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Prosthetic infection is one of the severe postoperative complications of arthroplasty. Mixed bacterial-fungal prosthetic infection is rare but can be disastrous. This case was a 76-year-old female suffered from prosthetic infection following total hip replacement due to femoral neck fracture and underwent multiple debridements. The culture of periprosthetic tissue was bacteriologically sterile following the first debridement, while the Staphylococcus hominis was identified in the second debridement in the previous hospitalization where fungal infection had not been considered. Thus the pathogen spectrum of anti-infection therapy failed to contain fungus. Ultimately, the culture result of our sampled periprosthetic tissue during the third debridement was Candida albicans without bacterium in our hospital. The fungal prosthetic infection was successfully treated by a two-stage revision with antifungal drugs. Accurate diagnosis and standardized treatment is the key to the therapy of infection after hip arthroplasty, especially for mixed bacterial-fungal prosthetic infection.

The absence of routine health check-ups during adolescence in low- and middle-income countries is a missed opportunity for prevention, early identification, and treatment of health issues, and health promotion. We aimed to codesign the content and delivery for routine adolescent health checkups in Zimbabwe, with adolescents and key adults in their lives.

We held participatory workshops with adolescents (16 workshops; 96 adolescents) and parents (8 workshops; 95 parents), and in-depth interviews with key informants including policymakers, programmers, and healthcare workers (n= 25). Analysis was iterative and the design of the checkups was refined based on participant preferences, document review of burden of disease data, and feasibility considerations.

Participants overwhelmingly supported the introduction of routine health checkups. Reported facilitators to attendance included free cost and desire to know one's health status. Barriers included tendencies for health service seeking only when ill, fear tiveness, and cost-effectiveness of such checkups is required.

Youth suicide is increasing at a significant rate and is the second leading cause of death for adolescents. There is an urgent public health need to address the youth suicide. Torin 1 research buy The objective of this study is to determine whether adolescents and young adults residing in states with greater mental health treatment capacity exhibited lower suicide rates than states with less treatment capacity.

We conducted a state-level analysis of mental health treatment capacity and suicide outcomes for adolescents and young adults aged 10-24 spanning 2002-2017 using data from Centers for Disease Control and Prevention, U.S. Bureau of Labor Statistics, Federal Bureau of Investigation, and other sources. Multivariable linear fixed-effects regression models tested the relationships among mental health treatment capacity and the total suicide, firearm suicide, and nonfirearm suicide rates per 100,000 persons aged 10-24.

We found a statistically significant inverse relationship between nonfirearm suicide and mental health trlations may provide greater protective effects against this most lethal method of firearm suicide.

Using U.S. National Survey of Family Growth (NSFG) data from 2006 to 2013, we characterized men aged 15-44years who reported not using a condom at their first vaginal intercourse (coitarche), while in a non-steady relationship with a female partner.

Men who reported ever having intercourse were asked about male and female contraceptives used at coitarche. Analysis was restricted to respondents whose first sexual relationship was reported as non-steady, thereby comprising a population for whom condoms are recommended for preventing both pregnancy and sexually transmitted infections. Demographic and behavioral factors were examined against condom use, with significant associations included in multivariable logistic regression. We additionally describe young men's receipt of various components of sex education prior to coitarche.

Nearly half (43%) of men aged 15-44 in the U.S. reported not using a condom at coitarche during a non-steady relationship. Among these men, coitarche was reported on average at 16rted among men in non-steady adolescent relationships and with mixed feelings about having sex. Condomless coitarche among these men is independently associated with initiating sex before the age of 15 and having sex with a younger female partner. These findings may guide how to structure young men's sexual education programing.

Heart transplantation in the setting of renal insufficiency is controversial. The objective of this study was to perform a descriptive analysis of patients who underwent orthotopic heart transplantation and renal replacement therapy (RRT) due to acute kidney injury (AKI).

An observational cohort study with retrospective data collection.

A tertiary care hospital.

Fifty-one patients underwent orthotopic heart transplantation with cardiogenic shock under inotrope dependence, with nine patients having preoperative RRT and 42 patients not having preoperative RRT.

There were no interventions.

Hospital mortality occurred in eight (15.6%) patients. Although there were no significant differences between the study groups (preoperative RRT 33.3% v controls 11.9%, p=0.1), this study was underpowered to detect differences in mortality. Dialysis also was required in 52.4% of patients who were not on preoperative RRT. All survivors had full recovery of kidney function with similar timing after transplant (18.5 dculatory Support profile was associated with important hospital mortality. Among hospital survivors, however, all patients had full renal recovery and by 25 months there was no difference in mortality between those who required preoperative RRT and those who did not.THE USE OF NEAR-INFRARED SPECTROSCOPY (NIRS) has increased significantly worldwide in the past decade. This technology, first described more than 40 years ago, is based on the fact that near-infrared light is able to penetrate biologic tissue and can obtain real-time, noninvasive information on tissue oxygenation and metabolism. In the clinical setting, NIRS has been able to provide clinicians potentially valuable information in patients with impaired microcirculations (systemic and cerebral). Near-infrared spectroscopy has progressed beyond assessment of brain oxygenation to monitor local tissue and muscle oxygenation and perfusion. This review analyzes the published data and provides the clinician a comprehensive account of the perioperative utility of NIRS in cardiac, vascular and thoracic surgery, as well as its increasing role in tissue/muscle oxygenation monitoring.

The objective of the present study was to translate and validate the Postoperative Handover Assessment Tool (PoHAT) in the Persian language.

The study used a descriptive, mixed-method design.

The present descriptive, mixed-method study was conducted in 2018 at Shahid Rajaee Hospital and Shiraz Nursing and Midwifery School, Shiraz University of Medical Sciences (Shiraz, Iran), to evaluate the psychometric properties of the Persian version of the PoHAT. The original version of PoHAT was translated into the Persian language and then back-translated for comparison. The face validity (qualitative), content validity (qualitative and quantitative), construct validity (experimental intervention method), and reliability (inter-rater reliability, internal consistency) of the Persian version of the PoHAT were assessed. Data were analyzed using SPSS software, version 22. P values less than 0.05 were considered statistically significant.

The content validity ratio of all the 34 items of the Persian version of the PoHAT ranged between 0.66 and 1. The content validity index for all items was within the acceptable range (between 0.92 and 1). The result of construct validity, using the experimental intervention method, showed a significant difference between before and after intervention (P < .05). The correlation coefficient for inter-rater reliability of all subscales (information, tasks, teamwork) and the total checklist was 0.89, 0.80, 0.94, and 0.85, respectively; the coefficient was significant for all subscales (P < .001).

The validity and reliability of the 34-item Persian version of the PoHAT were confirmed. The application of the PoHAT to assess the process and quality of postoperative handover in Iran and other Persian-speaking countries is recommended.

The validity and reliability of the 34-item Persian version of the PoHAT were confirmed. The application of the PoHAT to assess the process and quality of postoperative handover in Iran and other Persian-speaking countries is recommended.

Pediatric patients are at greater risk for both perioperative hypothermia and postoperative nausea and vomiting (PONV). The primary aim of this study was to investigate whether there is a relationship between intraoperative body temperature and PONV in children undergoing anesthesia. link2 The secondary aim was to investigate the relationship between PONV and intraoperative fentanyl use, age and duration of operation.

A prospective cohort study METHODS The study included 80 children who were undergoing lower abdominal surgery. Body temperature was monitored after routine preoperative preparation and standard induction. link3 Analgesic and antiemetic requirements and the presence of nausea and vomiting were assessed postoperatively on the 30th minute and the 6th, 12th and 24th hour.

The children with or without PONV were compared. At the postoperative 6th hour, the incidence of nausea was statistically significant in the children with a mean body temperature below 36°C (P=0.044; P < 0.05). The mean duration of the surgery was statistically significant longer in the children with PONV (P=0.001; P=0.004; P <0.05). Mean body temperature was not statistically significant when comparing children with and without vomiting(P > 0.05).

While a body temperature below 36°C increases the incidence of postoperative nausea, it does not cause an increase in the incidence of vomiting. A long operation time in pediatric patients causes an increase in the incidence of PONV. Although not statistically significant, PONV is encountered more than twice as much in patients receiving intraoperative fentanyl administration.

While a body temperature below 36°C increases the incidence of postoperative nausea, it does not cause an increase in the incidence of vomiting. A long operation time in pediatric patients causes an increase in the incidence of PONV. Although not statistically significant, PONV is encountered more than twice as much in patients receiving intraoperative fentanyl administration.

High-density lipoprotein cholesterol (HDL-C) concentration and variability are both important factors of cardiovascular disease (CVD) and mortality. We aimed to explore the associations of HDL-C and longitudinal change in HDL-C with risk of mortality.

We recruited a total of 69,163 participants aged ≥40 years and had medical examination records of HDL-C during 2010-2014 from the Yinzhou District, Ningbo, China. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. We observed a non-linear association of HDL-C with risks of non-accidental and CVD mortality. Compared with the moderate concentration group (1.4-1.6mmol/L), HDL-C<1mmol/L was associated with a higher risk of non-accidental mortality (HR 1.13 (95% CI 1.01-1.27)) and both HDL-C<1mmol/L and ≥2mmol/L were associated with a higher risk of CVD mortality (HRs 1.23 (95% CI 1.01-1.50) and 1.37 (95% CI 1.03-1.82), respectively). Compared with the stable group ([-0.1, +0.1mmol/L]), a large decrease ([-0.