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Journal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
People who received a SARS-CoV-2 vaccination had a lower risk of heart failure and blood clots in their veins and arteries after COVID-19 infection than those who had not been vaccinated, a recent study involving more than 20 million participants in Estonia, Spain, and the UK found.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
Amid an uptick in measles cases and outbreaks both in the US and abroad, the US Centers for Disease Control and Prevention (CDC) issued an alert on March 18 encouraging clinicians to work with schools and educators to ensure children are up-to-date on their measles-mumps-rubella (MMR) vaccines. As of March 28, 97 measles cases had been reported in 18 US states this year. Most of the cases have been linked to international travel.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
The US Food and Drug Administration (FDA) recently approved resmetirom, marketed as Rezdiffra, for adults with nonalcoholic steatohepatitis (NASH) without cirrhosis. NASH is a progressive fatty liver disease that affects up to 8 million people in the US and can cause liver inflammation and scarring, known as fibrosis. Resmetirom, an oral drug that reduces the accumulation of liver fat, can be used along with diet and exercise, which are the standard care for patients with NASH.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
A vaccine given during pregnancy that prevents respiratory syncytial virus (RSV) in infants was about 66% effective at protecting against RSV-associated respiratory illness, and about 69% effective at protecting against severe disease, according to a study in the New England Journal of Medicine. The data came from a randomized clinical trial involving more than 5000 pregnant people and their infants in 24 countries.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
For some individuals, post–COVID-19 condition, or long COVID, can result in symptoms of autonomic nervous system dysfunction, such as a heart palpitations and lightheadedness that occur when standing up, and fatigue. Together, these symptoms are known as postural orthostatic tachycardia syndrome (POTS).
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
This Medical News article discusses an intervention that uses empathy to address vaccine hesitancy in the clinic.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
Few, indeed, are the physicians who do not now and then advise a patient to make a change of climate. However difficult it might be to justify such a recommendation in every instance, or even in most cases, on the basis of precise physiologic knowledge or strictly scientific therapeutic consideration, the benefits that repeatedly accrue to persons thus ordered to a “change of scene” are often too indisputably real to be gainsaid. Change of climate may mean far more than transport to a place where altitude, regimen, temperature, moisture and other atmospheric conditions are different; it may mean removal from smoke and dust and other noxious agencies in the air; it may bring about new associations and furnish a new personal environment, whereby psychologic influences rather than climatic factors are brought into play in connection with the sick. Such personal features doubtless account for many benefits; they cannot encompass all the good that is often attributable to a new environment. Climatology, from the human standpoint, has not yet reached the dignity of an exact science. It still banks on combinations of tradition, unverified beliefs and empiric deductions. For the north temperate zone it has been alleged more than once that limitations imposed by weather cause many persons to lead unhygienic lives in winter, some individuals almost entering a state of hibernation. For some of these, spring brings a welcomed tonic change; others seek it by removing to a different locality. The meaning of sunshine in the form of direct insolation has become apparent in recent years in connection with various diseases. Tuberculosis and rickets, for example, can testify amply to the health-giving virtues of the direct rays of the sun. A recent writer has accordingly asserted that a study of the benefits obtained from a change of climate becomes more important each year as the systemic changes caused by different climates are better understood.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
The Original Investigation titled “Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection,” published in the June 13, 2023, issue of JAMA, has been corrected to include additional consortium authors and nonauthor collaborator names in a supplement.
Læs mere Tjek på PubMedPamplin, Jeremy C.; Veazey, Sena R.; Barczak, Stacie; Fonda, Stephanie J.; Serio-Melvin, Maria L.; Ross, Kevin S.; Colombo, Christopher J.
Critical Care Explorations, 10.05.2024
Tilføjet 10.05.2024
OBJECTIVES: To determine the impact of telementoring on caregiver performance during a high-fidelity medical simulation model (HFMSM) of a critically ill patient in a resource-limited setting. DESIGN: A two-center, randomized, controlled study using a HFMSM of a patient with community-acquired pneumonia complicated by acute respiratory distress syndrome. SETTING: A notional clinic in a remote location staffed by a single clinician and nonmedical assistant. PARTICIPANTS: Clinicians with limited experience managing critically ill patients. INTERVENTIONS: Telemedicine (TM) support. MEASUREMENTS: The primary outcome was clinical performance as measured by accuracy, reliability, and efficiency of care. Secondary outcomes were patient survival, procedural quality, subjective assessment of the HFMSM, and perceived workload. MAIN RESULTS: TM participants (N = 11) performed better than non-TM (NTM, N = 12) in providing expected care (accuracy), delivering care more consistently (reliability), and without consistent differences in efficiency (timeliness of care). Accuracy: TM completed 91% and NTM 42% of expected tasks and procedures. Efficiency: groups did not differ in the mean (± sd) minutes it took to obtain an advanced airway successfully (TM 15.2 ± 10.5 vs. NTM 22.8 ± 8.4, p = 0.10) or decompress a tension pneumothorax with a needle (TM 0.7 ± 0.5 vs. NTM 0.6 ± 0.9, p = 0.65). TM was slower than NTM in completing thoracostomy (22.3 ± 10.2 vs. 12.3 ± 4.8, p = 0.03). Reliability: TM performed 13 of 17 (76%) tasks with more consistent timing than NTM. TM completed 68% and NTM 29% of procedural quality metrics. Eighty-two percent of the TM participants versus 17% of the NTM participants simulated patients survived (p = 0.003). The groups similarly perceived the HFMSM as realistic, managed their patients with personal ownership, and experienced comparable workload and stress. CONCLUSIONS: Remote expertise provided with TM to caregivers in resource-limited settings improves caregiver performance, quality of care, and potentially real patient survival. HFMSM can be used to study interventions in ways not possible with real patients.
Læs mere Tjek på PubMedJennifer B. Glass, Kathrin Rousk
Trends in Microbiology, 10.05.2024
Tilføjet 10.05.2024
Nitrogen is a key element that is essential for the facilitation of biogeochemical processes across varied ecosystems. We now know that nitrogen cycling is incredibly complex in that it is more than just a cycle and comprises various microbe-mediated processes (nitrification, denitrification, etc.). Given the ubiquitousness of many of these processes across terrestrial (agricultural, for instance) and aquatic ecosystems, we have seen cases of cross-disciplinary collaboration whereby lessons learned from one ecosystem can be applied to another.
Læs mere Tjek på PubMedChristopher McCrory, Megan Lenardon, Ana Traven
Trends in Microbiology, 10.05.2024
Tilføjet 10.05.2024
The human gastrointestinal microbiome encompasses bacteria, fungi, and viruses forming complex bionetworks which, for organismal health, must be in a state of homeostasis. An important homeostatic mechanism derives from microbial competition, which maintains the relative abundance of microbial species in a healthy balance. Microbes compete for nutrients and secrete metabolites that inhibit other microbes. Short-chain fatty acids (SCFAs) are one such class of metabolites made by gut bacteria to very high levels. SCFAs are metabolised by microbes and host cells and have multiple roles in regulating cell physiology. Here, we review the mechanisms by which SCFAs regulate the fungal gut commensal Candida albicans. We discuss SCFA’s ability to inhibit fungal growth, limit invasive behaviours and modulate cell surface antigens recognised by immune cells. We review the mechanisms underlying these roles: regulation of gene expression, metabolism, signalling and SCFA-driven post-translational protein modifications by acylation, which contribute to changes in acylome dynamics of C. albicans with potentially large consequences for cell physiology. Given that the gut mycobiome is a reservoir for systemic disease and has also been implicated in inflammatory bowel disease, understanding the mechanisms by which bacterial metabolites, such as SCFAs, control the mycobiome might provide therapeutic avenues.
Læs mere Tjek på PubMedMark W. Smith, Thomas Willis, Elizabeth Mroz, William H. M. James, Megan J. Klaar, Simon N. Gosling, Christopher J. Thomas
Science, 10.05.2024
Tilføjet 10.05.2024
Yuyang Chen, Yiting Xu, Lin Wang, Yilin Liang, Naizhe Li, José Lourenço, Yun Yang, Qiushi Lin, Ligui Wang, He Zhao, Bernard Cazelles, Hongbin Song, Ziyan Liu, Zengmiao Wang, Oliver J. Brady, Simon Cauchemez, Huaiyu Tian
Science, 10.05.2024
Tilføjet 10.05.2024
Leslie Roberts
Science, 10.05.2024
Tilføjet 10.05.2024
Kai Kupferschmidt
Science, 10.05.2024
Tilføjet 10.05.2024
Jon Cohen
Science, 10.05.2024
Tilføjet 10.05.2024
Jess Libow
Lancet, 10.05.2024
Tilføjet 10.05.2024
In her 2013 essay collection, Meaty, the comedian and writer Samantha Irby quips that, “as autoimmune diseases go”, her diagnosis of Crohn\'s disease “is one of the least glamorous of the bunch”. As a patient with Crohn\'s disease myself, I can see why. Those who experience this chronic inflammatory disease of the gastrointestinal tract know all too well the stigmas and shame that can accompany its symptoms. Unsurprisingly, Crohn\'s disease rarely appears in literature not tinged with a self-help ethos.
Læs mere Tjek på PubMedIkechukwu Adigweme, Mohammed Yisa, Michael Ooko, Edem Akpalu, Andrew Bruce, Simon Donkor, Lamin B Jarju, Baba Danso, Anthony Mendy, David Jeffries, Anne Segonds-Pichon, Abdoulie Njie, Stephen Crooke, Elina El-Badry, Hilary Johnstone, Michael Royals, James L Goodson, Mark R Prausnitz, Devin V McAllister, Paul A Rota, Sebastien Henry, Ed Clarke
Lancet, 10.05.2024
Tilføjet 10.05.2024
The safety and immunogenicity data support the accelerated development of the MRV-MNP.
Læs mere Tjek på PubMedManachai Yingklang, Apisit Chaidee, Rungtiwa Dangtakot, Chanakan Jantawong, Ornuma Haonon, Chutima Sitthirach, Nguyen Thi Hai, Ubon Cha’on, Sirirat Anutrakulchai, Supot Kamsa-ard, Somchai Pinlaor
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Manachai Yingklang, Apisit Chaidee, Rungtiwa Dangtakot, Chanakan Jantawong, Ornuma Haonon, Chutima Sitthirach, Nguyen Thi Hai, Ubon Cha’on, Sirirat Anutrakulchai, Supot Kamsa-ard, Somchai Pinlaor
Læs mere Tjek på PubMedThe PLOS One Staff
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Anya Cushnie, Ralf Reintjes, Susanna Lehtinen-Jacks, J. Peter Figueroa
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Soha El-Shaer, Shaymaa H. Abdel-Rhman, Rasha Barwa, Ramadan Hassan
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
Læs mere Tjek på PubMedSe Ju Lee, Yae Jee Baek, Jin Nam Kim, Ki Hyun Lee, Eun Hwa Lee, Joon Sup Yeom, Jun Yong Choi, Nam Su Ku, Jin Young Ahn, Jung Ho Kim, Su Jin Jeong
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Se Ju Lee, Yae Jee Baek, Jin Nam Kim, Ki Hyun Lee, Eun Hwa Lee, Joon Sup Yeom, Jun Yong Choi, Nam Su Ku, Jin Young Ahn, Jung Ho Kim, Su Jin Jeong
Læs mere Tjek på PubMedMalaria Journal, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Plasmodium vivax relapses due to dormant liver hypnozoites can be prevented with primaquine. However, the dose must be adjusted in individuals with glucose-6-phosphate-dehydrogenase (G6PD) deficiency. In French Guiana, assessment of G6PD activity is typically delayed until day (D)14 to avoid the risk if misclassification. This study assessed the kinetics of G6PD activity throughout P. vivax infection to inform the timing of treatment. Methods For this retrospective monocentric study, data on G6PD activity between D1 and D28 after treatment initiation with chloroquine or artemisinin-based combination therapy were collected for patients followed at Cayenne Hospital, French Guiana, between January 2018 and December 2020. Patients were divided into three groups based on the number of available G6PD activity assessments: (i) at least two measurements during the P. vivax malaria infection; (ii) two measurements: one during the current infection and one previously; (iii) only one measurement during the malaria infection. Results In total, 210 patients were included (80, 20 and 110 in groups 1, 2 and 3, respectively). Data from group 1 showed that G6PD activity remained stable in each patient over time (D1, D3, D7, D14, D21, D28). None of the patients with normal G6PD activity during the initial phase (D1–D3) of the malaria episode (n = 44) was categorized as G6PD-deficient at D14. Patients with G6PD activity
Læs mere Tjek på PubMedMalaria Journal, 10.05.2024
Tilføjet 10.05.2024
Abstract Background In 2021 and 2023, the World Health Organization approved RTS,S/AS01 and R21/Matrix M malaria vaccines, respectively, for routine immunization of children in African countries with moderate to high transmission. These vaccines are made of Plasmodium falciparum circumsporozoite protein (PfCSP), but polymorphisms in the gene raise concerns regarding strain-specific responses and the long-term efficacy of these vaccines. This study assessed the Pfcsp genetic diversity, population structure and signatures of selection among parasites from areas of different malaria transmission intensities in Mainland Tanzania, to generate baseline data before the introduction of the malaria vaccines in the country. Methods The analysis involved 589 whole genome sequences generated by and as part of the MalariaGEN Community Project. The samples were collected between 2013 and January 2015 from five regions of Mainland Tanzania: Morogoro and Tanga (Muheza) (moderate transmission areas), and Kagera (Muleba), Lindi (Nachingwea), and Kigoma (Ujiji) (high transmission areas). Wright’s inbreeding coefficient (Fws), Wright’s fixation index (FST), principal component analysis, nucleotide diversity, and Tajima’s D were used to assess within-host parasite diversity, population structure and natural selection. Results Based on Fws (
Læs mere Tjek på PubMedSozaburo IharaBrian V. NguyenYukiko MiyamotoLars Eckmann1Department of Medicine, University of California San Diego, La Jolla, California, USA2Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Jeroen P. J. Saeij
Infection and Immunity, 10.05.2024
Tilføjet 10.05.2024
Scott T. NishiokaJoshua SnipperJimin LeeJoshua SchapiroRobert Z. ZhangHyewon AbeAndreas TillCheryl Y. M. Okumura1Biology Department, Occidental College, Los Angeles, California, USA2Division of Biological Sciences, University of California San Diego, La Jolla, California, USA3The San Diego Center for Systems Biology, University of California San Diego, La Jolla, California, USA4University Hospital of Bonn, Bonn, Germany, Kimberly A. Kline
Infection and Immunity, 10.05.2024
Tilføjet 10.05.2024
Bo YangBenjamin VaisvilDaniel SchmittJoseph CollinsEric YoungVinayak KapatralReeta Rao1Department of Biology and Biotechnology, Worcester Polytechnic Institute, Worcester, Massachusetts, USA2Igenbio, Inc., Chicago, Illinois, USA3Department of Chemical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts, USA, Mairi C. Noverr
Infection and Immunity, 10.05.2024
Tilføjet 10.05.2024
Infection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose The principal objective of this project was to review and thoroughly examine the chemical characteristics, pharmacological activity, and quantification methods associated with contezolid. Methods The article was based on published and ongoing preclinical and clinical studies on the application of contezolid. These studies included experiments on the physicochemical properties of contezolid, in vitro antimicrobial research, in vivo antimicrobial research, and clinical trials in various phases. There were no date restrictions on these studies. Results In June 2021, contezolid was approved for treating complicated skin and soft tissue infections. The structural modification of contezolid has resulted in better efficacy compared to linezolid. It inhibits bacterial growth by preventing the production of the functional 70S initiation complex required to translate bacterial proteins. The current evidence has indicated a substantial decline in myelosuppression and monoamine oxidase inhibition without impairing its antibacterial properties. Contezolid was found to have a more significant safety profile and to be metabolised by flavin monooxygenase 5, reducing the risk of harmful effects due to drug–drug interactions. Adjusting doses is unnecessary for patients with mild to moderate renal or hepatic insufficiency. Conclusion As an oral oxazolidinone antimicrobial agent, contezolid is effective against multi-drug resistant Gram-positive bacteria. The introduction of contezolid provided a new clinical option.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose To assess the Xpert MTB/XDR assay’s efficiency in promptly detecting resistance to isoniazid, fluoroquinolones, ethionamide, and second-line injectable drugs among tuberculosis (TB) patients. Methods From August 2020 to July 2021, TB suspected patient samples were enrolled at a tertiary care center for our study. We conducted mycobacterial culture, phenotypic DST using proportion method in liquid culture at WHO-recommended concentrations, and the line probe assay (LPA). Simultaneously, the Index test, Xpert MTB/XDR, was performed following the manufacturer’s instructions. Results Among 360 samples, 107 were excluded due to incomplete information. Resistance to isoniazid, levofloxacin and moxifloxacin was found in 45/251, 21/251 and 20/251 samples, respectively by phenotypic DST. The diagnostic accuracy of Index test, taking phenotypic DST as a reference standard, was 95.8%, 99.04%, and 99.05% for isoniazid, levofloxacin, and moxifloxacin, respectively. The Index test assay demonstrated a specificity of 99.1% for detecting SLID resistance, yielding a diagnostic accuracy of 99.2. Comparing the Index test with LPA revealed a significant enhancement in sensitivity for detecting isoniazid resistance (86.7% vs. 82.2%). Conclusions The Index test exhibited promising outcomes in identifying resistance to isoniazid and fluoroquinolones, surpassing the performance of the LPA. This could be valuable for promptly initiating treatment in cases of drug-resistant tuberculosis.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose Early diagnosis of surgical site infections (SSIs) could prevent surgical revision. Inflammatory markers (IMs), such as procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α), seem more accurate in diagnosing SSI than C-reactive protein (CRP) and white blood cell (WBC) count. The aim was to compare the predictive values of CRP, WBC count, PCT, IL-6, and TNF-α in SSI detection. Methods A total of 130 patients undergoing dorsal spondylodesis from 2019 to 2024 were enrolled in a prospective diagnostic study at a maximum care spine center. IMs were measured preoperatively and on the postoperative days (PODs) 1, 2, 3, 5, and 7. Patients with high suspicion of SSI underwent revision surgery. SSI was diagnosed when the microbiological evidence was positive. Patients were divided a posteriori into the non-infection and infection groups. Results IMs of 118 patients (66.9 ± 13.0 years, 61.0% females) were measured. Fifteen of the 118 patients (12.7%) developed an SSI. The groups differed with respect to existing hypertension, number of instrumented segments, region of surgery, CRPPOD1,7, PCTPOD7, and IL-6POD3,5,7. Binary logistic regression for SSI detection including these parameters showed an area under the curve (AUC) of 0.88 (95% CI 0.79–0.98; P
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Background and Aim A wide range of clinical manifestations and outcomes, including liver injury, have been reported in COVID-19 patients. We investigated the association of three substantial gene polymorphisms (FURIN, IFNL4, and TLR2) with COVID-19 disease susceptibility and severity to help predict prognosis. Methods 150 adult COVID-19-assured cases were categorized as follows: 78 patients with a non-severe presentation, 39 patients with severe disease, and 33 critically ill patients. In addition, 74 healthy controls were included. Clinical and laboratory evaluations were carried out, including complete and differential blood counts, D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin, ferritin, interleukin-6 (Il-6), and liver and kidney functions. FURIN (rs6226), IFNL4 (rs12979860), and TLR2 (rs3804099) genotyping allelic discrimination assays were conducted using real-time PCR. Results The FURIN, IFNL4, and TLR2 genotypes and their alleles differed significantly between COVID-19 patients and controls, as well as between patients with severe or critical illness and those with a non-severe presentation. According to a multivariable regression analysis, FURIN (C/T + T/T) and TLR2 (T/C + C/C) mutants were associated with COVID-19 susceptibility, with odds ratios of 3.293 and 2.839, respectively. FURIN C/C and IFNL4 T/T mutants were significantly linked to severe and critical illnesses. Multivariate regression analysis showed that FURIN (G/C + C/C) genotypes and IFNL4 T/T homozygosity were independent risk factors associated with increased mortality. Conclusion FURIN, IFNL4, and TLR2 gene variants are associated with the risk of COVID-19 occurrence as well as increased severity and poor outcomes in Egyptian patients.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA infections caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp) and Escherichia coli (CP-Ec). Methods A prospective cohort study was performed in 59 Spanish hospitals from February to March 2019, including the first 10 consecutive patients from whom CP-Kp or CP-Ec were isolated. Patients were stratified according to acquisition type. A multivariate analysis was performed to identify the impact of acquisition type in 30-day mortality. Results Overall, 386 patients were included (363 [94%] with CP-Kp and 23 [6%] CP-Ec); in 296 patients (76.3%), the CPE was causing an infection. Acquisition was CA in 31 (8.0%) patients, HCA in 183 (47.4%) and nosocomial in 172 (48.3%). Among patients with a HCA acquisition, 100 (54.6%) had been previously admitted to hospital and 71 (38.8%) were nursing home residents. Urinary tract infections accounted for 19/23 (82.6%), 89/130 (68.5%) and 42/143 (29.4%) of CA, HCA and nosocomial infections, respectively. Overall, 68 infections (23%) were bacteremia (8.7%, 17.7% and 30.1% of CA, HCA and nosocomial, respectively). Mortality in infections was 28% (13%, 14.6% and 42.7% of CA, HCA and nosocomial, respectively). Nosocomial bloodstream infections were associated with increased odds for mortality (adjusted OR, 4.00; 95%CI 1.21–13.19). Conclusions HCA and CA infections caused by CPE are frequent and clinically significant. This information may be useful for a better understanding of the epidemiology of CPE.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Our Hospital in Northern Italy assists 3817 people living with HIV (PLWH) and has faced the impact of COVID-19. Little is known about the impact of HIV infection on the risk of post-COVID-19 conditions (PCCs) onset. We aim to assess the incidence of PCC in PLWH and the factors associated with its occurrence. Methods We performed a retrospective, observational study including all PLWH > 18 years registered in the Brescia Health Protection Agency database, assessing SARS-CoV-2 burden, vaccination status, socio-demographic, and viro-immunological parameters from February 2020 until May 2022. Persistence of self-reported symptoms (clustered into gastrointestinal, respiratory, osteo-muscular, and neuro-behavioral symptoms) was evaluated after 3 months by a telephone-administered questionnaire. We estimated the associations between all variables and outcomes through univariate and multivariable logistic models. Results In the study period, 653 PLWH were diagnosed with SARS-CoV-2 infection (17.1%). We observed 19 (2.9%) reinfections, 71 (10.9%) hospitalizations, and 3 (0.5%) deaths. We interviewed 510/653 PLWH (78%), and 178 (PCCs prevalence 34.9%; CI 95% 30.7–39.2) reported persistent symptoms. Asthenia/fatigue was the most reported symptom (60/178), followed by muscular pain (54/178). In the multivariate regression model, there was a lower risk of PCCs in males respect to females (adjusted OR = 0.64; CI 95% 0.99–3.66), while hospitalization during acute infection was associated with an increased the risk of PCCs (adjusted OR = 1.9; CI 95% 0.99–3.66). Notably, no viro-immunological variable modified the PCCs risk onset. Conclusions Our study highlights a substantial prevalence of PCCs among PLWH, three months post-SARS-CoV-2 infection, independent of viro-immunological features or vaccination status.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose Patients hospitalized for community-acquired pneumonia (CAP) may have a higher risk of new-onset atrial fibrillation (NOAF). The C2HEST score was developed to evaluate the NOAF risk in the general population. Data on the value of the C2HEST score in acute patients admitted with CAP are lacking. We want to establish the predictive value of C2HEST score for NOAF in patients with CAP. Methods Patients with CAP enrolled in the SIXTUS cohort were enrolled. C2HEST score was calculated at baseline. In-hospital NOAF was recorded. Receiver-operating Characteristic (ROC) curve and multivariable Cox proportional hazard regression analysis were performed. Results We enrolled 473 patients (36% women, mean age 70.6 ± 16.5 years), and 54 NOAF occurred. Patients with NOAF were elderly, more frequently affected by hypertension, heart failure, previous stroke/transient ischemic attack, peripheral artery disease and hyperthyroidism. NOAF patients had also higher CURB-65, PSI class and CHA2DS2-VASc score. The C-index of C2HEST score for NOAF was 0.747 (95% confidence interval [95%CI] 0.705–0.786), higher compared to CURB-65 (0.611, 95%CI 0.566–0.655, p = 0.0016), PSI (0.665, 95%CI 0.621–0.708, p = 0.0199) and CHA2DS2-VASc score (0.696, 95%CI 0.652–0.737, p = 0.0762). The best combination of sensitivity (67%) and specificity (70%) was observed with a C2HEST score ≥ 4. This result was confirmed by the multivariable Cox analysis (Hazard Ratio [HR] for C2HEST score ≥ 4 was 10.7, 95%CI 2.0–57.9; p = 0.006), independently from the severity of pneumonia. Conclusion The C2HEST score was a useful predictive tool to identify patients at higher risk for NOAF during hospitalization for CAP. Clinical Trial Registration www.clinicaltrials.gov (NCT01773863)
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose The aim was to analyse the clinical and economic impact of carbapenemase-producing Enterobacterales (CPE) infections. Methods Case–control study. Adult patients with CPE infections were considered cases, while those with non-CPE infections were controls. Matching criteria were age (± 5 years), sex, source of infection and microorganism (ratio 1:2). Primary outcome was 30-day mortality. Secondary outcomes were 90-day mortality, clinical failure, hospitalisation costs and resource consumption. Results 246 patients (82 cases and 164 controls) were included. Klebsiella pneumoniae OXA-48 was the most common microorganism causing CPE infections. CPE cases had more prior comorbidities (p = 0.007), septic shock (p = 0.003), and were more likely to receive inappropriate empirical and definitive antibiotic treatment (both p
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose The influence of new SARS-CoV-2 variants on the post-COVID-19 condition (PCC) remains unanswered. Therefore, we examined the prevalence and predictors of PCC-related symptoms in patients infected with the SARS-CoV-2 variants delta or omicron. Methods We compared prevalences and risk factors of acute and PCC-related symptoms three months after primary infection (3MFU) between delta- and omicron-infected patients from the Cross-Sectoral Platform of the German National Pandemic Cohort Network. Health-related quality of life (HrQoL) was determined by the EQ-5D-5L index score and trend groups were calculated to describe changes of HrQoL between different time points. Results We considered 758 patients for our analysis (delta: n = 341; omicron: n = 417). Compared with omicron patients, delta patients had a similar prevalence of PCC at the 3MFU (p = 0.354), whereby fatigue occurred most frequently (n = 256, 34%). HrQoL was comparable between the groups with the lowest EQ-5D-5L index score (0.75, 95% CI 0.73–0.78) at disease onset. While most patients (69%, n = 348) never showed a declined HrQoL, it deteriorated substantially in 37 patients (7%) from the acute phase to the 3MFU of which 27 were infected with omicron. Conclusion With quality-controlled data from a multicenter cohort, we showed that PCC is an equally common challenge for patients infected with the SARS-CoV-2 variants delta and omicron at least for the German population. Developing the EQ-5D-5L index score trend groups showed that over two thirds of patients did not experience any restrictions in their HrQoL due to or after the SARS-CoV-2 infection at the 3MFU. Clinical Trail registration The cohort is registered at ClinicalTrials.gov since February 24, 2021 (Identifier: NCT04768998).
Læs mere Tjek på PubMedDe kyi, Yujia Xiao, Xia Wang, Shuwen Feng, Yuxin Wang, Lihong Liao, Shouyi Wang, Youping Deng, Junwen Zheng, Dongchi Zhao
International Journal of Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
The sharp increase in mycoplasma pneumoniae (MP) infection among children in mainland China in 2023 has raised concerns about a traditional infectious disease epidemic[1]. However, it is still impossible to accurately judge the epidemic scale, the infected objectives and the clinical outcome[2]. Until the mid-2023, strong regional epidemics occurred in northern China, mycoplasma pneumoniae pneumonia (MPP) in children attracted the attention of the World Health Organization[3].
Læs mere Tjek på PubMedAurélien Dinh, Clara Duran, Jacques Ropers, Frédérique Bouchand, Laurène Deconinck, Morgan Matt, Olivia Senard, Aurore Lagrange, Guillaume Mellon, Ruxandra Calin, Sabrina Makhloufi, Victoire de Lastours, Emmanuel Mathieu, Jean-Emmanuel Kahn, Elisabeth Rouveix, Julie Grenet, Jennifer Dumoulin, Thierry Chinet, Marion Pépin, Véronique Delcey, Sylvain Diamantis, Daniel Benhamou, Virginie Vitrat, Marie-Christine Dombret, Bertrand Renaud, Yann-Erick Claessens, José Labarère, Jean-Pierre Bedos, Philippe Aegerter, Anne-Claude Crémieux, the Pneumonia Short Treatment (PTC) Study Group
Clinical Microbiology and Infection, 9.05.2024
Tilføjet 9.05.2024
In this study, we aimed to assess the efficacy of different ways of administration and types of beta-lactams for hospitalized community-acquired pneumonia (CAP).
Læs mere Tjek på PubMedMurphy, M., Dutton, R., Gezahegne, K., Jones, N., Seager, J., Baird, S.
BMJ Open, 9.05.2024
Tilføjet 9.05.2024
ObjectiveTo understand the relationship between the COVID-19 pandemic and menstrual hygiene management (MHM) among adolescent girls in Ethiopia and to explore which girls were most affected by pandemic disruptions. DesignTwo rounds of data from surveys and interviews were collected with adolescent girls immediately prior to and during the COVID-19 pandemic. The primary analysis is cross-sectional, controlling for pre-COVID-19 covariates. SettingThe setting was three zones in two regions of Ethiopia: East Hararghe and East Shewa Zones in Oromia and South Gondar Zone in Amhara. Data were collected in December 2019–March 2020 and September 2020–February 2021. Participants742 adolescent girls, ages 11–25 years. Outcome measuresFour primary outcomes were explored (1) the number of challenges girls experienced; (2) adolescent-identified challenges managing menstrual hygiene; (3) adolescent-identified difficulties accessing MHM products and (4) adolescent-identified difficulties accessing soap or water. ResultsGirls who were more vulnerable to COVID-19 were more likely to have worse MHM outcomes. An SD increase in household vulnerability to COVID-19 was associated with an 8.7 percentage point increase in the likelihood that the respondent had difficulty getting MHM products (p
Læs mere Tjek på PubMedJohnson, D. R., Ghosh, D., Wagner, B. D., Carlton, E. J.
BMJ Open, 9.05.2024
Tilføjet 9.05.2024
ObjectivesTo assess whether increasing levels of hospital stress—measured by intensive care unit (ICU) bed occupancy (primary), ventilators in use and emergency department (ED) overflow—were associated with decreasing COVID-19 ICU patient survival in Colorado ICUs during the pre-Delta, Delta and Omicron variant eras. DesignA retrospective cohort study using discrete-time survival models, fit with generalised estimating equations. Setting34 hospital systems in Colorado, USA, with the highest patient volume ICUs during the COVID-19 pandemic. Participants9196 non-paediatric SARS-CoV-2 patients in Colorado hospitals admitted once to an ICU between 1 August 2020 and 1 March 2022 and followed for 28 days. Outcome measuresDeath or discharge to hospice. ResultsFor Delta-era COVID-19 ICU patients in Colorado, the odds of death were estimated to be 26% greater for patients exposed every day of their ICU admission to a facility experiencing its all-era 75th percentile ICU fullness or above, versus patients exposed for none of their days (OR: 1.26; 95% CI: 1.04 to 1.54; p=0.0102), adjusting for age, sex, length of ICU stay, vaccination status and hospital quality rating. For both Delta-era and Omicron-era patients, we also detected significantly increased mortality hazard associated with high ventilator utilisation rates and (in a subset of facilities) states of ED overflow. For pre-Delta-era patients, we estimated relatively null or even protective effects for the same fullness exposures, something which provides a meaningful contrast to previous studies that found increased hazards but were limited to pre-Delta study windows. ConclusionsOverall, and especially during the Delta era (when most Colorado facilities were at their fullest), increasing exposure to a fuller hospital was associated with an increasing mortality hazard for COVID-19 ICU patients.
Læs mere Tjek på PubMedBaye, T., Kassaw, A. T., Gebrie, D., Girmaw, F., Ashagrie, G.
BMJ Open, 9.05.2024
Tilføjet 9.05.2024
BackgroundTuberculosis (TB) remains a significant global health challenge, especially prevalent in the WHO African region. The WHO’s End TB Strategy emphasises effective treatment approaches such as directly observed therapy (DOT), yet the optimal implementation of DOT, whether through health facility-based (HF DOT) or community-based (CB DOT) approaches, remains uncertain. ObjectiveTo conduct a systematic comparison of the effectiveness and cost-effectiveness of Community-Based Directly Observed Treatment (CB DOT) versus Health Facility-Based Directly Observed Treatment (HF DOT) for tuberculosis (TB) treatment in African settings. MethodsWe will conduct a systematic review and meta-analysis following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will search PubMed, Embase, Web of Science, Scopus and the Cochrane Library for articles published up to 30 March 2023, without date restrictions. Eligible studies must be full economic evaluations conducted in African countries, comparing CB DOT to HF DOT regarding treatment outcomes and costs. Exclusion criteria include non-English, non-peer-reviewed or studies lacking caregiver involvement in CB DOT, health facility-based DOT comparison, direct comparability between CB DOT and HF DOT, significant selection bias or non-economic evaluations. Data extraction will be performed independently by reviewers, and meta-analyses will use STATA software. To pool the data, a random-effect model will be applied, and quality assessment of the studies will be conducted. Ethics and disseminationEthical approval is not required as the study will use previously published articles available publicly. Findings will be presented at international and national conferences and published in open-access, peer-reviewed journals. PROSPERO registration numberCRD42023443260.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.05.2024
Tilføjet 9.05.2024
Abstract Background Several models have been used to predict outbreaks during the COVID-19 pandemic, with limited success. We developed a simple mathematical model to accurately predict future epidemic waves. Methods We used data from the Ministry of Health, Labour and Welfare of Japan for newly confirmed COVID-19 cases. COVID-19 case data were summarized as weekly data, and epidemic waves were visualized and identified. The periodicity of COVID-19 in each prefecture of Japan was confirmed using time-series analysis and the autocorrelation coefficient, which was used to investigate the longer-term pattern of COVID-19 cases. Outcomes using the autocorrelation coefficient were visualized via a correlogram to capture the periodicity of the data. An algorithm for a simple prediction model of the seventh COVID-19 wave in Japan comprised three steps. Step 1: machine learning techniques were used to depict the regression lines for each epidemic wave, denoting the “rising trend line”; Step 2: an exponential function with good fit was identified from data of rising straight lines up to the sixth wave, and the timing of the rise of the seventh wave and speed of its spread were calculated; Step 3: a logistic function was created using the values calculated in Step 2 as coefficients to predict the seventh wave. The accuracy of the model in predicting the seventh wave was confirmed using data up to the sixth wave. Results Up to March 31, 2023, the correlation coefficient value was approximately 0.5, indicating significant periodicity. The spread of COVID-19 in Japan was repeated in a cycle of approximately 140 days. Although there was a slight lag in the starting and peak times in our predicted seventh wave compared with the actual epidemic, our developed prediction model had a fairly high degree of accuracy. Conclusion Our newly developed prediction model based on the rising trend line could predict COVID-19 outbreaks up to a few months in advance with high accuracy. The findings of the present study warrant further investigation regarding application to emerging infectious diseases other than COVID-19 in which the epidemic wave has high periodicity.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.05.2024
Tilføjet 9.05.2024
Abstract Background and objectives Amidst limited influenza treatment options, evaluating the safety of Oseltamivir and Baloxavir Marboxil is crucial, particularly given their comparable efficacy. This study investigates post-market safety profiles, exploring adverse events (AEs) and their drug associations to provide essential clinical references. Methods A meticulous analysis of FDA Adverse Event Reporting System (FAERS) data spanning the first quarter of 2004 to the fourth quarter of 2022 was conducted. Using data mining techniques like reporting odds ratio (ROR), proportional reporting ratio, Bayesian Confidence Propagation Neural Network, and Multiple Gamma Poisson Shrinkage, AEs related to Oseltamivir and Baloxavir Marboxil were examined. Venn analysis compared and selected specific AEs associated with each drug. Results Incorporating 15,104 Oseltamivir cases and 1,594 Baloxavir Marboxil cases, Wain analysis unveiled 21 common AEs across neurological, psychiatric, gastrointestinal, dermatological, respiratory, and infectious domains. Oseltamivir exhibited 221 significantly specific AEs, including appendicolith [ROR (95% CI), 459.53 (340.88 ∼ 619.47)], acne infantile [ROR (95% CI, 368.65 (118.89 ∼ 1143.09)], acute macular neuroretinopathy [ROR (95% CI), 294.92 (97.88 ∼ 888.64)], proctitis [ROR (95% CI), 245.74 (101.47 ∼ 595.31)], and Purpura senile [ROR (95% CI), 154.02 (81.96 ∼ 289.43)]. designated adverse events (DMEs) associated with Oseltamivir included fulminant hepatitis [ROR (95% CI), 12.12 (8.30-17.72), n=27], ventricular fibrillation [ROR (95% CI), 7.68 (6.01–9.83), n=64], toxic epidermal necrolysis [ROR (95% CI), 7.21 (5.74–9.05), n=75]. Baloxavir Marboxil exhibited 34 specific AEs, including Melaena [ROR (95% CI), 21.34 (14.15–32.18), n = 23], cystitis haemorrhagic [ROR (95% CI), 20.22 (7.57-54.00), n = 4], ileus paralytic [ROR (95% CI), 18.57 (5.98–57.71), n = 3], and haemorrhagic diathesis [ROR (95% CI), 16.86 (5.43–52.40)), n = 3]. DMEs associated with Baloxavir Marboxil included rhabdomyolysis [ROR (95% CI), 15.50 (10.53 ∼ 22.80), n = 26]. Conclusion Monitoring fulminant hepatitis during Oseltamivir treatment, especially in patients with liver-related diseases, is crucial. Oseltamivir’s potential to induce abnormal behavior, especially in adolescents, necessitates special attention. Baloxavir Marboxil, with lower hepatic toxicity, emerges as a potential alternative for patients with liver diseases. During Baloxavir Marboxil treatment, focused attention on the occurrence of rhabdomyolysis is advised, necessitating timely monitoring of relevant indicators for those with clinical manifestations. The comprehensive data aims to provide valuable insights for clinicians and healthcare practitioners, facilitating an understanding of the safety profiles of these influenza treatments in real-world scenarios.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.05.2024
Tilføjet 9.05.2024
Abstract Background Diarrhea poses a significant threat to the lives of children in The Gambia, accounting for approximately 9% of all deaths among children under the age of five. Addressing and reducing child mortality from diarrhea diseases is crucial for achieving the Sustainable Development Goal (SDG) 3, specifically target 3.2, which aims to eliminate preventable deaths in newborns and children under the age of five by 2030. Thus, this research aims to assess the prevalence and contextual factors associated with diarrhea among under-five children in The Gambia. Methods This research employed secondary data from the 2019/20 Gambia Demographic Health Survey (GDHS). The study initially involved 8,362 women aged between 15 and 49 years. Of these, 6,929 women with children under five were included in this analysis. Data were analyzed using STATA with cross-tabulation and model fitting. Multilevel logistic regression was applied to accommodate the hierarchical structure of the demographic health survey data. The model comparison parameters were BIC, AIC, deviance, and LLR. Variables with a p-value less than 0.05 were selected for multivariable analysis. The statistical significance of the factors was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a p-value of less than 0.05. Results The prevalence of diarrhea in under-five children was 53.2% in males and 46.8% in females. In the final model, Kerewan (aOR = 0.58; 95% CI = 0.33–0.98) and Basse (aOR = 0.59; 95% CI = 0.35–0.98) have significantly lower odds of childhood diarrhea compared to Banjul, female children show slightly lower, yet significant, odds of diarrhea compared to males (aOR = 0.96; 95% CI = 0.86–0.98), deliveries at government health centers are associated with higher odds of childhood diarrhea compared to home births (aOR = 1.24; 95% CI = 1.01–1.52). Mothers with post-secondary education had significantly lower odds of having children with diarrhea than those without any education (aOR = 0.50; 95% CI = 0.26–0.99) after controlling for confounders. Conclusion The study findings indicate that several factors significantly impact the risk of childhood diarrhea in The Gambia. These factors include region of residence, sex of the child, place of delivery, and education level of the mother. The study suggests that existing interventions aimed at improving child health outcomes in the country should take into consideration these influential factors. Addressing these modifiable factors can enhance the effectiveness of interventions and promote better health outcomes for children in Gambia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 9.05.2024
Tilføjet 9.05.2024
Abstract We report a very rare case of Listeria multiple brain abscesses manifested as delirium, which represented diagnostic and therapeutic challenges overcome only by the close cooperation between Infectious Diseases and Neuroradiology, without which a satisfactory outcome would not be achieved. An elderly man presented with confusion and drowsiness with a background of type-II diabetes mellitus. Although computed tomography of the brain only showed frontal lobe oedema, contrast magnetic resonance (MR) imaging showed numerous irregular rim-enhancing lesions containing central diffusion restriction, suggesting multiple pyogenic cerebral abscesses of unclear aetiology. Thereafter, Listeria monocytogenes was isolated from blood cultures, suggesting this as the causative organism. Deemed unsuitable for neurosurgical drainage, the patient received medical management with a protracted course of antibiotics. This case was extremely challenging, due to 1) the impossibility of source control, 2) the small number of effective antibiotics available to treat this condition, and 3) the inevitable antibiotic side-effects, derived from long-term exposure. A successful outcome was only possible thanks to strict close multidisciplinary follow up, requiring frequent MR imaging and a judicious antibiotic choice, including monitoring of their side-effects. Due to the rarity of this condition, there is lack of guidance on its management, hence the importance of multidisciplinary involvement with very close imaging and antibiotic monitoring.
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