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31 ud af 31 tidsskrifter valgt, ingen søgeord valgt, emner højest 7 dage gamle, sorteret efter nyeste først. Opdateret for 5 timer siden.226 emner vises.
Deepak Jakhar, Ishmeet Kaur
Nature Medicine, Published online: 08 April 2020; doi:10.1038/s41591-020-0853-0Potential of chloroquine and hydroxychloroquine to treat COVID-19 causes fears of shortages among people with systemic lupus erythematosus
Journal of Medical Virology, Accepted Article.
S. Sanche et al.
Dore G, Cowie B.
McGovern B, Ford C, Henn M, et al.
AbstractBackgroundRecurrent C. difficile infection (rCDI) is associated with loss of microbial diversity and microbe-derived secondary bile acids, which inhibit C. difficile germination and growth. SER-109, an investigational microbiome drug of donor-derived, purified spores, reduced recurrence in a dose-ranging, open-label Phase (Ph)1 study in subjects with multiply rCDI.MethodsIn a Ph2 double-blind trial, subjects with clinical resolution on standard-of-care antibiotics were stratified by age (< or ≥65 years) and randomized 2:1 to single-dose SER-109 or placebo. Subjects were diagnosed at study entry by PCR or toxin testing. Safety, C. difficile-positive diarrhea through week 8, SER-109 engraftment and bile acid changes were assessed.Results89 subjects were enrolled; 67% were female; 80.9% diagnosed by PCR. rCDI rates were lower in the SER-109 arm than placebo (44.1% versus 53.3%, respectively) but did not meet statistical significance. In a pre-planned analysis, rates were reduced among subjects ≥65 years (45.2% versus 80%, respectively; RR:1.77, 95% CI:1.11-2.81) while the
Russell C, Whittaker E, Dee D, et al.
AbstractAmongst 200 patients developing HAP outwith the ICU, 61% were treated empirically without broad-spectrum gram-negative coverage, with clinical cure in 69.7%. Lower disease severity markers(SIRS, hypoxia, tachypnoea, neutrophilia) and absence of diabetes mellitus and prior doxycycline treatment (but not time to HAP onset) identified patients not requiring broad-spectrum gram-negative coverage.
Nayagam S, Chan P, Zhao K, et al.
AbstractBackgroundIn 2016, the first global viral hepatitis elimination targets were endorsed. An estimated one-third of the world’s population of individuals with chronic hepatitis B virus (HBV) infection live in China and liver cancer is the sixth leading cause of mortality, but coverage of first-line antiviral treatment was low. In 2015, China was one of the first countries to initiate a consultative process for a renewed approach to viral hepatitis. We present the investment case for the scale-up of a comprehensive package of HBV interventions.MethodsA dynamic simulation model of HBV was developed and used to simulate the Chinese HBV epidemic. We evaluated the impact, costs, and return on investment of a comprehensive package of prevention and treatment interventions from a societal perspective, incorporating costs of management of end-stage liver disease and lost productivity costs.ResultsDespite the successes of historical vaccination scale-up since 1992, there will be a projected 60 million people still living with HBV in 2030 and 10 million HBV-related deaths, including 5.7 million HBV-related cancer deaths between 2015 and 2030. This could be reduced by 2.1 million by highly active case-finding and optimal antiviral treatment regimens. The package of interventions is likely to have a positive return on investment to society of US$1.57 per US dollar invested.ConclusionsIncreases in HBV-related deaths for the next few decades pose a major public health threat in China. Active case-finding and access to optimal antiviral treatment are required to mitigate this risk. This investment case approach provides a real-world example of how applied modeling can support national dialog and inform policy planning.
Harris P, Alexander M W.
whole genome sequencingmobile genetic elementsinfection controlcarbapenemase
de Man T, Yaffee A, Zhu W, et al.
AbstractBackgroundAntibiotic resistance is often spread through bacterial populations via conjugative plasmids. However, plasmid transfer is not well recognized in clinical settings because of technical limitations, and health care–associated infections are usually caused by clonal transmission of a single pathogen. In 2015, multiple species of carbapenem-resistant Enterobacteriaceae (CRE), all producing a rare carbapenemase, were identified among patients in an intensive care unit. This observation suggested a large, previously unrecognized plasmid transmission chain and prompted our investigation. MethodsElectronic medical record reviews, infection control observations, and environmental sampling completed the epidemiologic outbreak investigation. A laboratory analysis, conducted on patient and environmental isolates, included long-read whole-genome sequencing to fully elucidate plasmid DNA structures. Bioinformatics analyses were applied to infer plasmid transmission chains and results were subsequently confirmed using plasmid conjugation experiments.ResultsWe identified 14 Verona integron-encoded metallo-ß-lactamase (VIM)-producing CRE in 12 patients, and 1 additional isolate was obtained from a patient room sink drain. Whole-genome sequencing identified the horizontal transfer of blaVIM-1, a rare carbapenem resistance mechanism in the United States, via a promiscuous incompatibility group A/C2 plasmid that spread among 5 bacterial species isolated from patients and the environment.ConclusionsThis investigation represents the largest known outbreak of VIM-producing CRE in the United States to date, which comprises numerous bacterial species and strains. We present evidence of in-hospital plasmid transmission, as well as environmental contamination. Our findings demonstrate the potential for 2 types of hospital-acquired infection outbreaks: those due to clonal expansion and those due to the spread of conjugative plasmids encoding antibiotic resistance across species.
Perinel S, Launay M, Botelho-Nevers É, et al.
AbstractHydroxychloroquine (HCQ) appears to be a promising treatment for COVID-19. However, all ongoing clinical trials with HCQ use different dosing regimens, resulting on various concentrations PK studies are therefore needed to define the optimal dosing regimen.
Ji T, Chen H, Xu J, et al.
AbstractBackgroundTo control the spread of 2019 novel coronavirus disease (COVID-19), China sealed Wuhan on Jan 23, 2020 and soon expanded lockdown to other twelve cities in Hubei province. We aimed to describe the epidemiological characteristics in one of the cities and highlight the effect of current implemented lockdown and nonpharmaceutical interventions.MethodsWe retrieved data of reported cases in Huangshi and Wuhan from publicly available disease databases. Local epidemiological data on suspected or confirmed cases in Huangshi were collected through field investigation. Epidemic curves were constructed with data on reported and observed cases.ResultsThe accumulated confirmed COVID-19 cases and fatality in Huangshi were reported to be 1015 and 3.74% respectively, compared with 50006 and 5.08% in Wuhan till Mar 27, 2020. Right after Jan 24, the epidemic curve based on observed cases in Huangshi became flattened. Feb 1, 2020 was identified as the “turning point” as the epidemic in Huangshi faded soon afterwards. COVID-19 epidemic was characterized by mild cases in Huangshi, accounting for 82.66% of total cases. Moreover, 50 asymptomatic infections were identified in adults and children. Besides, we found confirmed cases in 19 familial clusters and 21 health care workers, supporting inter-human transmission.ConclusionsOur study reported the temporal dynamics and characteristics of the COVID-19 epidemic in Huangshi city, China, across the unprecedented intervention. Such new epidemiological inference might provide further guidance on current lockdown measures in high-risk cities and, subsequently, help improve public health intervention strategies against the pandemic on the country and global levels.
J. Russell Stothard, Maurice R. Odiere, Penelope A. Phillips-Howard
Effective future control of female genital schistosomiasis (FGS) requires an integrated and multisectoral approach, bringing together HIV, sexual and reproductive health, and reproductive rights sectors. In this article, an underappreciated but important connection between FGS and menstrual hygiene initiatives in Africa is highlighted.
Erikson SL, Johnson L. Will financial innovation transform pandemic response? Lancet Infect Dis 2020; published online March 30. https://doi.org/10.1016/S1473-3099(20)30150-X—The references in this comment were ordered incorrectly. These corrections have been made to online version as of April 7, 2020, and will be made to the printed version.
Weituo Zhang, Bi-yun Qian
On March 11, 2020, WHO declared the coronavirus disease 2019 (COVID-19) outbreak a global pandemic. Aggressive actions should be taken immediately to mitigate the spread of severe acute respiratory syndrome coronavirus 2. In their Comment, Yonghong Xiao and Mili Estee Torok1 rightly stated that infection prevention and control measures should be based on sound scientific principles. However, we disagree with the authors' views on certain measures that they consider to have “no scientific basis and have proven to be ineffective”.
Adam J Kucharski, Rosalind M Eggo
We thank Nian Xiong and colleagues for their response to our Article.1 Although we separated individuals into exposed and infectious compartments in the basic model, we also considered a sensitivity analysis whereby people became infectious in the second half of their incubation period, and obtained the same conclusion (Article appendix p 12). We allowed the reproduction number, R, to vary over time in our model, rather than simply fix this value, to capture possible variation in transmission as a result of control measures and behaviour change.
Nian Xiong, Tao Wang, Zhicheng Lin
We read with interest Adam Kucharski and colleagues' mathematical modelling study of the early dynamics of coronavirus disease 2019 (COVID-19).1 We agree that a stochastic transmission model might best fit with the reality around the Huanan Seafood Wholesale Market, which was the origin of the COVID-19 outbreak2 and 1 mile away from our hospitals in Wuhan. We appreciate the work making use of different datasets and considering travel. However, we have concerns about the clinical and strategic values of this work.
Elizabeth A Ashley, Aung Pyae Phyo
Progress in controlling malaria has slowed in recent years and the annual death toll remains above 400 000 globally, with most deaths caused by Plasmodium falciparum.1 The joint threats of increasing resistance to insecticides, artemisinin derivatives, and almost all other antimalarials in current use make the development of new classes of antimalarials a high priority.
Aditya H Gaur, James S McCarthy, John C Panetta, Ronald H Dallas, John Woodford, Li Tang, Amber M Smith, Tracy B Stewart, Kristen C Branum, Burgess B Freeman, Nehali D Patel, Elizabeth John, Stephan Chalon, Shelley Ost, Ryan N Heine, Julie L Richardson, Robbin Christensen, Patricia M Flynn, Yvonne Van Gessel, Branko Mitasev, Jörg J Möhrle, Fabian Gusovsky, Lidiya Bebrevska, R Kiplin Guy
The favourable pharmacokinetic, tolerability, and safety profile of SJ733, and rapid antiparasitic effect support its development as a fast-acting component of combination antimalarial therapy.
, Owens DK, Davidson KW, et al.
This 2020 Recommendation Statement from the US Preventive Services Task Force recommends against screening for bacterial vaginosis (BV) in pregnant persons not at increased risk for preterm delivery (D recommendation) and concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for BV in pregnant persons at increased risk for preterm delivery (I statement).
Kahwati LC, Clark R, Berkman N, et al.
This systematic review to support the 2020 US Preventive Services Task Force Recommendation Statement on screening for bacterial vaginosis (BV) summarizes published evidence on the benefits and harms of BV screening and treatment in pregnant adolescents and adults to prevent preterm delivery.
In this narrative medicine essay, a pediatrician describes how a 2-year-old’s game of peekaboo expresses her bewilderment and grief at the death of her twin brother.
Careful readers will notice a 2-year-old girl, Charlotte, named in the A Piece of My Mind essay (“The Peekaboo Visit)” and the poem (“The Key”) in this JAMA issue. They are the same child. Charlotte is a patient, a daughter, and for a too-brief period a twin sister, and submissions from her pediatrician and mother offered JAMA a rare opportunity to represent a family’s story from 2 perspectives. We hear much about shared decision-making, perhaps even shared story-telling, but the attempts of a physician and a mother to express their feelings of guilt and loss in poetic language, to find the words Charlotte was too young to have to grieve for her brother, helps us accompany them in their search for meaning. Poetry leaves us less alone in our private struggles with the limits of medicine’s magic, psychiatrist Jed Myers has written in these pages, and these 2 contributions demonstrate what that feels like. Writing doesn’t reverse loss or take away pain but it honors both, making them mean something. Hopefully, that’s a comfort to the writers and a lesson in empathy and in healing for readers.
For Charlotte Maud Greene and Peter Devaney Greene (2009-2011)
This JAMA Patient Page describes the US Preventive Services Task Force’s recent recommendations for screening for bacterial vaginosis during pregnancy.
Lebwohl B, Green PR, Söderling J, et al.
This population epidemiology study used Swedish histopathology registry data to estimate mortality risk in patients with vs without celiac disease.
Tap WD, Wagner AJ, Schöffski P, et al.
This randomized trial compares the effect of doxorubicin plus olaratumab vs doxorubicin plus placebo on overall survival in patients with advanced/metastatic soft tissue sarcoma and leiomyosarcoma.
This Medical Letter review summarizes mechanisms of action and evidence of effects of Aklief, a 0.005% topical cream approved in 2019 for treatment of acne vulgaris in patients aged 9 years or older.
Carayon P, Cassel C, Dzau VJ.
In Reply Our Viewpoint was a summary of a comprehensive National Academies of Sciences, Engineering, and Medicine (NASEM) report. Time pressure and high workload are work system factors that contribute to clinician burnout and affect patient care; however, many other work system factors can also increase clinician burnout. The review of the evidence in the NASEM report showed that there is not a single root cause of burnout among clinicians, including physicians, nurses, pharmacists, dentists, and other health care professionals who provide direct care to patients.
Singh JP, Fradley MG, Kutyifa V.
In Reply We agree with Dr Schwartz and colleagues that it would be worthwhile examining the time from the last anthracycline dose on the extent of CRT benefit. However, for CRT to work, there needed to have been concomitant conduction tissue disease because all the patients in our study had an accompanying LBBB contributing to the mechanical dyssynchrony that was corrected with CRT. The temporal relationship of the LBBB to the development of cardiomyopathy could influence the degree of response. We do not have data to examine the relationship between the last dose of anthracycline, the development of LBBB, and the onset of cardiomyopathy.
Arnold EL, Sikes DH, Harrington J.
To the Editor Our experiences from clinical practice improvement projects suggest very different approaches to resolving physician burnout from those advanced by Dr Carayon and colleagues. Their stated purpose to “…encourage health care leaders to prioritize the actions, procedures, and policies that deliver the greatest value to direct patient care…” implies that clinicians should continue trusting their future well-being to those who have been responsible for the “industrialization of health care delivery.” Furthermore, the authors’ proposals do not reflect our understanding of the root causes of physician burnout, and they would appear to only increase clinicians’ administrative burdens and costly health system bureaucracies.
Schwartz AM, Westerman S, Mandawat A.
To the Editor Dr Singh and colleagues reported that patients with chemotherapy-induced cardiomyopathy (CHIC) who met class I or II indications for cardiac resynchronization therapy (CRT) showed improvement in left ventricular ejection fraction (LVEF) and heart failure symptoms by 6 months following CRT implantation. We would like to raise a few points for consideration.
Hoffman A, Sloan CE, Maciejewski ML, et al.
This study characterizes annual changes in enrollment of Medicare and non-Medicare patients treated at dialysis facilities before and after 2011 payment reforms and 2014 Affordable Care Act changes that influenced reimbursements.
During recent months, if it wasn’t in the air (and it was) it was surely in the news—pollution. Of course there is nothing new about air pollution in the United States. For years residents and visitors in Los Angeles have complained about that city’s eye-smarting smog. And in 1948 Donora, Pa, lay under a five-day poisonous fog labeled “the brown plague.” As a result, 22 people died and 5,910 became ill.
The FDA is requiring that the allergy and asthma medication montelukast carry a boxed warning—its most prominent type of alert—to caution consumers and clinicians about the risk of neuropsychiatric events associated with the drug. Montelukast is marketed as Singulair and in generic form.
A monoclonal antibody that targets the CD38 receptor on multiple myeloma cells has been approved for adults who’ve received at least 2 prior treatments for the incurable blood cancer.
A recent FDA safety communication has warned patients and health professionals that the agency has not cleared any devices that use ozone gas or UV light to clean, sanitize, or disinfect continuous positive airway pressure (CPAP) devices.
Roland CL, Wong SL.
The treatment of soft tissue sarcomas (STSs), which encompass a group of more than 70 histologically and biologically distinct subtypes of cancer, is emblematic of an orphan disease. About 13 000 patients are diagnosed as having STS in the United States every year, survival rates are poor and have not changed in the last 40 years, and there is little funding to support scientific discovery of disease biology to improve treatment regimens. Clinical presentation and prognosis are influenced not only by the extent of disease and histological subtypes, but by tumor location as well. There is a significant unmet need for improved systemic therapies in the treatment of patients with STS.
Lewis AL, Laurent LC.
Bacterial vaginosis during pregnancy is associated with higher risks of pregnancy complications, including preterm birth, whether or not symptoms are reported. Bacterial vaginosis is currently considered to be a microbial imbalance of the lower genital tract characterized by low levels of “healthy” Lactobacillus and overgrowth of a mixed population of other bacterial genera, including Gardnerella, Atopobium, Prevotella, Mobiluncus, Sneathia, and other taxa. Many of these microbes are also common isolates from sites of intrauterine infection, including the placenta and amniotic fluid. These findings have motivated investigators to conduct clinical trials to examine the potential benefits and harms associated with screening and treatment of asymptomatic bacterial vaginosis in pregnant women, either applied to a general obstetric population or targeting women at increased risk for preterm delivery, such as those with prior preterm birth. This is particularly important in light of growing concerns about the effects of antibiotic use on long-term maternal and child health because of effects on their microbiomes.
In the Original Investigation entitled “Effect of Ubrogepant vs Placebo on Pain and the Most Bothersome Associated Symptom in the Acute Treatment of Migraine: The ACHIEVE II Randomized Clinical Trial” published in the November 19, 2019, issue of JAMA, imprecise language was used in the Discussion section and a typographical error occurred in Figure 2. In the second full paragraph on page 1896, the penultimate sentence should have read, “These results were obtained in a population sample older than the US population and may therefore be overestimates.” In Figure 2, the word optimal should have read optional. This article was corrected online.
In the Original Investigation titled “Association of Initial Disease-Modifying Therapy With Later Conversion to Secondary Progressive Multiple Sclerosis,” published in the January 15, 2019, issue of JAMA, the institutional affiliation for Dr Lugaresi was incorrectly presented. This article was corrected online.
Composed primarily of collagen and strengthened with cross-linked fibers, scar tissue that forms after a heart attack doesn’t contract as well as healthy muscle tissue. It can therefore compromise the organ’s ability to pump blood, which may lead to heart failure, arrhythmias, and sudden cardiac death. Scientists who developed a therapy that targets such scar formation, or fibrosis, recently brought their strategy a step closer to the clinic. After demonstrating its effectiveness in rodents, their latest work—a randomized, double-blinded pig study—validates the approach in a large-animal model.
This Medical News story examines the status of Makena, the only drug approved for the indication of preventing preterm birth.
This Medical News series offers an occasional roundup of developments in cardiovascular medicine.
Bauchner H, Golub RM, Zylke J.
Since January 1, 2020, JAMA and the JAMA Network journals have received hundreds of manuscripts and direct queries related to coronavirus disease 2019 (COVID-19), including research reports, case series and case reports, and opinion pieces. The editors have become aware that some of the patients described in some of these manuscripts, sometimes with overlapping authorship, have been reported in more than 1 submission. This inclusion of the same patients in more than 1 report has not been clearly indicated in the submitted manuscripts. This is of concern and may represent a lapse in ethical standards of scientific reporting.
In the US Preventive Services Task Force Evidence Report titled “Screening for Hepatitis C Virus Infection in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force” published online in JAMA on March 2, 2020, data and presentation were incorrect in the abstract and figures. In the abstract Conclusions, the value reported as 5% should have been reported as 95%. In Figure 1, the blue circle indicating key question 3 should have been presented on the first horizontal line at the left of the figure, just before the branch. In Figure 3, several percentages in the “Women” column were incorrect. This article was corrected online.
Patz JA, Stull VJ, Limaye VS.
This Viewpoint proposes that framing climate change as a human health crisis could accelerate climate action, and reviews evidence pointing toward the health benefits of transitioning to renewable energy, plant-based diets, and a global lower carbon footprint.
Wu Z, McGoogan JM.
This Viewpoint summarizes key epidemiologic and clinical findings from all cases of coronavirus disease 2019 (COVID-19) reported through February 11, 2020, in mainland China, and case trends in response to government attempts to control and contain the infection.
Wong JL, Leo Y, Tan C.
This Viewpoint discusses public health measures implemented in Singapore to manage potential COVID-19 infection based on the country’s experience with SARS in 2003 and reviews critical information gaps necessary to help manage the outbreak, such as viral shedding patterns and optimal timing of antiviral treatment after exposure.
Campbell BV, Mitchell PJ, Churilov L, et al.
This randomized clinical trial compares the effects of 2 tenecteplase doses (0.40 vs 0.25 mg/kg) prior to endovascular thrombectomy on blood flow restoration to brain ischemic territory in patients with large vessel occlusion ischemic stroke.
International Liver Congress (ILC) 2020
15.04.2020 - 19.04.2020
European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) 2020
18.04.2020 - 21.04.2020
DSI årsmøde 2020 (aflyst)
Hindsgavl Slot, Middelfart
1.05.2020 - 2.05.2020
Kursus i rejsemedicin 2020
Statens Serum Institut
4.05.2020 - 6.05.2020
5.05.2020 - 7.05.2020
COVID-19 retningslinje (2020)
National handlingsplan for antibiotika til mennesker (2017)
Retningslinjer til sundhedsprofessionelle vedr. håndtering af infektion med zikavirus (2019)
Antiviral behandling af hiv smittede personer (2019)
A sub-group of patients with hospital-acquired pneumonia do not require broad-spectrum gram-negative antimicrobial coverage
8.04.2020Clinical Infectious Diseases Advance Access
Potential of chloroquine and hydroxychloroquine to treat COVID-19 causes fears of shortages among people with systemic lupus erythematosus
Invisible spread of SARS-CoV-2
8.04.2020The Lancet Infectious Diseases
Correction to Lancet Infect Dis 2020; published online March 30. https://doi.org/10.1016/S1473-3099(20)30150-X
8.04.2020The Lancet Infectious Diseases
Making decisions to mitigate COVID-19 with limited knowledge
8.04.2020The Lancet Infectious Diseases
Hvad tænker Professor Jens Lundgren om"Dolutegravir plus Two Different Prodrugs of Tenofovir to Treat HIV."?
Hvorfor synes Professor Troels Lillebæk, at du bør læse"The global prevalence of latent tuberculosis: a systematic review and meta-analysis."?
Hvad mener Professor Lars Østergaard om artiklen"Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial."?
Hvad synes Professor Thomas Benfield om"Oral versus Intravenous Antibiotics for Bone and Joint Infection."?
Hvorfor anbefaler Professor Niels Obel artiklen"Early, Goal-Directed Therapy for Septic Shock - A Patient-Level Meta-Analysis."?
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