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3%), within the "indications" domain. For knowledge, lower scores were reported for domains related to "indications" (mean 1.49 ± 0.82/3), "resistance" (mean 1.06 ± 0.94/3), and "storage and disposal" (mean 1.23 ± 0.78/3).

These findings indicated a need to improve cadres' attitudes and knowledge prior their involvement as change agents for improving the rational use of antibiotics to minimise antibiotic resistance in Indonesia.

These findings indicated a need to improve cadres' attitudes and knowledge prior their involvement as change agents for improving the rational use of antibiotics to minimise antibiotic resistance in Indonesia.

Tuberculosis remains a major health problem worldwide, killing thousand adults and children every year mainly in developing countries as Brazil. The disease is socially determined, caused mainly by inequalities as overcrowding, bad conditions of housing, unemployment, and limited access to health care. The aim of this study was to identify the social inequalities associated with the onset of tuberculosis in disease-prone territories in a city from the Northeast.

This was an ecological study, which has gathered patients diagnosed with tuberculosis through secondary data source in a city from the northeast of Brazil. The GAMLSS statistical model has been applied considering as response variable the count of Tuberculosis cases and the independent variable, the social conditions. The double Poisson distribution was considered in the analysis. The best model fitted was selected according the Akaike information criterion value. For all tests, the p value < 0.05 was considered as statistically significant.

460 patients with diagnosis of tuberculosis were identified, which represents an incidence of 36.3 cases/100,000 in males and 20.7 cases/100,000 in females. Regarding social inequality associated with tuberculosis, income (households with per capita income between 1/8 and 3 minimum wages), gender and age (Proportion of males under 15 years of age) were associated with the disease.

The findings evidenced the social determinants associated with tuberculosis, with a greater occurrence of the disease in areas with mostly male children and low-income families, these issues must be managed within and beyond the health sector, which is mandatory for the Tuberculosis elimination.

The findings evidenced the social determinants associated with tuberculosis, with a greater occurrence of the disease in areas with mostly male children and low-income families, these issues must be managed within and beyond the health sector, which is mandatory for the Tuberculosis elimination.

Because of the adverse effects on human health of some antimicrobial ingredients in traditional toothpaste, consumers are increasingly turning to toothpastes with natural ingredients. This study evaluates the antimicrobial effect of toothpastes containing different natural active agents against three oral pathogens Streptococcus mutans, Streptococcus sanguinis, and Enterococcus faecalis.

This study tested one traditional toothpaste and seven different natural toothpastes containing theobromine, aloe vera, miswak, propolis, chitosan, enzymes and probiotics. The agar-well diffusion method was used to test the antimicrobial effect. Inhibition zones formed around toothpastes after 24 hours of incubation were measured and the data collected were statistically analyzed.

Toothpastes containing theobromine and chitosan and the traditional toothpaste showed antimicrobial efficacy for all tested bacteria. Toothpastes containing aloe vera, miswak, and propolis were only effective on S. mutans, while toothpastes containing probiotics and enzymes did not show any antimicrobial effect on the bacteria. Among toothpastes with natural ingredients, the theobromine-containing toothpaste showed the highest efficacy on S. mutans, while the aloe vera- and propolis-containing toothpastes had the lowest efficacy (p < 0.05).

Theobromine- and chitosan-containing toothpastes, which showed antimicrobial activity against all bacteria, can be recommended as alternatives to traditional toothpastes.

Theobromine- and chitosan-containing toothpastes, which showed antimicrobial activity against all bacteria, can be recommended as alternatives to traditional toothpastes.

Methicillin-Resistant Staphylococcus aureus (MRSA) is a S. aureus strain characterized by resistance to cloxacillin. Healthcare workers (HCWs), are recognized for their heightened risk for MRSA acquisition and possibly for MRSA nosocomial transmission. This cross-sectional study aimed to determine the prevalence and the associated risk factors of MRSA colonization among healthcare workers at Sultan Qaboos University Hospital (SQUH) in Oman.

A total of 200 nasal swab samples were collected from the healthcare workers at SQUH during the period October 2nd 2018 to January 7th 2019. All nasal swab samples were examined microbiologically for the presence of MRSA using the standard method and the results were confirmed by detection of the mecA product (PBP2a). Data on associated risk factors for MRSA colonization was collected and analyzed.

Forty-one of the 200 screened healthcare workers (20.5%) were found to have nasal carriage of Staphylococcus aureus of which 63.4% were Methicillin Sensitive and 36.6% were Methicillin-Resistant (MRSA). Methicillin-Resistant Staphylococcus aureus (MRSA) was isolated from fifteen of the 200 screened healthcare workers giving a prevalence rate of nasal colonization with MRSA of 7.5%. We found no statistical association between healthcare worker MRSA nasal colonization and age, gender, HCWs specialty, hand hygiene practices, skin condition, previous MRSA infection, and previous exposure to antibiotics.

Identification of the prevalence and the associated risk factors of MRSA colonization in healthcare workers mandates continuous surveillance and the implementation of all possible preventive measures to reduce re-occurrences.

Identification of the prevalence and the associated risk factors of MRSA colonization in healthcare workers mandates continuous surveillance and the implementation of all possible preventive measures to reduce re-occurrences.

We aimed to evaluate clinical and laboratory findings of hospitalized asthma and chronic obstructive pulmonary disease (COPD) patients with COVID-19 and demonstrate that they have different symptoms and/or laboratory results and outcomes than COVID-19 patients with comorbidity (CoV-com) and without comorbidity (CoV-alone).

The data of the demographic, clinical, laboratory findings of hospitalized CoV-alone, asthma, COPD patients with COVID-19 (CoV-asthma, CoV-COPD, respectively), and CoV-com were analyzed.

Out of 1082 patients hospitalized for COVID-19, 585 (54.1%) had CoV-alone, 40 (3.7%) had CoV-asthma, 46 (4.3%) had CoV-COPD and 411 (38%) had CoV-com. Cough, shortness of breath, fever and weakness were the most common four symptoms seen in all COVID-19 patients. Shortness of breath, myalgia, headache symptoms were more common in CoV-asthma than the other groups (p < 0.001, p < 0.01, p < 0.05 respectively). Sputum was more common in CoV-COPD than other groups (p < 0.01). COPD group most frequently had increased values, different from the other groups with CRP>5ng/mL in 91.3%, D-dimer > 0.05mg/dL in 89.1%, troponin > 0.014micg/L in %63.9, INR>1.15 in 52.2%, CK-MB>25U/L in 48.5%, PT>14s in 40.9% of patients (p < 0.05, p < 0.001, p < 0.001, p < 0.001, p < 0.05, p < 0.001, respectively). NT-ProBNP was found to have the highest AUC value and the best differentiating parameter for CoV-asthma from CoV-alone. Typical CT findings were present in 44.4% of CoV-alone, 57.5% of CoV-asthma, 28.3% of CoV-COPD and 38.9% of CoV-com groups. https://www.selleckchem.com/products/d-luciferin.html CoV-COPD and CoV-com patients died more frequently than other groups (17.8%, 18.5%).

CoV-asthma and CoV-COPD patients might have different symptoms and laboratory parameters than other COVID-19 patients which can guide the physicians.

CoV-asthma and CoV-COPD patients might have different symptoms and laboratory parameters than other COVID-19 patients which can guide the physicians.

In this study, we aimed investigate the relationship of SARS-CoV-2 viral load cycle threshold (Ct) values with pneumonia.

A total of 158 patients in whom SARS-CoV-2 was confirmed in upper respiratory tract (URT) samples with molecular method and who had computed tomography (CT) of the chest, between April 2020 and June 2020 were included in this retrospective cross-sectional study.

Mean age of 158 PCR positive patients was 45.22 ± 17.89 and 60.8% of them were male. Pneumonia was detected in 40.5% of the patients on their chest CT. A weak but significant correlation was found between SARS-CoV-2 Ct value detected with PCR in analysis of oropharyngeal/ nasopharyngeal (OP/NP) samples and chest CT score (Pearson's r 0.197, p = 0.01). No correlation was found between the first detected viral load Ct value and age, gender and mortality. There was no significant correlation between chest CT score and mortality. While the areas remaining under ROC curve for Ct value in analysis of OP/NP samples in prediction of chest CT score ≥ 1, ≥ 5 and ≥ 10 were 0.564, 0.640 and 0.703 respectively.

We found that the amount of SARS-CoV-2 viral load (inverse relationship with Ct) detected in OP/NP samples of patients with COVID-19 pneumonia did not reflect the increasing severity of pulmonary lesions on chest CT. Although primary target of SARS-CoV-2 is all epithelial cells of the respiratory tract we believe studies comparing viral loads in lower respiratory tract samples are needed to determine the severity of pulmonary disease.

We found that the amount of SARS-CoV-2 viral load (inverse relationship with Ct) detected in OP/NP samples of patients with COVID-19 pneumonia did not reflect the increasing severity of pulmonary lesions on chest CT. Although primary target of SARS-CoV-2 is all epithelial cells of the respiratory tract we believe studies comparing viral loads in lower respiratory tract samples are needed to determine the severity of pulmonary disease.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects mainly the lungs causing pneumonia and complications like acute respiratory distress syndrome. Pneumothorax is a rare manifestation of the disease. This report is a description of a series of patients with COVID-19 and spontaneous pneumothorax, some of them with associated pulmonary cysts.

Cases were collected retrospectively. We included clinical data from medical records and described radiologic findings. Patients that developed pneumothorax during mechanical ventilation were excluded.

Ten cases were included in this report, nine of them were male. The median age of our series was 62 years (IQR = 57-68). The median days since the onset of symptoms until the development of pneumothorax was 27 (IQR = 17-31), most cases developed after the second week of the diagnosis of pneumonia. Two cases required invasive mechanical ventilation, but pneumothorax occurred after ventilator weaning. Three cases showed subpleural pulmonary cysts.

Cysts and pneumothorax are rare manifestations of SARS-CoV-2 pneumonia with mechanisms not completely understood. This report highlights the role of CT scan in diagnosis of COVID-19 complications.

Cysts and pneumothorax are rare manifestations of SARS-CoV-2 pneumonia with mechanisms not completely understood. This report highlights the role of CT scan in diagnosis of COVID-19 complications.