dejar el consumo de tabaco, y la posibilidad de participar en un programa de deshabituación tabáquica. Resultados: Se han entrevistado un total de 143 FEAs; 64 mujeres y 79 hombres. Hay un 14% de exfumadores y fumadores actuales un total del 10,5%, de los cuales el 67% quiere dejar el hábito. Un 73% de los fumadores lo hace durante el horario laboral, siendo la cantidad de 2 cigarrillos la más consumida. El 60% de los fumadores utilizarían un programa de ayuda permanente para dejar de fumar. Las horas perdidas por el hábito tabáquico de los FEAs supone una pérdida anual de 143.512,96 euros. Conclusiones: Los resultados del estudio demuestran que a día de hoy, existe una concienciación cada vez mayor por parte de la sociedad sobre los efectos nocivos del tabaco, ya que: han aumentado los exfumadores, la mayoría de los fumadores quieren dejarlo, y además, utilizarían el programa de deshabituación tabáquica.

Palabras claves: prevalencia, tabaco, FEAs, Hospital Universitario Reina Sofía de Córdoba, deshabituación tabáquica.