Hasil untuk "Special situations and conditions"

Muhammad Azreen Mat Husin, Adrian Anthony Peirera, Thana Seelan et al.

Economic migrant workers are crucial for a country's development but may also contribute to transboundary transmission of antimicrobial resistance (AMR). This study aimed to investigate the silent carriage of ESBL-producing Escherichia coli (ESBLEC) and Klebsiella pneumoniae (ESBLKP) among economic migrants from Indonesia, Bangladesh and Nepal residing in Klang Valley, Malaysia. Between December 2023 and May 2024, 263 study participants of Indonesian, Bangladeshi, and Nepalese migrant communities were recruited and rectal swabs collected. Swabs were then cultured on CHROMagar™ ESBL; presumptive ESBL-positive strains were confirmed and antimicrobial susceptibility-tested using a VITEK 2 system. ESBL genotyping was also performed on confirmed isolates. A total of 67 and five strains were confirmed as ESBLEC and ESBLKP, respectively. Both ESBLEC and ESBLKP strains showed similar resistance to penicillin and 3rd generation cephalosporins, though more ESBLKP strains were resistant to 4th generation cephalosporins. More ESBLEC strains were resistant to ciprofloxacin. No carbapenem-resistant strains were detected. The blaCTX-M-1 gene family was predominantly found in ESBLEC strains from all three nationalities, while ESBLKP strains frequently harboured blaTEM, blaCTX-M, and blaSHV genes. The prevalence of ESBL-producing strains was highest among Bangladeshi participants (n = 16, 31.4 %), followed by Indonesians (n = 47, 29.7 %) and Nepalis (n = 9, 19.1 %) working in domestic or manufacturing sectors. These findings highlight the public health risks of high ESBLEC and ESBLKP carriage in healthy migrant workers, which may impact recruitment and retention, leading to labour shortages and higher costs. Screening and increased awareness are crucial to limit the spread of these pathogens.

Ahmed Azeez Hasan, Anis Kausar Ghazali, Najib Majdi Yaacob et al.

Objectives This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT). Methods A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity. Results Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors. Conclusion The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.

Zhiyu Xiong, Yuan Yuan, Bopeng Qiu et al.

Abstract Background Sleep quality decreased can result in a major health issue in older people with age. While not all sleep changes are pathological in older people’s life, severe disturbances may lead to depression, cognitive impairments, deterioration of quality of life, significant stresses for careers and increased healthcare costs. Despite the known benefits of exercise for improving sleep quality, it is necessary to identify the optimal exercise type and dose. Objective This systematic review and network meta-analysis (NMA) combined to examine evaluated the existing evidence on the effectiveness of different exercises, and to examine the dose and response relationship between overall and specific types with improving sleep quality in older people. Methods PubMed, Cochrane Central, Web of Science, and Embase were systematically searched for this review, including studies up to April 2025. Only randomized controlled trials were included. Studies involved at least one type of exercise intervention and reported changes in sleep quality assessments. To address the limitations of relying solely on statistical significance, we also calculated the minimal clinically important difference (MCID) to determine the smallest meaningful improvement in sleep quality among older people, both overall and across different exercise doses. Data analysis and visualization were conducted using the “meta”, “netmeta”, “MBNMA”, and “ggplot2” packages in the R environment. Results A total of 62 RCTs involving 5005 older adults were included. Overall, exercise significantly improved sleep quality, with clinically meaningful improvements achieved from as early as 5 weeks of intervention. The optimal exercise type was combined aerobic and resistance training, followed by aerobic exercise, resistance training, walking, and yoga. The estimated optimal exercise dose was around 660 to 990 METs*min/week, with longer durations at 15 weeks producing the greatest benefits. Improvements were more pronounced among participants with poorer baseline sleep quality. Conclusion If older people receive the most appropriate exercise intervention, they can obtain clinically meaningful benefits of improving sleep in the elderly within the WHO guidelines for exercise doses. The results support the WHO recommendation that combine aerobic exercise and resistance training should be an important part of interventions for the older people. Protocol registration PROSPERO registration number: CRD42024566751. Graphical Abstract

Lumeng Li, Xiuquan Gong

Abstract Background Public policies play a crucial role in enhancing practical hospice care services and have attracted significant attention in China in recent years. However, there is a lack of research systematically evaluating hospice care policies from an empirical perspective. Objectives To address this gap, we aimed to define and assess overall and individual indicators of hospice care policy importance, coherence, and performance in central, provincial, and local government policy guidelines in China. Methods We applied content analysis and text mining to 112 hospice care policy documents. Using the Policy Modeling Consistency Index (PMC-Index) model, we developed a comprehensive evaluation framework comprising 10 primary and 47 secondary indicators. Subsequently, we quantitatively evaluated 18 selected policy samples through both multidimensional holistic and individual-sample analyses, and examined improvement trends in three national-level stand-alone hospice care strategies. Results The average PMC-Index score of the 18 selected policy samples was 7.20 (out of 10.00), indicating a Good level of consistency. Two policies achieved an Excellent rating, eight were rated as Good, six Acceptable, and two Low. In terms of the 10 policy dimensions, Policy nature (X1) and Policy tools (X3) exhibited excellent performance, whereas Policy equity (X6) and Policy guarantee (X8) showed unsatisfactory performance. Notably, all three national-level stand-alone strategies were rated at the Good level and demonstrated improvements across different pilot periods. Conclusions Hospice care policies in China are considered comprehensive and rational, yet they have the potential for further improvement, especially in the areas of policy equity, guarantee of implementation, timeliness coordination, and multi-agent collaboration. Moreover, a series of practical national strategies play a significant role in the policy system. These findings offer valuable insights into the strengths and limitations of China’s hospice care policies, particularly from perspectives of policy equity and policy innovation. This serves as a reference for establishing a supportive policy environment conducive to the high-quality development of hospice care.

Célio José Borges, Pedro Eduardo Alexandria Botelho, Tiago Monteiro de Oliveira et al.

Este estudo consiste em um desdobramento inter-relacionado com a pesquisa sobre a institucionalização e políticas públicas do esporte e lazer em Rondônia, em consonância com o objetivo verificar, no âmbito da Junta Comercial do Estado de Rondônia – JUCER, no período de janeiro de 1980 a dezembro de 2022, o número de academias em Rondônia. Do ponto de vista da expansão de academias, a urbanização recente de Rondônia foi fator relevante e se deve aos desdobramentos do processo de integração da Amazônia. Processo esse resultado da migração iniciada na década de 1970 com a abertura da colonização dirigida (Faro, 2015), gerando o surgimento de núcleos urbanos, como centros político-administrativo-econômicos (NASCIMENTO; SANTOS e SILVA, 2012). Nesse contexto, empreendimentos em forma de academias de condicionamento físico, dança e esportes sentiram-se atraídos pelo momento econômico do Estado, e passaram a compor a Junta Comercial do Estado de Rondônia - JUCER, como empresas de atividades econômicas relacionadas às artes, cultura, esportes e recreação. Na primeira etapa da pesquisa estão as organizações de 1980 a 2018 e, na segunda, de 2019 a 2022. a) Empresas de Condicionamento Físico De acordo com o IBGE (2019), são compreendidas como atividades de condicionamento físico (fitness): ginástica, musculação, yoga, pilates, alongamento corporal, antiginástica, dentre outras. O Gráfico 1 ilustra o total de academias dos três segmentos, geral, ativa e inativa durante o período de janeiro de 1980 a dezembro de 2022.   Gráfico 1 - Demonstrativo geral de registros de empresas de condicionamento físico no período de 1980 a 2022. Fonte: Núcleo de Estatística/ Junta Comercial de Rondônia.   O Gráfico 2 registra a quantidade de academias ativas de condicionamento físico, que estavam em funcionamento no período de janeiro de 1980 a dezembro de 2022. Se comparada a relação entre os indicadores geral e ativa, observa-se que houve a permanência de 950 unidades e o fechamento de 188.   Gráfico 2 - Demonstrativo de aumento de registros de empresas  ativas de condicionamento físico  no período de 1980 a 2022. Fonte: Núcleo de Estatística/ Junta Comercial de Rondônia   b) Empresas de Ensino de Dança Foram registradas 277 academias de ensino de dança ativas no período de janeiro de 1980 e dezembro de 2022, demonstrando crescimento anual expressivo ao longo das quatro décadas. Dessas empresas, 238 mantiveram-se ativas, mesmo no período de pandemia.echadas.   c) Empresas de Ensino de Esportes Esta classe compreende também as atividades dos técnicos e assistentes de atividades esportivas praticadas por atletas profissionais. Como um dos eixos de estudo da pesquisa, essa definição reforça a relação das academias com o esporte de base e de rendimento.   Gráfico 3 - Demonstrativo geral de aumento de registros de empresas de ensino de esportes no período de 1980 a 2022. Fonte: Núcleo de Estatística/ Junta Comercial de Rondônia.   O Gráfico 3 indica 605 registros de empresas de ensino de esportes no período de janeiro de 1980 e dezembro de 2022. Evidencia crescimento anual expressivo ao longo das décadas e se aproxima dos dados das academias de condicionamento físico.   Gráfico 4 - Demonstrativo de aumento de registros de empresas ativas de ensino de esportes no período de 1980 a 2022. Fonte: Núcleo de Estatística/ Junta Comercial de Rondônia.   O indicativo de 455 registros das empresas de ensino de esportes ativas no período de janeiro de 1980 e dezembro de 2022 aponta crescimento anual. Do mesmo modo, observa-se que em relação aos dados do demonstrativo geral, das 605 empresas cadastradas, houve a permanência de 455 unidades, e o fechamento de 150 unidades.   Gráfico 5 - Demonstrativo da relação entre o quantitativo total de registros de empresas com registro na JUCER e total com permanência ativos no período de 1980 a 2022. Fonte: Núcleo de Estatística/ Junta Comercial de Rondônia. Por fim, de acordo com os dados acima, apresenta-se o demonstrativo da relação entre registro geral, manutenção (ativas) nas diferenças entre os números desses dois parâmetros, percebe-se o índice de fechamentos nas três categorias de academias. No cômputo total, dos três segmentos, é possível observar que em relação aos dados do demonstrativo geral, das 2020 empresas cadastradas, houve a permanência de 1643 unidades, e o fechamento de 377, durante o período pesquisado, de 1980 a 2022.   Palavras-chave: Academias. Esporte. Rondônia. JUCER.   REFERÊNCIAS FARO. Porto Velho, dezembro de 2015. Disponível em: file:///C:/Users/vitor/Downloads/235-704-1-PB.pdf. Acesso em: 20 mar. 2023. GILSON, Ricardo. A maioria dos municípios rondonienses perde população no Censo Demográfico 2022. Ascom/UNIR Publicada em 10 de abril de 2023 às 14:23. IBGE. Censo Demográfico Dados Gerais-Migração-Instrução e Fecundidade - Mortalidade. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/periodicos/72/cd_1980_v1_t4_n2_ro.pdf. Acesso em: 26 de Mar. 2023. IBGE. Resultados do universo relativos às características da população e dos domicílios. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/periodicos/82/cd_1991_n2_caracteristicas_populacao_domicilios_ro.pdf. Acesso em: 26 de Mar. 2023. IBGE. Panorama dos Estados. Disponível em:https://cidades.ibge.gov.br/brasil/ro/panorama Acesso em: 26 de Mar. 2023. IBGE, Cadastro Central de Empresas 2016. Rio de Janeiro: IBGE, 2018. Acesso em: 02 de Abr. 2019. NASCIMENTO, C. P. SANTOS, C. SILVA, M.  Porto Velho: a produção do espaço urbano de Rondônia (1980/2010). Revista Geografar, Curitiba, v.7, n.1,p.20-52,jun./2012. Disponível em: https://revistas.ufpr.br/geografar/article/viewFile/22447/18461. Acesso em: 20 Mar. 2023. Núcleo de Estatística/ Junta Comercial de Rondônia - 2019 e 2023.

Henny Endah Anggraeni, Aep Setiawan, Suhendi Irawan

Kittens in their first four weeks are in their most critical period because they do not yet have the ability to thermoregulate their bodies, and it is still difficult for them to adapt to environmental temperatures. Due to this condition, veterinary clinics and cat-lover communities need facilities that can maintain a kitten’s body temperature within the normal range. One way to help in the care of these kittens is to use a special incubator for animals. Incubators are useful in situations where animals cannot control their body temperature conditions. The expected method to monitor the work system of the incubator is internet-based monitoring, as part of IoT (internet of things). Monitoring is very important for animal health workers and cat lovers in monitoring the temperature and humidity in the incubator using the internet, which allows monitoring to be carried out anytime and anywhere from a smartphone through the Blynk application. The purpose of this research is to create an IoT-based kitten incubator monitoring system through the blynk application so that the owner or nurse of the kitten can monitor in real time via a smartphone so that time efficiency can be improved, by using NodeMCU ESP8266 microcontroller with fuzzy logic method. The incubator can work automatically to regulate the temperature through lighting and air settings in it, with the applied temperature ranging from 26 degrees to 30 degrees Celsius.

Joanna E. Klopotowska, Paul F. M. Kuks, Peter C. Wierenga et al.

Abstract Background The effectiveness of interventions to improve medication safety in older inpatients is unclear, given a paucity of properly designed intervention studies applying clinically relevant endpoints such as hospital-acquired preventable Adverse Drug Events (pADEs) and unrecognized Adverse Drug Events (uADEs). Therefore, we conducted a quality improvement study and used hospital-acquired pADEs and uADEs as main outcomes to assess the effect of an intervention aimed to improve medication safety in older inpatients. Method The study followed an interrupted time series design and consisted of three equally spaced sampling points during baseline and during intervention measurements. Each sampling point included between 80 to 90 patients. A total of 500 inpatients ≥65 years and admitted to internal medicine wards of three Dutch hospitals were included. An expert team retrospectively identified and assessed ADEs via a structured patient chart review. The findings from baseline measurement and meetings with the internal medicine and hospital pharmacy staff were used to design the intervention. The intervention consisted of a structured medication review by hospital pharmacists, followed by face-to-face feedback to prescribers, on average 3 days per week. Results The rate of hospital-acquired pADEs per 100 hospitalizations was reduced by 50.6% (difference 16.8, 95% confidence interval (CI): 9.0 to 24.6, P <  0.001), serious hospital-acquired pADEs by 62.7% (difference 12.8, 95% CI: 6.4 to 19.2, P <  0.001), and uADEs by 51.8% (difference 11.2, 95% CI: 4.4 to 18.0, P <  0.001). Additional analyses confirmed the robustness of the intervention effect, but residual bias cannot be excluded. Conclusions The intervention significantly decreased the overall and serious hospital-acquired pADE occurrence in older inpatients, and significantly improved overall ADE recognition by prescribers. Trial registration International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN64974377 , registration date (date assigned): 07/02/2011.

Marie V Ozanne, Grant D Brown, Breanna M Scorza et al.

<h4>Background</h4>Like many infectious diseases, there is no practical gold standard for diagnosing clinical visceral leishmaniasis (VL). Latent class modeling has been proposed to estimate a latent gold standard for identifying disease. These proposed models for VL have leveraged information from diagnostic tests with dichotomous serological and PCR assays, but have not employed continuous diagnostic test information.<h4>Methods/principal findings</h4>In this paper, we employ Bayesian latent class models to improve the identification of canine visceral leishmaniasis using the dichotomous PCR assay and the Dual Path Platform (DPP) serology test. The DPP test has historically been used as a dichotomous assay, but can also yield numerical information via the DPP reader. Using data collected from a cohort of hunting dogs across the United States, which were identified as having either negative or symptomatic disease, we evaluate the impact of including numerical DPP reader information as a proxy for immune response. We find that inclusion of DPP reader information allows us to illustrate changes in immune response as a function of age.<h4>Conclusions/significance</h4>Utilization of continuous DPP reader information can improve the correct discrimination between individuals that are negative for disease and those with clinical VL. These models provide a promising avenue for diagnostic testing in contexts with multiple, imperfect diagnostic tests. Specifically, they can easily be applied to human visceral leishmaniasis when diagnostic test results are available. Also, appropriate diagnosis of canine visceral leishmaniasis has important consequences for curtailing spread of disease to humans.

Celina Albanus, Travis Heggie, Simone Kattner et al.

Background: Water quality for tourists visiting South Luangwa National Park and other less developed regions is of the utmost importance in order to avoid gastrointestinal infections; one of the most common diseases among tourists. It is also important to the health of the local tourist accommodations and the local tourist economy. Methods: Water quality samples assessing microbiological contamination were taken from the borehole and point of use in 14 tourist lodges and camps. Turbidity was assessed optically with a DelAlgua turbidity tube. For microbiological analysis, samples were incubated in the DelAgua Dual Incubator at 37°C and 44°C. Thermotolerant Escherichia coli (E. coli) was used as the indicator bacterium for fecal pollution. Water samples were classified based of risk levels for pollution determined by the World Health Organization (WHO). Results: Fifty percent of borehole samples showed no contamination. Two were found to be at high risk and the others ranged between low and intermediate risk. At the point of use, 80% of the samples were clean and compliant with WHO guidelines. Water contamination generally improved from the borehole to point of use. Turbidity at borehole samples were clear in 75% of possible samples. At the point of use, turbidity was clear in 81% of samples. Conclusion: This study establishes the first baseline water quality data for tourist facilities at South Luangwa National Park in Zambia. While water quality at most sites is clean for human use, a regular monitoring system accompanied by maintenance is recommended.

Antonio Montresor, Pauline Mwinzi, Denise Mupfasoni et al.

Preventive chemotherapy interventions for the control of soil-transmitted helminthiases (STH) and schistosomiasis scaled up from a global coverage level of around 5% in the year 2000 to a coverage that surpassed 60% in the year 2019. The present paper analyses the concomitant reduction in the number of disability-adjusted life years (DALYs) lost due to STH and schistosomiasis during the same period, from 6.3 to 3.5 million DALYs. The cumulative gain during the 19-year period was estimated at over 26 million DALYs. Given the low cost of the intervention, our study suggests that deworming for STH and schistosomiasis is one of the most cost-effective public health interventions.

Linda Eklund, Filip Schagatay, Ellen Tufvesson et al.

Exposure to a cold climate is associated with an increased morbidity and mortality, but the specific mechanisms are largely unknown. People with cardiopulmonary disease and winter endurance athletes are particularly vulnerable. This study aimed to map multiple domains of airway responses to exercise in subzero temperature in healthy individuals. Thirty-one healthy subjects underwent whole-body exposures for 50 minutes on two occasions in an environmental chamber with intermittent moderate-intensity exercise in +10 °C and -10 °C. Lung function, plasma/urine CC16 , and symptoms were investigated before and after exposures. Compared to baseline, exercise in -10 °C decreased FEV1 (p=0.002), FEV1/FVC (p<0.001), and increased R20Hz (p=0.016), with no differences between exposures. Reactance increased after +10 °C (p=0.005), which differed (p=0.042) from a blunted response after exercise in -10 °C. Plasma CC16 increased significantly within exposures, without differences between exposures. Exercise in -10 °C elicited more intense symptoms from the upper airways, compared to +10 °C. Symptoms from the lower airways were few and mild.  Short-duration moderate-intensity exercise in -10 °C induces mild symptoms from the lower airways, no lung function decrements or enhanced leakage of biomarkers of airway epithelial injury, and no peripheral bronchodilatation, compared to exercise in +10 °C.

Jafar Yahyavi Dizaj, Maryam Tajvar, Yousef Mohammadzadeh

Objectives Over the past few decades, Iran has faced rapid demographic changes, including a sharp decline in birth rates and increased life expectancy. This has led to an increase in the average age of the population and an increase in the percentage of the elderly people which is called “the phenomena of aging”. The occurrence of this phenomenon in Iran is rapidly increasing, and therefore the Iranian community has limited opportunity to prepare for the aging challenges. One of the major challenges for the aging population is the rising health care costs due to the elderly's need for a variety of health services, which causes many households with elderly members to face significant economic problems. This study aims to evaluate the effect of the presence and age of elderly members on health care costs of the households in Iran.  Methods & Materials This study is a secondary analysis using 2016 national household, expenditure and income survey data . Sample size was 19337 households in rural areas and 18809 households in urban areas (total= 38146) in Iran. Linear regression analysis in STATA V. 14 was used to test the effect of variables on health care costs of households with and without elderly members.  Results There was a significant association between the presence of an elderly member in the household and increase in total health care expenditure and medical expenses, such that for one increase in the number of elderly members, total health care expenditure increased by 390,000 Tomans, and medical expenses increased by 195,000 Tomans. In terms of age, families with an elderly member aged 75-79 years had the highest care costs, while those with an elderly member aged 80 and more had the least cost increase. Moreover, household income, having a smoker member, having an income-earner member, living in urban areas, household head education, and health development rate of the province of residence had significant association with total health care expenditure and medical expenses of households. However, no association was found between having health insurance and medical expenses.  Conclusion Since the presence of an elderly member significantly increase the household health costs, future policies should be planned to support the families with elderly members. The health care system of Iran should also be prepared to meet to the health and medical needs of future ageing population.

Dae Hyoung Park, Jong Bouk Lee, Chun Ha Hwang et al.

Background Three-quarters of aged men experience lower urinary tract symptoms with benign prostate hypertrophy (BPH). Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) are standard endosurgical procedures in patients with BPH. Previous studies reported better results in patients undergoing HoLEP than in those undergoing TURP. Methods This study compared the efficiency and safety of conventional morcellation and morcellation performed after X-incision during enucleation, a newly added technique in HoLEP. Overall, 174 patients were selected as the final study population. The populations were stratified with respect to resected volumes. A t-test were used to compare the conventional morcellation and X-incision procedure groups. Results In morcellation times and rates, there were significant differences in stratified resected mass (g) between the groups. The results also showed a decreased incidence of bladder injury as a surgical complication. Conclusion We believe morcellation performed after X-incision procedure during enucleation is efficient and safe for older adults with BPH.

V. Korobkin, A. Kolodenkova

Mara Lucia Gravinatti, Álvaro A. Faccini-Martínez, Sandro Ricardo Ruys et al.

Maureen Laroche, Jean-Michel Berenger, Oleg Mediannikov et al.

BACKGROUND:Among the Reduviidae family, triatomines are giant blood-sucking bugs. They are well known in Central and South America where they transmit Trypanosoma cruzi to mammals, including humans, through their feces. This parasitic protozoan is the causative agent of Chagas disease, a major public health issue in endemic areas. Because of the medical and economic impact of Chagas disease, the presence of other arthropod-borne pathogens in triatomines was rarely investigated. METHODOLOGY/PRINCIPAL FINDINGS:In this study, seven triatomines species involved in the transmission of T. cruzi were molecularly screened for the presence of known pathogens generally associated with arthropods, such as Rickettsia, Bartonella, Anaplasmataceae, Borrelia species and Coxiella burnetii. Of all included triatomine species, only Eratyrus mucronatus specimens tested positive for Bartonella species for 56% of tested samples. A new genotype of Bartonella spp. was detected in 13/23 Eratyrus mucronatus specimens, an important vector of T. cruzi to humans. This bacterium was further characterized by sequencing fragments of the ftsZ, gltA and rpoB genes. Depending on the targeted gene, this agent shares 84% to 91% of identity with B. bacilliformis, the agent of Carrion's disease, a deadly sandfly-borne infectious disease endemic in South America. It is also closely related to animal pathogens such as B. bovis and B. chomelii. CONCLUSIONS:As E. mucronatus is an invasive species that occasionally feeds on humans, the presence of potentially pathogenic Bartonella-infected bugs could present another risk for human health, along with the T. cruzi issue.

Tumouh Al-Allaq, Terrie K DeBord, Honghu Liu et al.

N. Kluger, S. Aldasouqi

Izabel Alves das Chagas, Josana Camilo, M. D. dos Santos et al.

We present a cross-sectional study that aims to describe the sociodemographic and clinical conditions of individuals with diabetes mellitus and to analyze their knowledge of treatment five years after the end of an educational program in which they took part. In 2010, 40 individuals who had participated in a diabetes educational program for 12 months in 2005 at a primary care service were interviewed. A form was used for data collection that included their knowledge of the notion, physiopathology, and treatment of the disease; exercise; nutrition; foot care; self-monitoring of capillary blood glucose at home; hypoglycemia; chronic complications; special situations; and family support. The results showed that the volunteers incorporated the information about the notion, physiopathology, and treatment of the disease; exercise; foot care; self-monitoring; care associated with hypoglycemia; chronic complications; and special situations. In contrast, nutrition and family support require further reinforcement. It is concluded that five years after the end of the educational program, the participants kept most of the information provided.

Manuel Ordóñez Cabrera, A. Rosalsky, Andrei Volodin