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Phuntila Tharabenjasin, Aekkacha Moonwiriyakit, Jenjira Sontikun, Kanokphorn Timpratueang, Suhaibee Kuno, Thitinan Aiebchun, Nathjanan Jongkon, Rungrawee Mongkolrob, Noel Pabalan, Kiattawee Choowongkomon, Chatchai Muanprasat
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Phuntila Tharabenjasin, Aekkacha Moonwiriyakit, Jenjira Sontikun, Kanokphorn Timpratueang, Suhaibee Kuno, Thitinan Aiebchun, Nathjanan Jongkon, Rungrawee Mongkolrob, Noel Pabalan, Kiattawee Choowongkomon, Chatchai Muanprasat Allergic inflammation, which is the pathogenesis of allergic rhinitis and asthma, is associated with disruption of the airway epithelial barrier due to the effects of type 2 inflammatory cytokines, i.e. interleukin-4 and interleukin-13 (IL-4/13). The anti-allergic inflammatory effect of β-eudesmol (BE) on the tight junction (TJ) of the airway epithelium has not previously been reported. Herein, the barrier protective effect of BE was determined by measurement of transepithelial electrical resistance and by paracellular permeability assay in an IL-4/13-treated 16HBE14o- monolayer. Pre-treatment of BE concentration- and time- dependently inhibited IL-4/13-induced TJ barrier disruption, with the most significant effect observed at 20 μM. Cytotoxicity analyses showed that BE, either alone or in combination with IL-4/13, had no effect on cell viability. Western blot and immunofluorescence analyses showed that BE inhibited IL-4/13-induced mislocalization of TJ components, including occludin and zonula occludens-1 (ZO-1), without affecting the expression of these two proteins. In addition, the mechanism of the TJ-protective effect of BE was mediated by inhibition of IL-4/13-induced STAT6 phosphorylation, in which BE might serve as an antagonist of cytokine receptors. In silico molecular docking analysis demonstrated that BE potentially interacted with the site I pocket of the type 2 IL-4 receptor, likely at Asn-126 and Tyr-127 amino acid residues. It can therefore be concluded that BE is able to prevent IL-4/13-induced TJ disassembly by interfering with cytokine-receptor interaction, leading to suppression of STAT6-induced mislocalization of occludin and ZO-1. BE is a promising candidate for a therapeutic intervention for inflammatory airway epithelial disorders driven by IL-4/13.
Læs mere Tjek på PubMedStefanie Weigold, Susanne Gabriele Schorr, Alice Faust, Lena Woydack, Daniel Strech
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Stefanie Weigold, Susanne Gabriele Schorr, Alice Faust, Lena Woydack, Daniel Strech Background Very little is known about the practice-oriented challenges and potential response strategies for effective and efficient translation of informed consent and study prioritization in times of a pandemic. This stakeholder interview study aimed to identify the full spectrum of challenges and potential response strategies for informed consent and study prioritization in a pandemic setting. Methods We performed semi-structured interviews with German stakeholders involved in clinical research during the COVID-19 pandemic. We continued sampling and thematic text analysis of interview transcripts until thematic saturation of challenges and potential response strategies was reached. Results We conducted 21 interviews with investigators, oversight bodies, funders and research support units. For the first topic informed consent we identified three main themes: consent challenges, impact of consent challenges on clinical research, and potential strategies for consent challenges. For the second topic prioritization of clinical studies, we identified two main themes: perceived benefit of prioritization and potential strategies for prioritization. All main themes are further specified with subthemes. A supplementary table provides original quotes from the interviews for all subthemes. Discussion Potential response strategies for challenges with informed consent and study prioritization partly share common ground. High quality procedures for study prioritization, for example, seem to be a core response strategy in dealing with informed consent challenges. Especially in a research environment with particularly high uncertainty regarding potential treatment effects and further limitations for valid informed consent should the selection of clinical trials be very well justified from a scientific, medical, and ethics viewpoint.
Læs mere Tjek på PubMedRahmat Dapari, Kalaivani Muniandy, Ahmad Zaid Fattah Azman, Suhaili Abu Bakar, Mohd Nasir Mohd Desa, Lim Chee Hwa, Sukhvinder Singh Sandhu, Nooreen Farzana Mustapha, Norazman Mohd Rosli, Mohd ‘Ammar Ihsan Ahmad Zamzuri, Mohd Rohaizat Hassan, Nazri Che Dom, Syed Sharizman Syed Abdul Rahim, Balvinder Singh Gill, Nurulhusna Ab Hamid
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Rahmat Dapari, Kalaivani Muniandy, Ahmad Zaid Fattah Azman, Suhaili Abu Bakar, Mohd Nasir Mohd Desa, Lim Chee Hwa, Sukhvinder Singh Sandhu, Nooreen Farzana Mustapha, Norazman Mohd Rosli, Mohd ‘Ammar Ihsan Ahmad Zamzuri, Mohd Rohaizat Hassan, Nazri Che Dom, Syed Sharizman Syed Abdul Rahim, Balvinder Singh Gill, Nurulhusna Ab Hamid Background Dengue is a mosquito-borne disease caused by four distinct, closely related dengue viruses (DENV). Global dengue incidence has markedly increased in the past decades. The World Health Organization reported that cases increased from 505,430 in 2000 to 5.2 million in 2019. Similarly, the total dengue cases in Malaysia increased from 7,103 in 2000 to a peak of 130,101 in 2019. Knowledge, attitude, and practice (KAP) remain the most effective dengue prevention and control tools. Furthermore, school-based health education is key to enhancing knowledge and raising awareness of the seriousness of dengue among schoolchildren and transferring knowledge and practice from classrooms to homes. Thus, it is necessary to plan an integrated module for the primary prevention of dengue infection, specifically among schoolchildren. Aims The present study intends to develop, implement, and evaluate the effectiveness of a theory-based integrated dengue education and learning (iDEAL) module in improving the KAP, environmental cleanliness index, and dengue index among schoolchildren in Selangor and Kuala Lumpur. Methods This study is a single-blinded, cluster randomised controlled trial to be conducted from 1 September 2023 to 31 August 2025. The study will involve 20 primary and 20 secondary schools in Selangor and Kuala Lumpur. The 1600 participants will be randomly allocated to intervention and control groups based on selected clusters to avoid contamination. A cluster is a comparable school that fulfils the inclusion and exclusion criteria. The intervention group will receive the iDEAL module, while the control group will receive standard education. The iDEAL module will be developed following a systematic procedure and delivered in-person by trained researchers to the participants. The outcome will be measured using validated, self-administered questionnaires at baseline (T0), immediately (T1), one month (T2), and three months (T3) post-intervention to measure the intervention module effectiveness. The data will be analysed using IBM Statistical Package for Social Science (SPSS) version 28 and descriptive and inferential statistics. Within-group changes over time will be compared using one-way repeated measure analysis of variance for continuous and normally distributed variables. Within-group analysis of categorical data will use Cochran’s Q test. The main effect and interaction between and within the intervention and control groups at T0, T1, T2, and T3 will be tested using the generalised linear mixed model (GLMM). Hypothetically, the KAP, environmental cleanliness index, and dengue index among the intervention group will be significantly improved compared to the control group. The hypothesis will be tested using a significance level with a p-value of 0.05 and a confidence interval of 95%. Conclusions The study protocol outlines developing and testing an iDEAL module for schoolchildren in Selangor and Kuala Lumpur, with no socio-demographic differences expected. The intervention aims to improve KAP, environmental cleanliness index, and dengue index, potentially reducing dengue risk. Results could inform public health policies, emphasizing school-based interventions’ importance in combating diseases like dengue.
Læs mere Tjek på PubMedElhadi H. Aburawi, Linda Östlundh, Hanan E. Aburawi, Rami H. Al Rifai, Akshaya Bhagavathula, Abdelouahab Bellou
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Elhadi H. Aburawi, Linda Östlundh, Hanan E. Aburawi, Rami H. Al Rifai, Akshaya Bhagavathula, Abdelouahab Bellou Background Conotruncal congenital heart defects (CTD) are a subset of congenital heart diseases (CHD) that involve structural anomalies of the right, left, or both cardiac outflow tracts. CHD is caused by multifactorial inheritance and changes in the genes or chromosomes. Recently, CHD was found to be due to epigenetic alterations, which are a combination of genetic and other environmental factors. Epigenetics is the study of how a gene’s function changes as a result of environmental and behavioral influences. These causative factors can indirectly cause CHD by altering the DNA through epigenetic modifications. This is a protocol for a systematic review and meta-analysis that aims to explore whether the strength of association between various epigenetic changes and CTD types varies by race. Furthermore, to determine and compare the changes in gene expression of each mutation. Methods Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. A comprehensive pre-search has been developed in PubMed and PubMed’s Medical Subject Headings (MeSH). The final search will be performed in June 2023 in PubMed, Embase, Scopus, Web of Science, Cochrane Library, CIANHL, and PsycInfo, without restrictions on publication years. The Covidence systematic review software will be used for blinded screening and selection. Conflicts will be resolved by a third, independent reviewer. The risk of bias in selected studies will be assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The data to be extracted will cover basic information on the included studies, study sample size, number of patients with various types of epigenetic changes, number of patients with various CTD types, measures of association and their 95% confidence interval between each epigenetic change and each CTD. The protocol has been registered with the International Prospero Register of Systematic Review (PROSPERO) [CRD42023377597]. Discussion To the best of our knowledge, this protocol outlines the first systematic review and meta-analysis of the epigenetics of CTD. There is a growing body of evidence on epigenetics and its indirect involvement in disease by altering the DNA through epigenetic modifications in the genes associated with the causative factors for CHD. We will conduct a comprehensive and systematic search for literature in the above-mentioned seven core biomedical databases. It is very important to identify population-specific risk factors for CHD, which will have significant creative, custom-made, and effective prevention programs for the future generation.
Læs mere Tjek på PubMedQian Sun, Sohail Ahmad Javeed, Yong Tang, Yan Feng
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Qian Sun, Sohail Ahmad Javeed, Yong Tang, Yan Feng With the rapid progress of urbanization in China, the real estate industry, characterized by a long industrial chain, has become a pillar industry for economic development. Therefore, we inspect the nexus between land finance, housing prices, and economic growth. For this purpose, we use the panel data of 277 cities at the prefecture level or above in China from 2011 to 2019, and empirically examine it by using the Panel Vector Auto Regression (PVAR) model. The results show that there is a causal relationship between housing prices and economic growth. Housing prices promote economic growth in the short term and inhibit it in the long term. Both economic growth and housing prices have a significant impact on land finance. The economic growth show a significantly positive impact, while housing prices promote land finance in the short term with a long-term trend from positive to negative. This is the first study that tries to probe the relationship between urban housing prices, land finance, and economic growth by considering 277 prefecture-level and above cities in China. To promote the stable development of the regional economy, local governments need to overcome their dependence on the housing market and land finance and promote the healthy development of the housing market.
Læs mere Tjek på PubMedObed Duah Kwaku Asumadu, Michael Boah, Dennis Chirawurah, Joyce Aputere Ndago, Vida Nyagre Yakong, David Abatanie Kanligi, Martin Nyaaba Adokiya
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Obed Duah Kwaku Asumadu, Michael Boah, Dennis Chirawurah, Joyce Aputere Ndago, Vida Nyagre Yakong, David Abatanie Kanligi, Martin Nyaaba Adokiya Background The COVID-19 pandemic affected expectant mothers seeking maternal health services in most developing countries. Access and utilization of maternal health services including antenatal care (ANC) attendance and skilled delivery declined drastically resulting in adverse pregnancy outcomes. This study assessed pregnancy outcomes before and during COVID-19 pandemic in Tamale Metropolis, Ghana. Methods/Design A retrospective cohort study design was employed. A random sampling technique was used to select 450 women who delivered before or during the COVID-19 pandemic in Tamale Metropolis, Ghana. The respondents were interviewed using structured questionnaire at their homes. In this study, the data collected were socio-demographics characteristics, ANC attendance, before or during pandemic delivery, place of delivery and birth outcomes. Chi-square test and bivariate logistic regression analyses were performed under significant level of 0.05 to determine factors associated with the outcome variables. Result Of the 450 respondents, 51.8% were between 26 and 30 years of age. More than half (52.2%) of the respondents had no formal education and 93.3% were married. The majority (60.4%) of the respondents described their residence as urban setting. About 31.6% of the women delivered before the pandemic. The COVID-19 pandemic influenced place of delivery. The proportion of women who attended at least one ANC visit (84.5% before vs 70.5% during), and delivered at a hospital (76.8% before vs 72.4% during) were higher before the pandemic. More women were likely to deliver at home during COVID-19 (OR: 2.38, 95%CI: 1.52–3.74, p
Læs mere Tjek på PubMedI. M. Brus, A. S. J. Teng, S. C. M. Heemskerk, S. Polinder, P. Tieleman, E. Hartman, B. Dollekens, J. A. Haagsma, I. Spronk
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by I. M. Brus, A. S. J. Teng, S. C. M. Heemskerk, S. Polinder, P. Tieleman, E. Hartman, B. Dollekens, J. A. Haagsma, I. Spronk Objective To determine work participation, social roles, and empowerment of QFS patients ≥10-year after infection. Methods QFS patients ≥10-year after acute infection, who were of working age, participated in a cross-sectional survey study. Work participation, fulfilment of social roles, and empowerment outcomes were studied for the total population, as well as for subgroups based on employment type and current work status. Associations between empowerment, work and social roles were examined. Results 291 participants were included. Of the 250 participants who had paid work before Q-fever, 80.4% stopped working or worked less hours due to QFS. For each social role, more than half of the participants (56.6–87.8%) spent less time on the role compared to before Q-fever. The median empowerment score was 41.0 (IQR: 37.0–44.0) out of 60. A higher empowerment score was significantly associated with lower odds of performing all social roles less due to QFS (OR = 0.871–0.933; p
Læs mere Tjek på PubMedNicole Redvers, Sarah Larson, Olivia Rajpathy, Devon Olson
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Nicole Redvers, Sarah Larson, Olivia Rajpathy, Devon Olson Background Significant health disparities exist among American Indian and Alaska Natives (AI/ANs), yet AI/ANs are substantially underrepresented within health-related research, including randomized controlled trials (RCTs). Although research has previously charted representation inequities, there is however a gap in the literature documenting best practice for recruitment techniques of AI/ANs into RCTs. Therefore, the aim of this review was to systematically gather and analyze the published literature to identify common strategies for AI/AN participant recruitment for RCTs in the US. Methods A scoping review methodology was engaged with a systematic search operationalized within relevant databases to February 19, 2022, with an additional updated search being carried out up until January 1, 2023: PubMed, Embase, Web of Science, PsycINFO, CINAHL, and Google Scholar. A two-stage article review process was engaged with double reviewers using Covidence review software. Content analysis was then carried out within the included articles by two reviewers using NVivo software to identify common categories within the data on the topic area. Results Our review identified forty-one relevant articles with the main categories of recruitment strategies being: 1) recruitment methods for AI/ANs into RCTs (passive advertising recruitment approaches, individual-level recruitment approaches, relational methods of recruitment); 2) recruitment personnel used within RCTs; and, 3) relevant recruitment setting. The majority of the included studies used a culturally relevant intervention, as well as a community-involved approach to operationalizing the research. Conclusion Increasing AI/AN representation in RCTs is essential for generating evidence-based interventions that effectively address health disparities and improve health outcomes. Researchers and funding agencies should prioritize the engagement, inclusion, and leadership of AI/AN communities throughout the RCT research process. This includes early community involvement in study design, implementation of culturally tailored recruitment strategies, and dissemination of research findings in formats accessible to AI/AN communities.
Læs mere Tjek på PubMedTakayuki Yamaji, Takahiro Harada, Yu Hashimoto, Yukiko Nakano, Masato Kajikawa, Kenichi Yoshimura, Chikara Goto, Yiming Han, Aya Mizobuchi, Farina Mohamad Yusoff, Shinji Kishimoto, Tatsuya Maruhashi, Ayumu Nakashima, Yukihito Higashi
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Takayuki Yamaji, Takahiro Harada, Yu Hashimoto, Yukiko Nakano, Masato Kajikawa, Kenichi Yoshimura, Chikara Goto, Yiming Han, Aya Mizobuchi, Farina Mohamad Yusoff, Shinji Kishimoto, Tatsuya Maruhashi, Ayumu Nakashima, Yukihito Higashi The effects of Covid-19 vaccines on vascular function are still controversial. We evaluated the effects of BNT162b2 vaccine (BioNTech and Pfizer) on endothelial function assessed by flow-mediated vasodilation (FMD) and vascular smooth muscle function assessed by nitroglycerine-induced vasodilation (NID). This study was a prospective observational study. A total of 23 medical staff at Hiroshima University Hospital were enrolled in this study. FMD and NID were measured before vaccination and two weeks and six months after the 2nd dose of vaccination. FMD was significantly smaller two weeks after the 2nd dose of vaccination than before vaccination (6.5±2.4% and 8.2±2.6%, p = 0.03). FMD was significantly larger at six months than at two weeks after the 2nd dose of vaccination (8.2±3.0% and 6.5±2.4%, p = 0.03). There was no significant difference between FMD before vaccination and that at six months after the 2nd dose of vaccination (8.2±2.6% to 8.2±3.0%, p = 0.96). NID values were similar before vaccination and at two weeks, and six months after vaccination (p = 0.89). The BNT162b2 Covid-19 vaccine temporally impaired endothelial function but not vascular smooth muscle function, and the impaired endothelial function returned to the baseline level within six months after vaccination.
Læs mere Tjek på PubMedXiaojing Shen, Xiaolin Zhu, Hairong Liu, Rongtao Yuan, Qingyuan Guo, Peng Zhao
PLoS One Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
by Xiaojing Shen, Xiaolin Zhu, Hairong Liu, Rongtao Yuan, Qingyuan Guo, Peng Zhao Growing evidence has increasingly suggested a potential linkage between the oral microbiome and various diseases, including pancreatic ductal adenocarcinoma (PDAC). However, the utilization of gene-level information derived from the oral microbiome for diagnosing PDAC remains unexplored. In this study, we sought to investigate the novel potential of leveraging genomic signatures associated with antibiotic resistance genes (ARGs) within the oral microbiome for the diagnosis of PDAC. By conducting an analysis of oral microbiome samples obtained from PDAC patients, we successfully identified specific ARGs that displayed distinct sequence abundance profiles correlated with the presence of PDAC. In the healthy group, three ARGs were found to be enriched, whereas 21 ARGs were enriched in PDAC patients. Remarkably, these ARGs from oral microbiome exhibited promising diagnostic capabilities for PDAC (AUROC = 0.79), providing a non-invasive and early detection method. Our findings not only provide novel modal data for diagnosing PDAC but also shed light on the intricate interplay between the oral microbiome and PDAC.
Læs mere Tjek på PubMedMalaria Journal, 30.04.2024
Tilføjet 30.04.2024
Abstract Background Malaria treatment in sub-Saharan Africa is faced with challenges including unreliable supply of efficacious agents, substandard medicines coupled with high price of artemisinin-based combinations. This affects access to effective treatment increasing risk of malaria parasite resistance development and adverse drug events. This study investigated access to quality-assured artemisinin-based combination therapy (QAACT) medicines among clients of selected private drug-outlets in Uganda. Methods This was a cross sectional study where exit interviews were conducted among clients of private drug outlets in low and high malaria transmission settings in Uganda. This study adapted the World Health Organization/Health Action International (WHO/HAI) standardized criteria. Data was collected using a validated questionnaire. Data entry screen with checks was created in Epi-data ver 4.2 software and data entered in duplicate. Data was transferred to STATA ver 14.0 and cleaned prior to analysis. The analysis was done at 95% level of significance. Results A total of 1114 exit interviews were conducted among systematically sampled drug outlet clients. Over half, 54.9% (611/1114) of the participants were males. Majority, 97.2% (1083/1114) purchased an artemisinin-based combination anti-malarial. Most, 55.5% (618/1114) of the participants had a laboratory diagnosis of malaria. Majority, 77.9% (868/1114) of the participants obtained anti-malarial agents without a prescription. Less than a third, 27.7% (309/1114) of the participants obtained a QAACT. Of the participants who obtained QAACT, more than half 56.9% (173/309) reported finding the medicine expensive. The predictors of accessing a QAACT anti-malarial among drug outlet clients include type of drug outlet visited (aPR = 0.74; 95%CI 0.6, 0.91), not obtaining full dose (3-day treatment) of ACT (aPR = 0.49; 95%CI 0.33, 0.73), not finding the ACT expensive (aPR = 1.24; 95%CI 1.03, 1.49), post-primary education (aPR = 1.29; 95%CI 1.07,1.56), business occupation (aPR = 1.24; 95%CI 1.02,1.50) and not having a prescription (aPR = 0.76; 95%CI 0.63, 0.92). Conclusion Less than a third of the private drug outlet clients obtained a QAACT for management of malaria symptoms. Individuals who did not find artemisinin-based combinations to be expensive were more likely to obtain a QAACT anti-malarial. The Ministry of Health needs to conduct regular surveillance to monitor accessibility of QAACT anti-malarial agents under the current private sector copayment mechanism.
Læs mere Tjek på PubMedMalaria Journal, 30.04.2024
Tilføjet 30.04.2024
Abstract Background The decreasing residual efficacy of insecticides is an important factor when making decisions on insecticide choice for national malaria control programmes. The major challenge to using chemicals for vector control is the selection for the development of insecticide resistance. Since insecticide resistance has been recorded for most of the existing insecticides used for indoor residual spraying, namely, DDT, pyrethroids, organophosphates and carbamates, and new chemicals are necessary for the continued success of indoor residual spraying. The aim of this study was to assess the residual efficacy of Actellic 300CS, SumiShield™ 50WG and Fludora®Fusion by spraying on different wall surfaces. Methods One hundred and sixty-eight houses with different wall surface types (mud, cement, painted cement, and tin) which represented the rural house wall surface types in KwaZulu-Natal, South Africa were used to evaluate the residual efficacy of Actellic 300CS, SumiShield 50WG and Fludora®Fusion with DDT as the positive control. All houses were sprayed by experienced spray operators from the Malaria Control Programme. Efficacy of these insecticides were evaluated by contact bioassays against Anopheles arabiensis, a vector species. The residual efficacy of the insecticide formulations was evaluated against a susceptible insectary-reared population of An. arabiensis using WHO cone bioassays. Results Effectiveness of the three insecticides was observed up to 12 months post-spray. When assessing the achievement of 100% mortality over time, SumiShield performed significantly better than DDT on mud (OR 2.28, 95% CI 1.72–3.04) and painted cement wall types (OR 3.52, 95% CI 2.36–5.26). On cement wall types, Actellic was found to be less effective than DDT (OR 0.55, 95% CI 0.37–0.82) while Fludora®Fusion was less effective on tin wall types (OR 0.67, 95% CI 0.47–0.95). When compared to the combined efficacy of DDT on mud surfaces, SumiShield applied to each of the mud, cement and painted cement wall types and DDT applied to the cement wall types was found to be significantly more effective. These insecticides usually resulted in 100% mortality for up to 12 months with a delayed mortality period of 96–144 h, depending on the insecticide evaluated and the surface type sprayed. Conclusion Field evaluation of these insecticides have shown that Actellic, SumiShield and Fludora®Fusion are suitable replacements for DDT. Each of these insecticides can be used for malaria vector control, requiring just one spray round. These insecticides can be used in rotation or as mosaic spraying.
Læs mere Tjek på PubMedMalaria Journal, 30.04.2024
Tilføjet 30.04.2024
Abstract Introduction Introduction: Malaria continues to be the leading cause of hospitalization and death in Angola, a country in sub- Saharan Africa. In 2023, in the first quarter, 2,744,682 cases were registered, and of these 2,673 patients died due to malaria disease. Previous studies have shown that the ABO blood group can affect the progression of malaria to severe conditions after P. falciparum infection, while the sickle cell gene offers relative protection. Objective We investigated changes in the blood count according to blood groups (ABO/Rh) and sickle cell trait in patients with malaria in Luanda, capital of Angola. Methodology This was a longitudinal, prospective and observational study with 198 patients hospitalized for malaria. Results Of the 198 patients studied, 13(6.6%) were ABRh(+), 4(2.0%) were ARh(-), 49(24.7%) were ARh(+), 42(21, 2%) were BRh (+), 5(2.5%) were ORh(-) and 85(42.9%) were ORh(+). For sickle cell trait, 145(73.2%) were AA, 37(18.7%) were AS and 16(8.1%) were SS. No statistical relationship was observed between age group, sex, parasitemia, clinical picture, hematocrit, MCV, HCM, MCHC, leukocytes, NEUT, LINF and PTL values with blood groups (p0.05). There was no relationship between age, parasitemia, clinical condition, MCV, HCM and MCHC values, leukocytes, NEUT and LINF with sickle cell trait (p0.05). Conclusion It is imperative to differentiate patients with malaria based on blood groups and sickle cell trait, taking into account mainly the blood count parameters that demonstrate that there are patients who, depending on blood group or sickle cell trait, may react weakly to malaria infection regardless of the degree of parasitemia and medical prognosis.
Læs mere Tjek på PubMedGiulia Matusali, Valentina Mazzotta, Silvia Meschi, Francesca Colavita, Roberta Gagliardini, Aurora Bettini, Cesare Ernesto Maria Gruber, Alessandra Vergori, Paola Gallì, Daniele Focosi, Enrico Girardi, Andrea Antinori, Fabrizio Maggi
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Rongyuan Gao, Chenchen Feng, Zizhang Sheng, Feng Li, Dan Wang
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Xing‐Yu Leng, Ling‐Zhai Zhao, Lu Liao, Kang‐Hong Jin, Jia‐Min Feng, Fu‐Chun Zhang
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Saini Chen, Zhimin Jiang, Qiuchen Li, Wenliang Pan, Yu Chen, Jinhua Liu
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Fengge Wang, Yidan Gao, Abram L. Wagner, Yihan Lu
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Swapna Thomas, Maria K. Smatti, Haya Alsulaiti, Hadeel T. Zedan, Ali H. Eid, Ali A. Hssain, Laith J. Abu Raddad, Giusy Gentilcore, Allal Ouhtit, Asmaa A. Althani, Gheyath K. Nasrallah, Jean‐Charles Grivel, Hadi M. Yassine
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Feng Shi, Li Shang, Min Zhou, Cong Lv, Yueshuo Li, Cheng Luo, Na Liu, Jingchen Lu, Min Tang, Xiangjian Luo, Jing Xu, Jia Fan, Jian Zhou, Qiang Gao, Weizhong Wu, Weihua Jia, Hailin Wang, Ya Cao
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Ashok Kumar, Ananya Chatterji, Vijay Kumar Sharma, Vikas Ambiya, Sushil Kumar, Kundan Tandel
Journal of Medical Virology, 30.04.2024
Tilføjet 30.04.2024
Vidmantas PetraitisRuta PetraitienePovilas KavaliauskasEthan NaingAndrew GarciaVilma ZigmantaiteRamune GrigaleviciuteAudrius KucinskasAlius PockeviciusRimantas StakauskasThomas J. Walsh1Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, New York, New York, USA2The Biological Research Center, Lithuanian University of Health Sciences, Kaunas, Lithuania3Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania4Department of Veterinary Pathobiology, Veterinary Academy, Pathology Center, Lithuanian University of Health Sciences, Kaunas, Lithuania5Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA, Anne-Catrin Uhlemann
Antimicrobial Agents And Chemotherapy, 30.04.2024
Tilføjet 30.04.2024
Yongkang ChenXiaohong LiFengyang HanBeihong JiYuan LiJingjing YanMin WangJun FanShuye ZhangLu LuPeng Zou1Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, School of Basic Medical Sciences and Shanghai Public Health Clinical Center, Fudan University, Shanghai, China2Clinical Center for BioTherapy, Zhongshan Hospital, Fudan University, Shanghai, China3Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 30.04.2024
Tilføjet 30.04.2024
Amir Ben-ShmuelItai GlinertAssa SittnerElad Bar-DavidJosef SchlomovitzHaim LevyShay Weiss1Department of Infectious Diseases, Israel Institute for Biological Research, Ness Ziona, Israel, Helen Boucher
Antimicrobial Agents And Chemotherapy, 30.04.2024
Tilføjet 30.04.2024
Faris G. Bakri, Heyam H. Mukattash, Hiam Esmeiran, Glenna Schluck, Casey K. Storme, Erica Broach, Tsedal Mebrahtu, Mohammad Alhawarat, Anais Valencia-Ruiz, Oussama M'Hamdi, Jennifer A. Malia, Zebiba Hassen, Mah'd M.S. Shafei, Ala Y. Alkhatib, Mahmoud Gazo, Saied A. Jaradat, Yessenia Gomez, Samantha McGeehon, Melanie D. McCauley, Sarah C. Moreland, Janice M. Darden, Mihret Amare, Trevor A. Crowell, Sandhya Vasan, Nelson L. Michael, Julie A. Ake, Kayvon Modjarrad, Paul T. Scott, Sheila A. Peel, Shilpa Hakre, RV505 study group
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Limited epidemiologic studies have been conducted in Jordan describing the HIV epidemic. This study aimed to address this gap to inform HIV prevention and control.
Læs mere Tjek på PubMedNaira Dekhil, Helmi Mardassi
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Multidrug-resistant tuberculosis (MDR-TB) is caused by TB bacteria that are resistant to at least isoniazid and rifampicin, the two most potent TB drugs. This form of TB infection remains a major public health concern globally, which has been exacerbated by the HIV epidemic. The recent advent of the COVID-19 pandemic has further severely complicated the situation, by disrupting healthcare systems. Indeed, the burden of MDR-TB increased by 3% between 2020 and 2021, with 450 000 new cases of rifampicin-resistant TB in 2021, thus hampering the global TB control efforts [1].
Læs mere Tjek på PubMedAngel N. Desai, Marion Koopmans, Ashley Otter, Martin P. Grobusch, Pikka Jokelainen, Barry Atkinson, Flavia Cunha, Sofia R. Valdoleiros, Veronica G. Preda, Francesco Maria Fusco, Chantal P. Rovers, Gilbert Greub, Antonino Di Caro, Lone Simonsen, Francine Ntoumi, Eskild Petersen
Clinical Microbiology and Infection, 30.04.2024
Tilføjet 30.04.2024
Mpox, a zoonotic disease resulting from infection with monkeypox virus (MPXV), was previously considered endemic to central- and west Africa. However, an ongoing global outbreak of clade IIb (previously known as West African clade) MPXV associated with human-to-human transmission primarily through sexual contact has occurred since May 2022, with introduction of MPXV to regions and countries that had previously only reported sporadic imported cases [1], [2].
Læs mere Tjek på PubMedSung-Woon Kang, Jeongjae Lee, Seong Min Kim, Dahye Kang, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim
Clinical Microbiology and Infection, 30.04.2024
Tilføjet 30.04.2024
The interferon-gamma releasing assay (IGRA) has been widely used to diagnose latent tuberculosis infection (TBI). However, there are limited data on the association between performance in the IGRA and risk of tuberculosis disease (TBD), as well as on the appropriate IGRA threshold for initiating TBI treatment.
Læs mere Tjek på PubMedAlba Antequera, Agustina Dal Molin-Veglia, Jesús López-Alcalde, Noelia Álvarez-Díaz, Alfonso Muriel, José Muñoz
Clinical Microbiology and Infection, 30.04.2024
Tilføjet 30.04.2024
The risk of Trypanosoma cruzi reactivation is poorly understood. Previous studies evaluating the risk of reactivation report imprecise findings, and recommendations for monitoring and management from clinical guidelines rely on consensus opinion.
Læs mere Tjek på PubMedHend AlqedariKhaled AltabtbaeiJosh L EspinozaSaadoun Bin-HasanMohammad AlghounaimAbdullah AlawadyAbdullah AltabtabaeSarah AlJamaanSriraman DevarajanTahreer AlShammariMohammed Ben EidMichele MatsuokaHyesun JangChristopher L DupontMarcelo Freire, Bruce Levine
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 30.04.2024
Tilføjet 30.04.2024
FEMS Microbiology Reviews, 30.04.2024
Tilføjet 30.04.2024
Abstract The rise of multidrug-resistant bacteria underlines the need for innovative treatments, yet the introduction of new drugs has stagnated despite numerous antimicrobial discoveries. A major hurdle is a poor correlation between promising in vitro data and in vivo efficacy in animal models, which is essential for clinical development. Early in vivo testing is hindered by the expense and complexity of existing animal models. Therefore, there is a pressing need for cost-effective, rapid pre-clinical models with high translational value. To overcome these challenges, zebrafish embryos have emerged as an attractive model for infectious disease studies, offering advantages such as ethical alignment, rapid development, ease of maintenance, and genetic manipulability. The zebrafish embryo infection model, involving microinjection or immersion of pathogens and potential antibiotic hit compounds, provides a promising solution for early-stage drug screening. It offers a cost-effective and rapid means of assessing the efficacy, toxicity and mechanism of action of compounds in a whole-organism context. This review discusses the experimental design of this model, but also its benefits and challenges. Additionally, it highlights recently identified compounds in the zebrafish embryo infection model and discusses the relevance of the model in predicting the compound\'s clinical potential.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract Background Evidence about the clinical impact of rapid diagnostic tests (RDT) for the diagnosis of bloodstream infections is limited, and whether RDT are superior to conventional blood cultures (BC) embedded within antimicrobial stewardship programs (ASP) is unknown.Methods We performed network meta-analyses (NMA) using results from studies of patients with bloodstream infection with the aim of comparing the clinical impact of RDT (applied on positive BC broth or whole blood) to conventional BC, both assessed with and without ASP with respect to mortality, length of stay (LOS) and time to optimal therapy (TOT).Results Eighty-eight papers were selected, including 25,682 patient encounters. There was an appreciable amount of statistical heterogeneity within each meta-analysis. The NMA showed a significant reduction in mortality associated with the use of RDT + ASP vs BC alone (OR 0.72, 95%CI 0.59, 0.87) and with the use of RDT + ASP vs BC + ASP (OR 0.78 95%CI 0.63, 0.96). No benefit in survival was found associated with the use of RDT alone nor with BC + ASP compared to BC alone. A reduction in LOS was associated with RDT + ASP vs BC alone (0.91, 95%CI 0.84, 0.98) while no difference in LOS was shown between any other groups. A reduced TOT was shown when RDT + ASP was compared to BC alone (-29 h, 95%CI -35, -23), BC + ASP (-18 h, 95%CI -27, -10) and to RDT alone (-12 h, 95%CI -20, -3).Conclusion The use of RDT + ASP may lead to a survival benefit even when introduced in settings already adopting effective ASP in association with conventional BC.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract Background Pre-transplant respiratory virus (RV) infections have been associated with negative transplant outcomes in adult hematopoietic cell transplantation (HCT) recipients. In the era of HCT delay due to high-risk RVs, we examined the impact of pre-transplant RV detection on transplant outcomes in a pediatric HCT recipients.Methods This retrospective cohort study included myeloablative allogeneic HCT recipients from 2010 to 2019. All patients were screened for RV at least once within 90 days before HCT using RT-PCR, regardless of symptoms. Post-transplant outcomes included days alive and out of hospital (DAOH) and progression to lower respiratory tract infection (LRTI).Results Among 310 patients, 134 had a RV detected in the 90 days prior to HCT. In univariable analysis, transplant factors including younger age, total body irradiation, umbilical cord blood transplantation, lymphocyte count less than 100/mm3, and HCT comorbidity index score ≥3, and viral factors including symptomatic infection, human rhinovirus (HRV) as a virus type, and symptomatic pre-transplant upper respiratory tract infection (URTI) were associated with fewer DAOH. In multivariable analysis, transplant factors remained significant, but not viral factors. There was a higher incidence of progression to post-transplant LRTI with the same pre-transplant RV if the last positive PCR before HCT was ≤30 days compared to >30 days (p=0.007).Conclusion In the setting of recommending HCT delay for high-risk RVs, symptomatic URTI, including HRV infections, may lead to increased duration of hospitalization and early progression to LRTI when transplantation is performed within 30 days of the last positive PCR test.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract Medical historians typically situate the origins of the antimicrobial era during the early germ period at the turn of the 20th century. They have regarded the development of chemical compounds designed to treat infectious diseases by killing their causative germ as the beginning of the antimicrobial era. Scholars, however, had been speculating about the causal relationship between germs and diseases for centuries beforehand. One of them also addressed the practical applications of this theory. The Italian physician Fracastoro proposed in 1546 that infectious diseases could be treated by administering substances to antagonize disease causing germs. He claimed that health could be restored to people who became ill with infections by nullifying the responsible germs at a time when investigators could not see germs or investigate their ability to cause disease. The long genealogy of antimicrobial therapy from its conception to its fruition took place over the span of several centuries.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract In a multi-hospital cohort study of 3392 patients, positive urinalysis parameters had poor positive predictive value for diagnosing urinary tract infection (UTI). Combined urinalysis parameters (pyuria or nitrite) performed better than pyuria alone for ruling out UTI. However, performance of all urinalysis parameters was poor in older women.
Læs mere Tjek på PubMedClinical Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract This study describes the largest cohort to date (n=147) of pregnant patients living with HIV on bictegravir (BIC). BIC in pregnancy was associated with high levels of viral suppression and similar perinatal outcomes to published literature. These findings support consideration for use of BIC in management of HIV during pregnancy.
Læs mere Tjek på PubMedXiaolong Yan, Xin Zhao, Yin Du, Hao Wang, Li Liu, Qi Wang, Jianhua Liu, Sheng Wei
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
The coronavirus disease 2019 (COVID-19) pandemic has profound implications for global public health. As of March 17, 2023, there have been a staggering 774.9 million confirmed cases and 7.0 million deaths around the world [1]. Following the relaxing of the strict control strategy for COVID-19 in China in December 2022, the number of infections has grown rapidly [2]. Although the World Health Organization declared an end to the pandemic emergency on May 5, 2023 [3], localized endemic remains a possibility in the future due to the waning of vaccine-induced and infection-acquired immunity, and ongoing viral mutations [4].
Læs mere Tjek på PubMedM.L. Martinez-Fierro, A. Perez-Favila, S.M. Zorrilla Alfaro, S.A. Oropeza-de Lara, I. Garza-Veloz, L.S. Hernandez-Marquez, E.F. Gutierrez-Vela, I. Delgado-Enciso, I.P. Rodriguez-Sanchez
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
To analyze the gene variants of the renin-angiotensin-aldosterone system (RAAS) and determine their association with the severity and outcome of coronavirus disease 19 (COVID-19).
Læs mere Tjek på PubMedBittencourt AL, Farre L
International Journal of Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Infective dermatitis was described as a new disease in 1966, in Jamaica, 14 years before the discovery of the human T-cell lymphotropic virus type-1 (HTLV-1), as a severe form of chronically infected eczema occurring early in childhood [1]. In 1990, it was linked to this virus and began to be named infective dermatitis associated with HTLV-1 (IDH) [2]. In 1998, the criteria for its diagnosis were well established [3].
Læs mere Tjek på PubMedKing, W., Homer, T., Harding, C., Mossop, H., Chadwick, T., Abouhajar, A., Vale, L.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
ObjectivesTo estimate the cost-effectiveness of methenamine hippurate compared with antibiotic prophylaxis in the management of recurrent urinary tract infections. DesignMulticentre, open-label, randomised, non-inferiority trial. SettingEight centres in the UK, recruiting from June 2016 to June 2018. ParticipantsWomen aged ≥18 years with recurrent urinary tract infections, requiring prophylactic treatment. InterventionsWomen were randomised to receive once-daily antibiotic prophylaxis or twice-daily methenamine hippurate for 12 months. Treatment allocation was not masked and crossover between arms was allowed. Primary and secondary outcome measuresThe primary economic outcome was the incremental cost per quality-adjusted life year (QALY) gained at 18 months. All costs were collected from a UK National Health Service perspective. QALYs were estimated based on responses to the EQ-5D-5L administered at baseline, 3, 6, 9, 12 and 18 months. Incremental costs and QALYs were estimated using an adjusted analysis which controlled for observed and unobserved characteristics. Stochastic sensitivity analysis was used to illustrate uncertainty on a cost-effectiveness plane and a cost-effectiveness acceptability curve. A sensitivity analysis, not specified in the protocol, considered the costs associated with antibiotic resistance. ResultsData on 205 participants were included in the economic analysis. On average, methenamine hippurate was less costly (–£40; 95% CI: –684 to 603) and more effective (0.014 QALYs; 95% CI: –0.05 to 0.07) than antibiotic prophylaxis. Over the range of values considered for an additional QALY, the probability of methenamine hippurate being considered cost-effective ranged from 51% to 67%. ConclusionsOn average, methenamine hippurate was less costly and more effective than antibiotic prophylaxis but these results are subject to uncertainty. Methenamine hippurate is more likely to be considered cost-effective when the benefits of reduced antibiotic use were included in the analysis. Trial registration number ISRCTN70219762.
Læs mere Tjek på PubMedWildeman, P., Rolfson, O., Wretenberg, P., Natman, J., Gordon, M., Söderquist, B., Lindgren, V.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
ObjectivesProsthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA) entailing increased mortality, decreased quality of life and high healthcare costs. The primary aim was to investigate whether the national project: Prosthesis Related Infections Shall be Stopped (PRISS) reduced PJI incidence after primary THA; the secondary aim was to evaluate other possible benefits of PRISS, such as shorter time to diagnosis. DesignCohort study. SettingIn 2009, a nationwide, multidisciplinary infection control programme was launched in Sweden, PRISS, which aimed to reduce the PJI burden by 50%. ParticipantsWe obtained data on patients undergoing primary THA from the Swedish Arthroplasty Registry 2012–2014, (n=45 723 patients, 49 946 THAs). Using personal identity numbers, this cohort was matched with the Swedish Prescribed Drug Registry. Medical records of patients with ≥4 weeks’ antibiotic consumption were reviewed to verify PJI diagnosis (n=2240, 2569 THAs). ResultsThe cumulative incidence of PJI following the PRISS Project was 1.2% (95% CI 1.1% to 1.3%) as compared with 0.9% (95% CI 0.8% to 1.0%) before. Cox regression models for the PJI incidence post-PRISS indicates there was no statistical significance difference versus pre-PRISS (HR 1.1 (95% CI 0.9 to 1.3)). There was similar time to PJI diagnosis after the PRISS Project 24 vs 23 days (p=0.5). ConclusionsDespite the comprehensive nationwide PRISS Project, Swedish PJI incidence was higher after the project and time to diagnosis remained unchanged. Factors contributing to PJI, such as increasing obesity, higher American Society of Anesthesiology class and more fractures as indications, explain the PJI increase among primary THA patients.
Læs mere Tjek på PubMedPadhani, Z. A., Rahman, A. R., Lakhani, S., Yasin, R., Khan, M. H., Mirani, M., Jamali, M., Ali Khan, Z., Khatoon, S., Partab, R., ul Haq, A., Kampalath, V., Hosseinalipour, S.-M., Blanchet, K., Das, J. K.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
ObjectiveMigrants and refugees are at a disadvantage in accessing basic necessities. The objective of this study is to assess the inequity in access, needs and determinants of COVID-19 vaccination among refugees and migrant populations in Pakistan. DesignWe conducted a mixed-method study comprising a cross-sectional survey and a qualitative study. In this paper, we will only report the findings from the cross-sectional survey. SettingThis survey was conducted in different cities of Pakistan including Quetta, Karachi and Hyderabad. ParticipantsA total of 570 participants were surveyed including refugees and migrants, both in regular and irregular situations. Primary and secondary outcome measuresThe primary outcome of the study was to estimate the proportion of refugees and migrants, both in regular and irregular situations vaccinated against COVID-19 and assess the inequity. The 2 test and Fisher’s exact test were used to determine the significant differences in proportions between refugees and migrants and between regions. ResultsThe survey showed that only 26.9% of the refugee and migrant population were tested for COVID-19, 4.56% contracted coronavirus, and 3.85% were hospitalised due to COVID-19. About 66% of the refugees and migrants were fully vaccinated including those who received the single-dose vaccine or received all two doses, and 17.6% were partially vaccinated. Despite vaccination campaigns by the government, 14.4% of the refugee and migrant population remained unvaccinated mostly because of vaccines not being offered, distant vaccination sites, limited access, unavailability of COVID-19 vaccine or due to a difficult registration process. Vaccination rates varied across provinces, genders and migrant populations due to misconceptions, and several social, cultural and geographical barriers. ConclusionThis study highlights the COVID-19 vaccine coverage, access and inequity faced by refugees and migrants during the pandemic. It suggests early prioritisation of policies inclusive of all refugees and migrants and the provision of identification documents to ease access to basic necessities.
Læs mere Tjek på PubMedLuo, W., Xiao, Z., Yang, X., Wu, R., Li, J., Yu, Z., Guo, S., Nie, B., Liu, D.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
IntroductionType 2 diabetes and non-alcoholic fatty liver disease (NAFLD) often coexist and increase risk for developing liver fibrosis and diabetes complications if no effective measures are taken. Dietary intervention is known to be able to achieve diabetes remission, while evidence regarding the long-term effect on liver fat is limited for comorbidity management of type 2 diabetes and NAFLD. This study aims to investigate the long-term effect of a Chinese Medical Nutrition Therapy (CMNT) diet accompanied by intermittent energy restriction on reducing liver fat and glycated haemoglobin (HbA1c) in patients with type 2 diabetes and NAFLD. Methods and analysisThis is a multicentre two-armed parallel randomised controlled trial study. 120 participants with type 2 diabetes and NAFLD will be recruited from the physical examination centres of multiple hospitals in China. Participants will be randomly allocated 1:1 to either the CMNT group or the usual care group. The CMNT group will be instructed to consume the provided specific meal replacement Chinese medicinal foods consisting of 6 cycles of 5 consecutive days followed by 10 days of regular food intake. The usual care group will be given standard dietary advice. Primary outcomes are changes in the controlled attenuation parameter value by transient elastography and HbA1c level. Secondary outcomes include differences in anthropometrics, clinical blood markers, questionnaires, gut microbiota and metabolomics. Further follow-up will be performed at 6 months, 1 year and 2 years. Ethics and disseminationThe study protocol was approved by the Biomedical Research Ethics Committee of Hunan Agricultural University (BRECHAU20200235). The results will be disseminated via relevant peer-reviewed publications and conference presentations. Trial registration number NCT05439226.
Læs mere Tjek på PubMedArmengol, M., Hayward, G., Abbott, M. G., Bird, C., Bergmann, J. H. M., Glogowska, M.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
ObjectiveTo explore the experiences of healthcare professionals (HCPs) and parents of urine collection methods, to identify barriers to successful sampling and what could improve the process. DesignQualitative research, using individual semistructured interviews with HCPs and parents. The interviews were audiorecorded, transcribed and thematically analysed. SettingUK-based HCPs from primary and secondary care settings and parents with experience with urine collection in primary and/or secondary care settings. ParticipantsHCPs who were involved in aiding, supervising or ordering urine samples. Parents who had experience with urine collection in at least one precontinent child. Results13 HCPs and 16 parents were interviewed. 2 participating HCPs were general practitioners (GPs), 11 worked in paediatric secondary care settings (8 were nurses and 3 were doctors). Two parents had children with underlying conditions where frequent urine collection was required to rule out infections. HCPs and parents reported that there were no straightforward methods of urine collection for precontinent children. Each method—‘clean catch’, urine bag and urine pad—had limitations and problems with usage. ‘Clean catch’, regarded as the gold standard by HCPs with a lower risk of contamination, often proved difficult for parents to achieve. Other methods had elevated risk of contamination but were more acceptable to parents because they were less challenging. Many of the parents expressed the need for more information about urine collection. ConclusionsCurrent methods of urine collection are challenging to use and may be prone to contamination. A new device is required to assist with urine collection in precontinent children, to simplify and reduce the stress of the situation for those involved. Parents are key partners in the process of urine collection with young children. Meeting their expressed need for more information could be an important way to achieve better-quality samples while awaiting a new device.
Læs mere Tjek på PubMedGamble, A. R., McKay, M. J., Anderson, D. B., Pappas, E., Alvarez Cooper, I., Macpherson, S., Harris, I. A., Filbay, S. R., McCaffery, K., Thompson, R., Hoffmann, T. C., Maher, C. G., Zadro, J. R.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
AimTo develop and user test an evidence-based patient decision aid for children and adolescents who are considering anterior cruciate ligament (ACL) reconstruction. DesignMixed-methods study describing the development of a patient decision aid. SettingA draft decision aid was developed by a multidisciplinary steering group (including various types of health professionals and researchers, and consumers) informed by the best available evidence and existing patient decision aids. ParticipantsPeople who ruptured their ACL when they were under 18 years old (ie, adolescents), their parents, and health professionals who manage these patients. Participants were recruited through social media and the network outreach of the steering group. Primary and secondary outcomesSemistructured interviews and questionnaires were used to gather feedback on the decision aid. The feedback was used to refine the decision aid and assess acceptability. An iterative cycle of interviews, refining the aid according to feedback and further interviews, was used. Interviews were analysed using reflexive thematic analysis. ResultsWe conducted 32 interviews; 16 health professionals (12 physiotherapists, 4 orthopaedic surgeons) and 16 people who ruptured their ACL when they were under 18 years old (7 were adolescents and 9 were adults at the time of the interview). Parents participated in 8 interviews. Most health professionals, patients and parents rated the aid’s acceptability as good-to-excellent. Health professionals and patients agreed on most aspects of the decision aid, but some health professionals had differing views on non-surgical management, risk of harms, treatment protocols and evidence on benefits and harms. ConclusionOur patient decision aid is an acceptable tool to help children and adolescents choose an appropriate management option following ACL rupture with their parents and health professionals. A clinical trial evaluating the potential benefit of this tool for children and adolescents considering ACL reconstruction is warranted.
Læs mere Tjek på PubMedLi, W., Chung, S. L., Lei, M., Yang, X., Jin, Z.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
BackgroundSevere pneumonia (SP) stands as one of the most prevalent critical illnesses encountered in clinical practice, characterised by its rapid onset and progression, numerous complications and elevated mortality rates. While modern medical interventions primarily focus on symptomatic management such as anti-infective therapy and mechanical ventilation, challenges including high drug resistance and suboptimal therapeutic outcomes for certain patients persist. Dry cupping as an ancient practice with over a millennium of clinical use in China is renowned for its convenience and perceived clinical efficacy in various illnesses. Nevertheless, the lack of well-designed studies assessing its effects remains a notable gap in the literature. This protocol describes a placebo-controlled, randomised, single-blind study to evaluate the efficacy and safety of dry cupping as an adjuvant treatment for SP. Methods and analysis66 patients diagnosed with SP, aged 18–80 years, will be randomly divided into two groups: intervention group, receiving 10 times of dry cupping treatment; control group, receiving placebo dry cupping therapy. Both applications are used in bilateral Fei Shu (BL13), Pi Shu (BL21) and Shen Shu (BL22) cupping. The application will be conducted once a day for 10 days. Participants will be assessed before treatment (D0), after the first intervention (D1), after the fifth intervention (D5) and after treatment ended (D10). The assessments include blood oxygen saturation, respiratory rate, traditional Chinese medicine symptom score, inflammatory response, mechanical ventilation time and oxygen condition. Ethics and disseminationThis protocol has been approved by the Ethics Committee of Shanghai Seventh People’s Hospital (2023-7th-HIBR-070). The results of the study will be disseminated to participants through social networks and will be submitted to a peer-reviewed journal and scientific meetings. Trial registration numberChiCTR2300076958.
Læs mere Tjek på PubMedTrocheris-Fumery, O., Scetbon, C., Flet, T., Meynier, J., Sellier, M., Rumbach, M., Badaoui, R., Villeret, L., Tarpin, P., Abou-Arab, O., Bar, S., Dupont, H.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
BackgroundPost-induction anaesthesia often promotes intraoperative hypotension (IOH) that can worsen postoperative outcomes. This study aims to assess the benefit of norepinephrine versus ephedrine at the induction of anaesthesia to prevent postoperative complications following major abdominal surgery by preventing IOH. Methods and analysisThe EPON STUDY is a prospective single-centre randomised controlled trial with the planned inclusion of 500 patients scheduled for major abdominal surgery at the Amiens University Hospital. The inclusion criteria are patients aged over 50 years weighing more than 50 kg with an American Society of Anesthesiologists physical status score of ≥2 undergoing major abdominal surgery under general anaesthesia. Patients are allocated either to the intervention group (n=250) or the standard group (n=250). In the intervention group, the prevention of post-induction IOH is performed with norepinephrine (dilution to 0.016 mg/mL) using an electric syringe pump at a rate of 0.48 mg/h (30 mL/h) from the start of anaesthesia and then titrated to achieve the haemodynamic target. In the control group, the prevention of post-induction IOH is performed with manual titration of ephedrine, with a maximal dose of 30 mg, followed by perfusion with norepinephrine. In both groups, the haemodynamic target to maintain is a mean arterial pressure (MAP) of 65 mm Hg or 70 mm Hg for patients with a medical history of hypertension. An intention-to-treat analysis will be performed. The primary outcome is the Clavien–Dindo score assessed up to 30 days postoperatively. The secondary endpoints are the length of hospital stay and length of stay in an intensive care unit/postoperative care unit; postoperative renal function; postoperative cardiovascular, respiratory, neurological, haematological and infectious complications at 1 month; and volume of intraoperative vascular filling and mortality at 1 month. Ethics and disseminationEthical approval was obtained from the committee of protection of the persons of Ile de France in May 2021 (number 21 05 41). The authors will be involved in disseminating the research findings (through attending conferences and co-authoring papers). The results of the study will be disseminated via peer-reviewed publications and presentations at national and international conferences. Trial registration number NCT05276596.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract Quantifying the potential spatial spread of an infectious pathogen is key to defining effective containment and control strategies. The aim of this study is to estimate the risk of SARS-CoV-2 transmission at different distances in Italy before the first regional lockdown was imposed, identifying important sources of national spreading. To do this, we leverage on a probabilistic model applied to daily symptomatic cases retrospectively ascertained in each Italian municipality with symptom onset between January 28 and March 7, 2020. Results are validated using a multi-patch dynamic transmission model reproducing the spatiotemporal distribution of identified cases. Our results show that the contribution of short-distance ( (le 10 km)) transmission increased from less than 40% in the last week of January to more than 80% in the first week of March 2020. On March 7, 2020, that is the day before the first regional lockdown was imposed, more than 200 local transmission foci were contributing to the spread of SARS-CoV-2 in Italy. At the time, isolation measures imposed only on municipalities with at least ten ascertained cases would have left uncontrolled more than 75% of spillover transmission from the already affected municipalities. In early March, national-wide restrictions were required to curb short-distance transmission of SARS-CoV-2 in Italy.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.04.2024
Tilføjet 30.04.2024
Abstract Background Clinically, most patients with Kaposi\'s sarcoma (KS) are male, and several direct and indirect mechanisms may underlie this increased susceptibility in men, Kaposi\'s sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), is considered to be the primary etiological agent responsible for KS. Thus, we propose the hypothesis that men are more susceptible to HHV-8 infection, leading to a higher incidence of Kaposi\'s sarcoma among males. A meta-analysis was conducted to evaluate the association between gender and HHV-8 seropositivity in the general population. Methods A comprehensive literature search was performed using 6 online databases: PubMed, EMBASE, Cochrane library, Web of Science, CNKI, and Wanfang. Studies published before March 15, 2023, were included. Results In all, 33 articles including 41 studies were included in the meta-analysis. In the included adult population. men had a higher risk of HHV-8 infection than did women in adult populations from all over the world (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.01–1.15), but no differences were found in child population from all over the world (OR: 0.90, 95% CI: 0.79–1.01). There was a significant difference in HHV-8 seroprevalence between men and women in sub-Saharan Africa (SSA) adult population (OR: 1.15, 95% CI: 1.05–1.26). However, no significant differences were observed in sub-Saharan Africa (SSA) child population (OR: 0.90, 95%CI 0.78–1.03). As for other continents, the results showed no significant difference, such as the Asian population (OR: 1.03, 95%CI: 0.92–1.16). or the European and American populations (OR 1.01, 95%CI 0.87–1.17). Conclusion There was a slight gender disparity for HHV-8 infection in the adult population. Among the adult populations from SSA and globally, men were more likely to be infected with HHV-8 than were women. However, no statistical significance was observed in the child populations from SSA and globally. In the future, the inclusion of more standardized studies may strengthen the results of this study.
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