Explore the vast range of titles available.

Introduction: Managing information related to multimorbidity in hospital care is crucial for planning strategies to prevent health problems in high-risk patients in order to enable healthcare systems to be organized more efficiently. Objective: To describe the formal healthcare network path for patients with and without multimorbidity in relation to the use of public healthcare networks after discharge. Materials and Methods: A quantitative descriptive cross-sectional study was conducted with primary data from 445 patients admitted to a university hospital in 2018. Data were collected through analysis of medical records and telephone interviews. Results were analyzed by absolute and relative frequency. Results: A flowchart was developed representing the healthcare network locations used by the patient after hospital discharge based on morbidity. It was possible to confirm the existence of a high prevalence of referral (with multimorbidity (WM): 93.52%, without multimorbidity (WOM): 97.71%) and secondary care attendance, low prevalence of referral (WM: 42.45%, WOM: 36.27%) and primary care attendance (WM: 61.29%, WOM: 64.81%). When putting the three levels of healthcare together, low attendance (WM: 17.98% - WOM: 21.89%) was observed in both groups under study. Discussion: Similar attendance at all healthcare network locations is problematic as these are unequal populations and thus, with different needs. Conclusions: It is important to encourage follow-up of patients with multimorbidity in the primary care network, especially in the period after hospital discharge and strengthen the healthcare network. How to cite this article: Lima, Melina Lopes; Bordin, Danielle; Furquim, Renata Cristini Fernandes; Cabral, Luciane Patrícia Andreani; Muller, Erildo Vicente; Fadel, Cristina Berger.  Caminho na rede formal de cuidado em saúde de pacientes pós-alta hospitalar segundo multimorbidade. Revista Cuidarte. 2022;13(1):e1279 http://dx.doi.org/10.15649/cuidarte.1279 Introdução: A gestão de informações associadas à multimorbidade na atenção hospitalar é relevante para o planejamento de estratégias de prevenção de agravos à saúde em pacientes de maior risco, a fim de oportunizar a organização de sistemas de saúde de modo eficiente. Objetivo: O presente trabalho objetivoudelinear o caminho formal percorrido por pacientes com e sem multimorbidade, considerando o uso da rede pública de saúde após a internação hospitalar. Materiais e métodos: Realizou-se um estudo quantitativo, transversal, descritivo, utilizando dados primários de 445 pacientes internados em um hospital universitário, no ano de 2018. Os dados foram coletados através de análise do prontuário médico e entrevista telefônica. Os resultados foram analisados por meio de frequência absoluta e relativa. Resultados: Desenvolveu-se um fluxograma, representando os pontos da rede de saúde utilizados pelo paciente após a alta hospitalar, segundo multimorbidade. Verificou-se uma alta prevalência de encaminhamento (com multimorbidade (CM) 93,52%; sem multimorbidade (SM) 97,71%) e comparecimento na atenção secundária à saúde (CM 86,15%; SM 89,63%), um baixo encaminhamento (CM 42,45%; SM 36,27%) e comparecimento na atenção primária à saúde (CM 61,29%; SM 64,81%), e considerando os 3 níveis de atenção juntos, houve um baixo comparecimento (CM 17,98%; SM 21,89%) para ambos os grupos investigados. Discussão: Entende-se que a semelhança de comparecimento em todos os pontos da rede por ambos os grupos é um problema, por tratar de forma igual populações desiguais e consequentemente com necessidades diversas. Conclusões: Sinaliza-se a importância de maior incentivo ao acompanhamento de pacientes com multimorbidade na rede primária de saúde, especialmente no período de pós-alta hospitalar, e a necessidade de fortalecimento da Rede de Atenção à Saúde. Como citar este artigo: Lima, Melina Lopes; Bordin, Danielle; Furquim, Renata Cristini Fernandes; Cabral, Luciane Patrícia Andreani; Muller, Erildo Vicente; Fadel, Cristina Berger. Caminho na rede formal de cuidado em saúde de pacientes pós-alta hospitalar segundo multimorbidade. Revista Cuidarte. 2022;13(1):e1279 http://dx.doi.org/10.15649/cuidarte.1279 Introducción: La gestión de la información asociada a la multimorbilidad en la atención hospitalaria es crucial para la planificación de estrategias de prevención de problemas de salud en los pacientes de mayor riesgo, con el fin de permitir organizar los sistemas de salud de forma eficiente. Objetivo: Describir la ruta formal recorrida por los pacientes con y sin multimorbilidades con base en el uso de la red pública de salud después de la hospitalización. Materiales y métodos: Se realizó un estudio cuantitativo, transversal y descriptivo con datos primarios de 445 pacientes ingresados en un hospital universitario en 2018. Los datos se recolectaron mediante el análisis de historias clínicas y entrevistas telefónicas. Los resultados se analizaron a través de frecuencia absoluta y relativa. Resultados: Se elaboró un flujograma que representa los puntos de la red de atención en salud utilizados por el paciente tras el alta hospitalaria según la morbilidad. Se confirmó la existencia de una alta prevalencia de remisión (con multimorbilidad (CM): 93.52%, sin multimorbilidad (SM): 97.71%) y asistencia a atención secundaria, baja remisión (CM: 42.45% - SM: 36.27%) y asistencia a atención primaria (CM: 61.29% - SM: 64.81%); al incluir los tres niveles de atención en conjunto se evidenció una baja asistencia (CM: 17.98% - SM: 21.89%) en ambos grupos investigados. Discusión: Se considera problemático la similitud en la asistencia en todos los puntos de la red por parte de ambos grupos, por tratarse de poblaciones desiguales y, en consecuencia, con necesidades diferentes. Conclusiones: Se señala la importancia de incentivar el seguimiento de los pacientes con multimorbilidades en la red de atención primaria, especialmente en el periodo posterior al alta hospitalaria y la necesidad de reforzar la red de atención en salud. Como citar este artículo: Lima, Melina Lopes; Bordin, Danielle; Furquim, Renata Cristini Fernandes; Cabral, Luciane Patrícia Andreani; Muller, Erildo Vicente; Fadel, Cristina Berger. Caminho na rede formal de cuidado em saúde de pacientes pós-alta hospitalar segundo multimorbidade. Revista Cuidarte. 2022;13(1):e1279 http://dx.doi.org/10.15649/cuidarte.1279

A total of 669 individual cow milk samples originating from asymptomatic cows from 16 dairy farms were examined for the presence of microorganisms with the potential to cause mastitis. Coagulase-negative staphylococci clearly predominated (53.5% positive samples) followed by streptococci and enterococci (both occurring in 16.1% samples). Among streptococci, so-called mastitis streptococci (S. uberis, S. dysgalactiae and S. agalactiae) prevailed (11.7% positive samples). Enterobacteriaceae were found in 10.0% samples, most of which (6.6% samples) were positive for Escherichia coli. Yeasts (mainly Candida spp.) were found in 8.2% samples. One of the major mastitis pathogens, Staphylococcus aureus subsp. aureus, was isolated from 9.0% of samples. S. aureus isolates were further characterised in terms of their capability to form biofilm, antimicrobial susceptibility and clonality (PFGE). All S. aureus isolates were capable of biofilm formation and were generally susceptible to the majority of tested antibiotics. The exception was ampicillin, resistance to which was observed in 27.7% isolates. Therefore, the relatively frequent occurrence of S. aureus could be attributed to persistent intramammary infections due to biofilm formation rather than low efficacy of particular antibiotics. PFGE analysis revealed clonal spread of certain S. aureus isolates within and between farms indicating that certain lineages of S. aureus mastitis strains are particularly successful.

The prevalence of brucellosis was determined in buffaloes, cattle, sheep and goats in the districts Bagerhat, Bogra, Gaibangha, Mymensingh and Sirajgonj in Bangladesh. A total of 550 sera samples (105 buffaloes, 188 cattle, 127 goats and 130 sheep) were screened by RBT and were further confirmed with I-ELISA. A structured questionnaire was used to collect epidemiological information. The overall serological prevalence derived from the samples was 2.87% in buffaloes, 2.66% in cattle, 3.15% in goats, and 2.31% in sheep. The prevalence was relatively higher in females than in males in cattle, goats and sheep, but an insignificantly higher prevalence was observed in buffalo males than buffalo females. A significant association was found between abortion or age and occurrence of brucellosis. Our results provide (a) a comparison of the prevalence of brucellosis in different livestock species in Bangladesh, (b) constitute baseline data for further study of Brucella infections, and (c) are a starting point for the control of brucellosis.

Bluetongue is a non-contagious disease of domestic and wild ruminants caused by a virus within the Orbivirus genus of the family Reoviridae and transmitted by Culicoides biting midges. It is a reportable disease of considerable socioeconomic concern and of major importance for the international trade of animals and animal products. In the past, bluetongue endemic areas were found between latitudes 40 deg N and 35 deg S; however, bluetongue has recently spread far beyond this traditional range. This is in accordance with the extension of areas in which the biting midge Culicoides imicola, the major vector of the virus in the 'Old World', is active. After 1998 new serotypes of bluetongue virus (BTV) were discovered in Southern European and Mediterranean countries. Since 2006 BTV-serotype 8 has also been reported from the countries in Northern and Western Europe where Culicoides imicola has not been found. In such cases, BTV is transmitted by Palearctic biting midges, such as C. obsoletus or C. dewulfi, and the disease has thus spread much further north than BTV has ever previously been detected. New BTV serotypes have recently been identified also in Israel, Australia and the USA. This review presents comprehensive information on this dangerous disease including its history, spread, routes of transmission and host range, as well as the causative agent and pathogenesis and diagnosis of the disease. It also deals with relevant preventive and control measures to be implemented in areas with bluetongue outbreaks.

Muga silkworm is endemic to Assam and adjoining areas in North-Eastern India, and naturally produces golden silk. From time immemorial, many ethnic and tribal groups have produced muga silk. Muga silkworms are mostly wild unlike the mulberry silkworm, which is completely domesticated. The muga silkworm is a single species with little genetic variation among populations, survives harsh climatic conditions and is subject to various diseases, pests and predators. Due to the high incidence of disease and natural enemies, and variations in climatic conditions, the production of muga silk has recently declined dramatically. In order to improve the productivity of this silkworm it is important to have a better knowledge of both its host plants and biology. Lack of knowledge of its genetics and host plants is a major bottleneck. This paper reviews various aspects of muga silkworm culture, including the availability of different populations, and methods used to select for improvement in survival, cocoon yield, disease resistance, conservation and egg production.

Serum samples were collected from 251 healthy adult goats in the Czech Republic during the years 2006 to 2009 in order to determine the seroprevalence of T. gondii and N. caninum. Sera samples were tested for serum antibodies to Toxoplasma gondii by an enzyme-linked immunosorbent assay with cut off equal to or higher than 50% S/P. The same samples were tested for serum antibodies to Neospora caninum by a competitive-inhibition enzyme-linked immunosorbent assay with cut off equal to or higher than 30% inhibition; positive sera were confirmed by an indirect fluorescent antibody test with cut-off titre equal to or higher than 40. Sera positive in both tests were marked as positive. In total, 166 and 15 goat sera reacted positively for T. gondii and N. caninum antibodies, respectively. All sera positive for N. caninum antibodies were simultaneously positive for T. gondii antibodies. This is the first detection of N. caninum antibodies in goats in the Czech Republic. Our findings indicate that goats in the Czech Republic are frequently exposed to T. gondii, but less frequently to N. caninum.

Background. Overweight in adults is associated with increased morbidity and mortality. In contrast, the long-term effect of overweight in adolescence on morbidity and mortality is not known. Methods. We studied the relation between overweight and morbidity and mortality in 508 lean or overweight adolescents 13 to 18 years old who participated in the Harvard Growth Study of 1922 to 1935. Overweight adolescents were defined as those with a body-mass index that on two occasions was greater than the 75th percentile in subjects of the same age and sex in a large national survey. Lean adolescents were defined as those with a body-mass index between the 25th and 50th percentiles. Subjects who were still alive were interviewed in 1988 to obtain information about their medical history, weight, functional capacity, and other risk factors. For those who had died, information on the cause of death was obtained from death certificates. Results. Overweight in adolescent subjects was associated with an increased risk of mortality from all causes and disease-specific mortality among men, but not among women. The relative risks among men were 1.8 (95 percent confidence interval, 1.2 to 2.7; P = 0.004) for mortality from all causes and 2.3 (95 percent confidence interval, 1.4 to 4.1; P = 0.002) for mortality from coronary heart disease. The risk of morbidity from coronary heart disease and atherosclerosis was increased among men and women who had been overweight in adolescence. The risk of colorectal cancer and gout was increased among men and the risk of arthritis was increased among women who had been overweight in adolescence. Overweight in adolescence was a more powerful predictor of these risks than overweight in adulthood. Conclusions. Overweight in adolescence predicted a broad range of adverse health effects that were independent of adult weight after 55 years of follow-up.

The aim of this paper was to review the status of bovine tuberculosis (BTB) in Ethiopia in relation with the existing animal husbandry systems and abattoir meat inspection surveillances. Ethiopia is one of the African countries where tuberculosis is widespread in both humans and cattle. The disease is considered as one of the major livestock diseases that results in high morbidity and mortality, although the current status on the actual prevalence rate of BTB at a national level is yet unknown. Detection of BTB is based mainly on tuberculin skin testing, abattoir meat inspection and very rarely on bacteriological techniques. The prevalence rates vary from 3.4% (small farms) to 50% (intensive dairy farms) and from 3.5% to 5.2% in slaughterhouses. Control measures, economic impacts and zoonotic aspect of the disease are also briefly reviewed.

The aim of this study was to evaluate the prevalence of bovine tuberculosis (TB) and the magnitude and trend of tuberculous lesions in slaughtered cattle (1994 to 2010) as well as tuberculin skin tests (TST) in 2,853 cattle (84 herds) of 39 livestock rearing communities in the highlands of Cameroon. Out of 129,165 slaughtered cattle inspected, 599 (0.46%; 95% CI: 0.43%-0.50%) showed suspected tuberculous lesions among a total of 983 (0.76%; 95% CI: 0.71%-0.81%) identified pathologies. The monthly TB detection rates ranged from 0.30% (95% CI: 0.20%-0.40%) to 0.81% (95% CI: 0.64%-0.98%) and annual rates from 0.04% (95% CI: 0%-0.11%) to 1.46% (95% CI: 1.22%-1.69%). The rates were not affected by season and fluctuating peaks were also recorded. The comparative TST revealed that bovine TB was widely distributed in live cattle (4.67%; 95% CI: 3.89%-5.44%) and was significantly higher in the Western highlands than Adamawa plateaux. Comparative TST bovine TB reactors were higher (P less than 0.05) in cattle managed in semi-intensive and beef production systems compared to the others. Animals in small herds showed signif. higher rates than those in large herds. Bovine TB prevalence in exotic/upgraded cattle was comparable to that of the Red Bororo zebu but signif. higher than the rates in Guadali and White Fulani zebus. Among the indigenous zebus, the rate was signif. higher in Red Bororo than the Guadali and White Fulani. Sex did not influence bovine TB prevalence in this study but diagnosis of the disease was signif. higher among adult/older cattle than in younger animals. Further analysis of the TST responses revealed that atypical mycobacterial infections was widespread and 6.83% of tested animals showed positive reactions at both bovine and avian tuberculin injection sites and a strong association between skin responses to both tuberculins. Our study confirms that bovine TB is prevalent in live cattle and abattoirs in Cameroon.

Resection of hepatocellular carcinoma is associated with high rates of morbidity and mortality. Since intensive nutritional support can reduce the catabolic response and improve protein synthesis and liver regeneration, we performed a prospective study to investigate whether perioperative nutritional support could improve outcome in patients undergoing hepatectomy for hepatocellular carcinoma. We studied 124 patients undergoing resection of hepatocellular carcinoma. Sixty-four patients (39 with cirrhosis, 18 with chronic active hepatitis, and 7 with no associated liver disease) were randomly assigned to receive perioperative intravenous nutritional support in addition to their oral diet, and 60 patients (33 with cirrhosis, 12 with chronic active hepatitis, and 15 with no associated liver disease) were randomly assigned to a control group. The perioperative nutritional therapy consisted of a solution enriched with 35 percent branched-chain amino acids, dextrose, and lipid emulsion (50 percent medium-chain triglycerides) given intravenously for 14 days perioperatively. There was a reduction in the overall postoperative morbidity rate in the perioperative-nutrition group as compared with the control group (34 percent vs. 55 percent; relative risk, 0.66; 95 percent confidence interval, 0.45 to 0.96), predominantly because of fewer septic complications (17 percent vs. 37 percent; relative risk, 0.57; 95 percent confidence interval, 0.34 to 0.96). There were also a reduction in the requirement for diuretic agents to control ascites (25 percent vs. 50 percent; relative risk, 0.57; 95 percent confidence interval, 0.37 to 0.87), less weight loss after hepatectomy (median loss, 0 kg vs. 1.4 kg; P = 0.01), and less deterioration of liver function as measured by the change in the rate of clearance of indocyanine green (-2.8 percent vs. -4.8 percent at 20 minutes, P = 0.05)