The aim of this study was to determine factors causing delay in tuberculosis diagnosis and treatment in Croatia. It included 240 adults with pulmonary tuberculosis, who were interviewed for demographics, socioeconomic, lifestyle, and personal health data. Total delay was defined as a number of days from the onset of symptoms to the initiation of therapy. The median and the 75th percentile of the total delay were 68 and 120 days, respectively: 16.7 % of the patients initiated treatment within the first month, 23.8 % within the second month, 23.3 % within the third month, 12.9 % within the fourth month, and 23.3 % more than four months after the symptoms appeared. Long delay (exceeding median delay) was strongly associated with drug abuse (p=0.021). Extreme delay (75th percentile of delay) was significantly associated with the lowest level of education (p=0.021), below minimal income (p=0.039), minimal to average income (p=0.020), current smoking (p=0.050), and co-morbidity (p=0.048). In the multivariate model, long delay remained associated with drug abuse, while extreme delay was associated with the lowest level of education (p=0.033) and current (p=0.017) and ex-smoking (p=0.045).In a setting with decreasing TB incidence, the reported delay can be reduced by increasing health education, not only about tuberculosis per se, but about health in general and attitudes towards prevention and early care. It is also important to increase tuberculosis knowledge among healthcare workers as well as their diagnostic skills.
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http://dx.doi.org/10.2478/10004-1254-63-2012-2129 | DOI Listing |
Sci Rep
January 2025
Center of Excellence for Antimicrobial Resistance and Stewardship, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
The pathogenic oomycete Pythium insidiosum causes a fatal infectious illness known as pythiosis, impacting humans and certain animals in numerous countries in the tropics and subtropics. Delayed diagnosis is a primary factor contributing to the heightened morbidity and mortality associated with the disease. Several new serodiagnostic methods have been developed to improve the identification of pythiosis.
View Article and Find Full Text PDFJ Neuroinflammation
January 2025
Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, 2 Jingba Road, Zhengzhou, Henan, China.
Background: Intracerebral hemorrhage (ICH) causes prominent deposition of extracellular matrix molecules, particularly the chondroitin sulphate proteoglycan (CSPG) member neurocan. In tissue culture, neurocan impedes the properties of oligodendrocytes. Whether therapeutic reduction of neurocan promotes oligodendrogenesis and functional recovery in ICH is unknown.
View Article and Find Full Text PDFBMC Pediatr
January 2025
Geriatric Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background: This case report describes a unique presentation of sphingosine-1-phosphate lyase insufficiency syndrome (SPLIS) caused by a rare SGPL1 variant, highlighting the diagnostic and management challenges associated with this condition.
Case Presentation: A 2-year-old Iranian female presented with steroid-resistant nephrotic syndrome (NS), primary adrenal insufficiency (AI), growth delay, seizures, and hyperpigmentation. Laboratory evaluation revealed hypoalbuminemia, significant proteinuria, hyperkalemia, and elevated adrenocorticotropic hormone (ACTH) levels.
BMJ Open
January 2025
Department of Emergency Medicine, St Michael's Hospital, Toronto, Ontario, Canada.
Introduction: Traumatic injuries are a significant public health concern globally, resulting in substantial mortality, hospitalisation and healthcare burden. Despite the establishment of specialised trauma centres, there remains considerable variability in trauma-care practices and outcomes, particularly in the initial phase of trauma resuscitation in the trauma bay. This stage is prone to preventable errors leading to adverse events (AEs) that can impact patient outcomes.
View Article and Find Full Text PDFMicrosurgery
January 2025
Division of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Open abdomen treatment (OAT) is associated with significant morbidity and mortality. In cases where primary or delayed fascial closure cannot be achieved, vacuum-assisted wound closure and mesh-mediated fascial traction are indicated, which often result in a planned ventral hernia. If secondary skin closure is not feasible, common treatment of granulated abdominal defects involves split-thickness skin-grafting or healing by secondary intention leading to significant scarring and sometimes mutilating defects.
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