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BackgroundAlthough the association of neutrophil to lymphocyte ratio (NLR) with mortality in trauma patients has recently been shown, there is a paucity of research on the association with other outcomes. Recent studies suggest that the NLR has a predictive value of mortality in trauma patients during various times of admission. This study aimed to determine the prognostic impact of NLR at the presentation in critically ill trauma patients.MethodsA retrospective cohort study of adult trauma patients between July 2017 and November 2017 in Tishreen Hospital. All patients who had arrived at the emergency department with multi-trauma injury within the age category (14–80 years) were included in this analysis. The prophetical capability of NLR on mortality was assessed by the receiver operative characteristics (ROC) curve. To identify the impact of the NLR on survival, a separate log-rank test was used. Multivariable Cox proportional hazard modeling was used to identify independent predictors of mortality.ResultsThroughout the time of the study, 566 patients met the inclusion criteria. Of these, 98.8% were male, 75.8% sustained penetrating trauma, and median age [IQR25–IQR75] was 26 [23–32]. Ninety-seven patients (17.1%) had major trauma, with an Injury Severity Score (ISS) ≥ 15. Using the ROC curve analyses hospitalization day 1, optimal NLR cutoff values of 4.00 were calculated by maximizing the Youden index. Kaplan-Meier curves revealed an NLR greater than or equal to these cutoff values as a marker for increased in-hospital mortality (p = 0.020, log-rank test). The Cox regression model demonstrated significant collinearity among the predictive variables (all VIF results < 2). Only ISS > 15 has a significant statistical relation with elevated NLR on day 1 (p = 0.010).ConclusionsElevated NLR on day 1 has high predictive power for overall survival during the first 30 days after trauma, but it was not independent of other factors.

Listeria monocytogenes is one of the most important emerging foodborne pathogens. The objectives of this work were to investigate the incidence of Listeria spp. and L. monocytogenes in soft cheese and ice cream in Assiut city, Egypt, and to examine the effect of some probiotic Bifidobacterium spp. (Bifidobacterium breve, Bifidobacterium animalis, or a mixture of the two) on the viability of L. monocytogenes in soft cheese. The existence of Listeria spp. and L. monocytogenes was examined in 30 samples of soft cheese and 30 samples of ice cream. Bacteriological analyses and molecular identification (using 16S rRNA gene and hlyA gene for Listeria spp. and L. monocytogenes, respectively) were performed on those samples. Additionally, Bifidobacterium spp. were incorporated in the making of soft cheese to study their inhibitory impacts on L. monocytogenes. Out of 60 samples of soft cheese and ice cream, 25 samples showed Listeria spp., while L. monocytogenes was found in only 2 soft cheese samples. Approximately 37% of soft cheese samples (11 out of 30) had Listeria spp. with about 18.0% (2 out of 11) exhibiting L. monocytogenes. In ice cream samples, Listeria spp. was presented by 47% (14 out of 30), while L. monocytogenes was not exhibited. Moreover, the addition of B. animalis to soft cheese in a concentration of 5% or combined with B. breve with a concentration of 2.5% for each resulted in decreasing L. monocytogenes efficiently during the ripening of soft cheese for 28 d. Listeria spp. is widely found in milk products. Probiotic bacteria, such as Bifidobacterium spp., can be utilized as a natural antimicrobial to preserve food and dairy products.

Adherence to antihypertensives is crucial for control of blood pressure. This study analyzed factors and interventions that could affect adherence to antihypertensives in the US. PubMed, Scopus, Web of Science, and Embase were searched on January 21, 2022 and December 25, 2023 for studies on the adherence to antihypertensives in the US. Nineteen studies and 23 545 747 patients were included in the analysis, which showed that adherence to antihypertensives was the highest among Whites (OR: 1.47, 95% CI 1.34–1.61 compared to African Americans). Employment status and sex were associated with insignificant differences in adherence rates. In contrast, marital status yielded a significant difference where unmarried patients demonstrated low adherence rates compared to married ones (OR: 0.8, 95% CI 0.67–0.95). On analysis of comorbidities, diabetic patients reported lower adherence to antihypertensives (OR: 0.95, 95% CI 0.92–0.97); furthermore, patients who did not have Alzheimer showed higher adherence rates. Different BMIs did not significantly affect the adherence rates. Patients without insurance reported significantly lower adherence rates than insured patients (OR: 3.93, 95% CI 3.43–4.51). Polypill users had higher adherence rates compared with the free‐dose combination (OR: 1.21, 95% CI 1.2–1.21), while telepharmacy did not prove to be as effective. Lower adherence rates were seen among African Americans, uninsured, or younger patients. Accordingly, interventions such as fixed‐dose combinations should be targeted at susceptible groups. Obesity and overweight did not affect the adherence to antihypertensives.

Background To evaluate the discriminatory ability of imaging modalities' scoring systems in the prediction of COVID‐19 adverse outcomes like ICU admission, ventilatory support, or mortality. Methods We searched PUBMED, EBSCO, WEB OF SCIENCE, and SCOPUS. Two authors independently screened the resulting papers for fulfillment criteria. Meta‐DiSc version 1.4, RevMan version 5.4, and MedCalc version 19.1 were used for test accuracy analysis, sensitivity and specificity analysis, and pooling Area under the curve for discriminatory assessment, respectively. Results Regarding mortality prediction, the computed tomography (CT) showed significantly higher sensitivity [80%; 95% CI 0.74–0.85] and positive likelihood ratio (PLR) [4.41 95% CI 2.94–6.61] relative to the Lung Ultrasound Score (LUS) approach, while the LUS approached the CT scan with specificity of 81% [95% CI 0.78–0.83] and negative likelihood ratio (NLR) of [0.32; 95% CI 0.16–0.64]. The pooled area under ROC for LUS was [AUC = 0.777, 95% CI 0.701–0.852; p < 0.001, I2 = 74.86%, p = 0.019] while the pooled area under ROC for CT severity score was [AUC = 0.855, 95% CI 0.78–0.93; p < 0.001, I2 = 93.73%, p < 0.001]. Regarding adverse outcomes prediction, the LUS had a slightly higher specificity of [78%; 95% CI 0.75–0.80] and PLR of [3.60; 95% CI 2.28–5.68] compared to CT score. The pooled AUC using LUS was (0.77, 95% CI 0.719–0.832; p < 0.001), while using CT severity score was (0.843, 95% CI 0.787–0.898; p < 0.001), and using X‐ray scores was (0.814, 95% CI 0.751–0.878; p < 0.001). Conclusion CT severity score showed a better discriminatory ability in predicting COVID‐19 adverse outcomes, as in‐hospital mortality, ICU admission, and need for ventilatory support compared to LUS and X‐RAY scores, while the LUS, being more specific, had a slightly better prognostic value. Computed tomography (CT) had a higher sensitivity (80% vs. 60%) and positive likelihood ratio in predicting both mortality and or any adverse outcomes such as ICU admission, ventilatory support need, and mortality as compared to Lung Ultrasound score. Thus, CT is superior to ultrasound in ruling out severe outcomes of COVID‐19. Lung ultrasound score had a slightly higher specificity compared to CT in both mortality prediction and prediction of any adverse outcome. Lung ultrasound's performance is thus better in ruling in the occurrence of the adverse outcomes. The use of LUS can be superior as regards to the prediction of adverse events and patients' stratification as it is more specific in rolling out such adverse outcomes.

Background and Aims Antibiotic resistance is seen as a worldwide health risk as a result of the overuse of antibiotics. Many countries noted that antibiotic usage was high during the COVID‐19 pandemic. The purpose of this study is to evaluate Syrians' knowledge, attitudes, and practice about the use of antibiotics and antibiotic resistance during the COVID‐19 epidemic. Methods A cross‐sectional study was conducted using an online questionnaire to collect the data from the Syrian population from February 5 to March 4, 2022. Syrians 18 years or older all over the world were able to participate in this study. A convenience snowball sampling method was used. SPSS version 20.0 was used to analyze the data. To examine the results, binominal logistic regression was used. Statistical significance was defined as a p < 0.05. Results Out of 2406 respondents, 60.2% knew that transmission of COVID‐19 could occur even if the patient has not developed any symptoms, and 91.6% were able to recognize the main clinical symptoms of COVID‐19. There was a statistically significant difference between male and female knowledge of COVID‐19 (p = 0.002), with males having 3.78 ± 2.1 (2.7–3.87) and females scoring 3.93 ± 2.3 (3.7–4.1). Newly graduated students have more knowledge of COVID‐19 than other subtypes of Job (p = 0.0001), and those with medical practice are more knowledgeable than those without (p = 0.0001). Only 16.6% answered that taking antibiotics would not speed up the recovery from all the infections. 65.3% answered correctly that misuse of antibiotics could cause antibiotic resistance. Conclusion Our study concluded that the Syrian population demonstrated good knowledge of COVID‐19 and moderate acceptance of the new norm. Knowledge regarding antibiotic use and resistance and practice of preventive measures was poor, which can encourage the health authorities to develop community education programs to increase public awareness of the usage of antibiotics and safety protocols during the COVID‐19 pandemic.