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Mian Zi Tee, Soo Ching Lee, Yi Xian Er, Nan Jiun Yap, Romano Ngui, Alice V. Easton, Vinnie Wei Yin Siow, Kee Seong Ng, Christopher Chiong Meng Boey, Kek Heng Chua, Ken Cadwell, P’ng Loke, Yvonne Ai Lian Lim
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 13.08.2022
by Mian Zi Tee, Soo Ching Lee, Yi Xian Er, Nan Jiun Yap, Romano Ngui, Alice V. Easton, Vinnie Wei Yin Siow, Kee Seong Ng, Christopher Chiong Meng Boey, Kek Heng Chua, Ken Cadwell, P’ng Loke, Yvonne Ai Lian Lim
In Malaysia, soil-transmitted helminth (STH) infections still persist among indigenous communities. In the past, local studies have focused mostly on epidemiologic aspects of STH infections with a scarcity of information on the efficacy of deworming treatment. The present study consisted of 2 phases: a cross-sectional phase on current epidemiological status and risk factors of STH infections and a longitudinal study over 6 weeks on triple dose albendazole efficacy against STH infections. A total of 253 participants were recruited at baseline and a pre-tested questionnaire was administered to obtain information on socio-demographics, environmental and behavioural risk factors. Stool samples were evaluated using a modified Kato-Katz technique. Cure rate (CR) and egg reduction rate (ERR) were assessed at 3 weeks following a 3-day course of 400mg albendazole treatment and infection status were observed again at 6 weeks. Baseline positivity of trichuriasis, ascariasis and hookworm infections were 56.1%, 11.9% and 20.2%, respectively. Multivariate analysis showed age below 18 years old (P = 0.004), without latrine in house (P = 0.042) and indiscriminate defecation (P = 0.032) were associated with STH infections. In the longitudinal study (N = 89), CR for trichuriasis was 64.6%, while CR of 100% was observed for both ascariasis and hookworm. ERR was above 90% for all three STH species. A rapid increased of Trichuris trichiura egg output was observed at 6 weeks. In conclusion, STH infections are highly prevalent among indigenous communities. Children and teenagers, poor sanitation and hygiene behaviour were determinants for STH infections. Triple dose albendazole is found to be efficacious against Ascaris lumbricoides and hookworm infections but has moderate curative effect with high ERR against T. trichiura. Although triple dose albendazole regimen has logistic challenges and may not be a routine option, consideration of this treatment regime may still be necessary in selective communities to reduce high intensity of T. trichiura infection.
Læs mere Tjek på PubMedXiaoling Shui, Fang Wang, Ling Li, Qian Liang
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Xiaoling Shui, Fang Wang, Ling Li, Qian Liang
Background Since the successful development of Coronavirus Disease (COVID-19) vaccine, COVID-19 vaccination has been actively advocated all over the world. As the key population for COVID-19 vaccination, the acceptance of Healthcare Workers (HCWs) is not only related to their risk of contracting COVID-19 infection at work, but also affects the decision of the general population on COVID-19 vaccination. Currently, a series of observational studies have been conducted on the acceptance of COVID-19 vaccines among HCWs in China, but there are presently no all-inclusive reviews. Therefore, this paper reviewed to identify a reliable estimate of acceptance rate of COVID-19 vaccine among HCWs in China. Methods We conducted a search on PubMed, EMbase, The Cochrane Library, Web of Science, CNKI (Chinese National Knowledge Infrastructure), Wanfang Database, CBM (Chinese Biomedical Literature Database) and VIP database (Chinese Scientific Journal Database) from January 2020 to June 2022. The quality of included articles was estimated using the Newcastle-Ottawa Quality Assessment tool suitable for cross-sectional studies and STATA 16 was used for analysis, A random-effects model was used to calculate acceptance rate for COVID-19 vaccine, as well as subgroup analysis and sensitivity analysis. Result This review included 18 studies involving 45,760 subjects, all of which were of medium or high quality. Meta-analysis results represented that, the pooled estimated acceptance rate of COVID-19 vaccine among HCWs in China was 78% (95%CI: 73–83%), and the pooled acceptance rate in 2021 (82%, 95%CI: 78–86%) was significantly higher than that in 2020 (73%, 95%CI: 65%-81%). Subgroup analysis showed different acceptance rates for COVID-19 vaccine among HCWs with different characteristics. Conclusion The result revealed that HCWs in China generally have a high acceptance rate of COVID-19 vaccines, but the acceptance rate varies with different characteristics of the population. Therefore, corresponding training should be carried out for HCWs with different characteristics, and they should play an exemplary and leading role in COVID-19 vaccination, so as to improve the vaccination rate of the whole population and form an immune barrier at an early date.
Læs mere Tjek på PubMedJagir R. Hussan, Stuart G. Irwin, Brya Mathews, Simon Swift, Dustin L. Williams, Jillian Cornish
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Jagir R. Hussan, Stuart G. Irwin, Brya Mathews, Simon Swift, Dustin L. Williams, Jillian Cornish
The rise in antibiotic resistance has stimulated research into adjuvants that can improve the efficacy of broad-spectrum antibiotics. Lactoferrin is a candidate adjuvant; it is a multifunctional iron-binding protein with antimicrobial properties. It is known to show dose-dependent antimicrobial activity against Staphylococcus aureus through iron sequestration and repression of β–lactamase expression. However, S. aureus can extract iron from lactoferrin through siderophores for their growth, which confounds the resolution of lactoferrin’s method of action. We measured the minimum inhibitory concentration (MIC) for a range of lactoferrin/ β–lactam antibiotic dose combinations and observed that at low doses (< 0.39 μM), lactoferrin contributes to increased S. aureus growth, but at higher doses (> 6.25 μM), iron-depleted native lactoferrin reduced bacterial growth and reduced the MIC of the β-lactam-antibiotic cefazolin. This differential behaviour points to a bacterial population response to the lactoferrin/ β–lactam dose combination. Here, with the aid of a mathematical model, we show that lactoferrin stratifies the bacterial population, and the resulting population heterogeneity is at the basis of the dose dependent response seen. Further, lactoferrin disables a sub-population from β-lactam-induced production of β-lactamase, which when sufficiently large reduces the population’s ability to recover after being treated by an antibiotic. Our analysis shows that an optimal dose of lactoferrin acts as a suitable adjuvant to eliminate S. aureus colonies using β-lactams, but sub-inhibitory doses of lactoferrin reduces the efficacy of β-lactams.
Læs mere Tjek på PubMedJiayao Lei, Mark Clements, Miriam Elfström, Kalle Conneryd Lundgren, Joakim Dillner
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Jiayao Lei, Mark Clements, Miriam Elfström, Kalle Conneryd Lundgren, Joakim Dillner
Background Prediction of SARS-CoV-2-induced sick leave among healthcare workers (HCWs) is essential for being able to plan the healthcare response to the epidemic. Methods During first wave of the SARS-Cov-2 epidemic (April 23rd to June 24th, 2020), the HCWs in the greater Stockholm region in Sweden were invited to a study of past or present SARS-CoV-2 infection. We develop a discrete time Markov model using a cohort of 9449 healthcare workers (HCWs) who had complete data on SARS-CoV-2 RNA and antibodies as well as sick leave data for the calendar year 2020. The one-week and standardized longer term transition probabilities of sick leave and the ratios of the standardized probabilities for the baseline covariate distribution were compared with the referent period (an independent period when there were no SARS-CoV-2 infections) in relation to PCR results, serology results and gender. Results The one-week probabilities of transitioning from healthy to partial sick leave or full sick leave during the outbreak as compared to after the outbreak were highest for healthy HCWs testing positive for large amounts of virus (ratio: 3.69, (95% confidence interval, CI: 2.44–5.59) and 6.67 (95% CI: 1.58–28.13), respectively). The proportion of all sick leaves attributed to COVID-19 during outbreak was at most 55% (95% CI: 50%-59%). Conclusions A robust Markov model enabled use of simple SARS-CoV-2 testing data for quantifying past and future COVID-related sick leave among HCWs, which can serve as a basis for planning of healthcare during outbreaks.
Læs mere Tjek på PubMedAlberto Amedeo, Giacomo Beci, Maddalena Giglia, Giulia Lombardi, Francesco Bisognin, Federico Chiarucci, Ilaria Corsini, Paola Dal Monte, Marina Tadolini
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Alberto Amedeo, Giacomo Beci, Maddalena Giglia, Giulia Lombardi, Francesco Bisognin, Federico Chiarucci, Ilaria Corsini, Paola Dal Monte, Marina Tadolini
Background Clinical interpretation of trace results by Xpert MTB/RIF Ultra assay (Ultra) used as an initial diagnostic test for tuberculosis (TB) may be challenging. The aim of the study was to evaluate the frequency and epidemiology of trace readouts in routine clinical practice in a low TB prevalence setting and to propose guidance on how to manage patients with trace calls considering the data available (clinical, radiological, bacteriological etc.). Materials and methods A retrospective, observational, monocentric study was conducted at IRCCS Azienda Ospedaliero-Universitaria of Bologna, Italy between November 2017—December 2020. Presumptive TB patients with at least one Ultra trace result during diagnostic workup before treatment were included in the study. Patients with ongoing anti-TB treatment at the time of the trace call result or with no clinical data available were excluded from the study. Results Fifty-nine presumptive TB patients with Ultra trace readouts were included in the study (mean age 37.0 years, 61% males). Four patients had a history of TB in the last 2 years. Twenty-five (42.4%) of the 59 samples with trace results were respiratory material. 57/59 (96.6%) patients started anti-TB treatment soon after obtaining trace results, based on clinical, radiological or other information available, while for two patients with a recent history of TB the trace result did not lead to anti-TB treatment. Culture was positive for M. tuberculosis for 31/59 (52.5%) samples with trace calls: 13/25 (52.0%) were respiratory samples and 18/33 (54.5%) non-respiratory samples. The clinical and/or radiological findings of 47/57 (82.4%) patients given anti-TB therapy improved during treatment. Conclusion In low TB incidence settings, Ultra trace calls in presumptive TB patients should be considered as true-positive and treatment should be started promptly, except in cases of recent history of TB, where careful evaluation of other diagnostic criteria is necessary before starting anti-TB treatment. A decisional algorithm for clinical management is proposed.
Læs mere Tjek på PubMedYoshiki Miyasaka, Jinxi Wang, Kosuke Hattori, Yuko Yamauchi, Miho Hoshi, Kazuto Yoshimi, Saeko Ishida, Tomoji Mashimo
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Yoshiki Miyasaka, Jinxi Wang, Kosuke Hattori, Yuko Yamauchi, Miho Hoshi, Kazuto Yoshimi, Saeko Ishida, Tomoji Mashimo
Immunodeficient animals are valuable models for the engraftment of exogenous tissues; they are widely used in many fields, including the creation of humanized animal models, as well as regenerative medicine and oncology. Compared with mice, laboratory rats have a larger body size and can more easily undergo transplantation of various tissues and organs. Considering the absence of high-quality resources of immunodeficient rats, we used the CRISPR/Cas9 genome editing system to knock out the interleukin-2 receptor gamma chain gene (Il2rg) in F344/Jcl rats—alone or together with recombination activating gene 2 (Rag2)—to create a high-quality bioresource that researchers can freely use: severe combined immunodeficiency (SCID) rats. We selected one founder rat with frame-shift mutations in both Il2rg (5-bp del) and Rag2 ([1-bp del+2-bp ins]/[7-bp del+2-bp ins]), then conducted mating to establish a line of immunodeficient rats. The immunodeficiency phenotype was preliminarily confirmed by the presence of severe thymic hypoplasia in Il2rg-single knockout (sKO) and Il2rg/Rag2-double knockout (dKO) rats. Assessment of blood cell counts in peripheral blood showed that the white blood cell count was significantly decreased in sKO and dKO rats, while the red blood cell count was unaffected. The decrease in white blood cell count was mainly caused by a decrease in lymphocytes. Furthermore, analyses of lymphocyte populations via flow cytometry showed that the numbers of B cells (CD3- CD45+) and natural killer cells (CD3- CD161+) were markedly reduced in both knockout rats. In contrast, T cells were markedly reduced but showed slightly different results between sKO and dKO rats. Notably, our immunodeficient rats do not exhibit growth retardation or gametogenesis defects. This high-quality SCID rat resource is now managed by the National BioResource Project in Japan. Our SCID rat model has been used in various research fields, demonstrating its importance as a bioresource.
Læs mere Tjek på PubMedFassikaw Kebede Bizuneh, Tadesse Tolossa, Nemera Eticha Bekonjo, Bizuneh Wakuma
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Fassikaw Kebede Bizuneh, Tadesse Tolossa, Nemera Eticha Bekonjo, Bizuneh Wakuma
Background Severe Acute Malnutrition (SAM) has become a major public health challenge in developing countries including Ethiopia, especially among the underprivileged population. Ethiopia is among the developing countries with the highest burden of acute malnutrition among under-five children. Though, plenty of studies were done on the magnitude of acute malnutrition among under-five children in Ethiopia, there is a limited evidence on time to recovery from SAM and its predictors among children aged 6–59 months in Ethiopia, particularly in the study area. Objectives The study was aimed to assess the time to recovery from SAM and its predictors among children aged 6–59 months at Asosa general hospital (AGH), Benishangul Gumuz, Ethiopia. Methods A Five years retrospective follow-up study design was employed among 454 children admitted with SAM in AGH from January 2015 to December 2019. The data were extracted from the patient medical records using checklist. The data were coded and entered into Epi-Data 3.1; then exported to STATA/SE-14 for analysis. Proportional Cox regression was performed to identify predictors of recovery time. A proportional hazard assumption was checked. Variables with AHR at 95% CI and P-value less than 0.05 in the multivariable Cox proportional regression was considered as significant predictors of recovery time. Findings Among the 454 included records of children with SAM, 65.4% (95%CI: 50.1, 69.2) of them were recovered at the end of the follow-up with a median recovery time of 15 IQR(11–18)days. The incidence rate of recovery was 5.28 per 100 child days’ observations. Being HIV Negative (AHR = 2.19: 95% CI 1.28, 3.73), Marasmic (AHR = 1.69: 95% CI 1.18, 2.42), and marasmic-kwashiorkor child (AHR = 1.60: 95% CI (1.09, 2.37) independently predicted recovery time. Conclusions Though the time to recovery from severe acute malnutrition was in the acceptable range, the proportion of recovery was found to be low in the study area compared to sphere standard. The prognosis of children with severe acute malnutrition was determined by the HIV status of the child and the type of malnutrition experienced. Further strengthening of malnutrition therapeutic centers and routine checkup of the nutritional status of HIV positive children should be emphasized to reduce child mortality and morbidity from under-nutrition.
Læs mere Tjek på PubMedLorena Vigón, Miguel Galán, Montserrat Torres, Antonio J. Martín-Galiano, Sara Rodríguez-Mora, Elena Mateos, Magdalena Corona, Rosa Malo, Cristina Navarro, María Aránzazu Murciano-Antón, Valentín García-Gutiérrez, Vicente Planelles, Jorge Martínez-Laso, María Rosa López-Huertas, Mayte Coiras, on behalf of the Multidisciplinary Group of Study of COVID-19 (MGS-COVID)
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Lorena Vigón, Miguel Galán, Montserrat Torres, Antonio J. Martín-Galiano, Sara Rodríguez-Mora, Elena Mateos, Magdalena Corona, Rosa Malo, Cristina Navarro, María Aránzazu Murciano-Antón, Valentín García-Gutiérrez, Vicente Planelles, Jorge Martínez-Laso, María Rosa López-Huertas, Mayte Coiras, on behalf of the Multidisciplinary Group of Study of COVID-19 (MGS-COVID)
The clinical presentations of COVID-19 may range from an asymptomatic or mild infection to a critical or fatal disease. Several host factors such as elderly age, male gender, and previous comorbidities seem to be involved in the most severe outcomes, but also an impaired immune response that causes a hyperinflammatory state but is unable to clear the infection. In order to get further understanding about this impaired immune response, we aimed to determine the association of specific HLA alleles with different clinical presentations of COVID-19. Therefore, we analyzed HLA Class I and II, as well as KIR gene sequences, in 72 individuals with Spanish Mediterranean Caucasian ethnicity who presented mild, severe, or critical COVID-19, according to their clinical characteristics and management. This cohort was recruited in Madrid (Spain) during the first and second pandemic waves between April and October 2020. There were no significant differences in HLA-A or HLA-B alleles among groups. However, despite the small sample size, we found that HLA-C alleles from group C1 HLA-C*08:02, -C*12:03, or -C*16:01 were more frequently associated in individuals with mild COVID-19 (43.8%) than in individuals with severe (8.3%; p = 0.0030; pc = 0.033) and critical (16.1%; p = 0.0014; pc = 0.0154) disease. C1 alleles are supposed to be highly efficient to present peptides to T cells, and HLA-C*12:03 may present a high number of verified epitopes from abundant SARS-CoV-2 proteins M, N, and S, thereby being allegedly able to trigger an efficient antiviral response. On the contrary, C2 alleles are usually poorly expressed on the cell surface due to low association with β2-microglobulin (β2M) and peptides, which may impede the adequate formation of stable HLA-C/β2M/peptide heterotrimers. Consequently, this pilot study described significant differences in the presence of specific HLA-C1 alleles in individuals with different clinical presentations of COVID-19, thereby suggesting that HLA haplotyping could be valuable to get further understanding in the underlying mechanisms of the impaired immune response during critical COVID-19.
Læs mere Tjek på PubMedFaisal Alasmari, Mahmoud Mukahal, Alaa Ashraf Alqurashi, Molla Huq, Fatima Alabdrabalnabi, Abdullah AlJurayyan, Shymaa Moshobab Alkahtani, Fatimah Salem Assari, Rahaf Bashaweeh, Rana Salam, Solaf Aldera, Ohud Mohammed Alkinani, Talal Almutairi, Kholoud AlEnizi, Imad Tleyjeh
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Faisal Alasmari, Mahmoud Mukahal, Alaa Ashraf Alqurashi, Molla Huq, Fatima Alabdrabalnabi, Abdullah AlJurayyan, Shymaa Moshobab Alkahtani, Fatimah Salem Assari, Rahaf Bashaweeh, Rana Salam, Solaf Aldera, Ohud Mohammed Alkinani, Talal Almutairi, Kholoud AlEnizi, Imad Tleyjeh
Seroprevalence of SARS-CoV-2 IgG among health care workers (HCWs) is crucial to inform infection control programs. Conflicting reports have emerged on the longevity of SARS-CoV-2 IgG. Our objective is to describe the prevalence of SARS-CoV-2 IgG in HCWs and perform 8 months longitudinal follow-up (FU) to assess the duration of detectable IgG. In addition, we aim to explore the risk factors associated with positive SARS-CoV-2 IgG. The study was conducted at a large COVID-19 public hospital in Riyadh, Saudi Arabia. All HCWs were recruited by social media platform. The SARS-CoV-2 IgG assay against SARS-CoV-2 nucleocapsid antigen was used. Multivariable logistic regression was used to examine association between IgG seropositive status and clinical and epidemiological factors. A total of 2528 (33% of the 7737 eligible HCWs) participated in the survey and 2523 underwent baseline serological testing in June 2020. The largest occupation groups sampled were nurses [n = 1351(18%)], physicians [n = 456 (6%)], administrators [n = 277 (3.6%)], allied HCWs [n = 205(3%)], pharmacists [n = 95(1.2%)], respiratory therapists [n = 40(0.5%)], infection control staff [n = 21(0.27%], and others [n = 83 (1%)]. The total cohort median age was 36 (31–43) years and 66.3% were females. 273 were IgG seropositive at baseline with a seroprevalence of 10.8% 95% CI (9.6%-12.1%). 165/185 and 44/112 were persistently IgG positive, at 2–3 months and 6 months FU respectively. The median (25th– 75th percentile) IgG level at the 3 different time points was 5.86 (3.57–7.04), 3.91 (2.46–5.38), 2.52 (1.80–3.99) respectively. Respiratory therapists OR 2.38, (P = 0.035), and those with hypertension OR = 1.86, (P = 0.009) were more likely to be seropositive. A high proportion of seropositive staff had prior symptoms 214/273(78%), prior anosmia was associated with the presence of antibodies, with an odds ratio of 9.25 (p<0.001), as well as fever and cough. Being a non-smoker, non-Saudi, and previously diagnosed with COVID-19 infection by PCR were statistically significantly different by seroprevalence status. We found that the seroprevalence of IgG against SARS-CoV-2 nucleocapsid antigen was 10.8% in HCWs at the peak of the pandemic in Saudi Arabia. We also observed a decreasing temporal trend of IgG seropositivity over 8 months follow up period.
Læs mere Tjek på PubMedCornel Anyisile Kibona, Zhang Yuejie, Lu Tian
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Cornel Anyisile Kibona, Zhang Yuejie, Lu Tian
Beef meat production is the key to reducing poverty, achieving food security and nutrition, promoting exports, economic growth, and industrialization. Despite a large number of beef cattle, Tanzania continues to import beef meat and its contribution to GDP is low. Thus, this study used time-series panel data to analyze the beef meat industry in Tanzania from 1990 to 2019, with a particular focus on identifying the reasons and direction of the correlation between beef meat output and its determinants in the production processes. The study applied both descriptive statistics and the Cobb-Douglas production function model, using the Ordinary Least Squares (OLS) based estimator to analyze the data. Descriptive analyses revealed that Tanzania’s beef meat production increased by 283,871 tons (59.3%-a positive trend) between 1990 and 2019. This increase was accompanied by approximately 29.75%, 53.05%, and 42.42% increases in beef cattle yield (carcass weight (hg) per head, beef cattle inventory, and the number of beef cattle slaughtered, respectively). However, the analysis further revealed that a 2.8% decrease in beef cattle extraction (low harvesting) rate due to low market participation, continues to be a critical barrier to increasing beef meat production in Tanzania. Furthermore, econometric estimates showed that the key factors that positively influenced beef meat output at a 5% significance level (P < 0.05) included beef cattle population (inventory), beef cattle yield (carcass weight (kg) per head, and the number of beef cattle slaughtered, with elasticity coefficients of 0.146, 0.469, and 0.564, respectively). While the number of beef cattle exported positively influenced beef meat production at the 10% significance level (P < 0.1) with an elasticity coefficient of 0.028. Surprisingly, invested credit to agriculture (farm credits) and imported pure-bred beef cattle had a negative impact on beef meat output but were statistically insignificant at P < 0.05. The results of this study have implications as to what factors need to be addressed to further improve beef meat production, thereby reducing its reliance on imports. We suggest that the Tanzania government and policymakers need to establish balanced policies for beef farmers and appropriately manage them so that beef meat development can be induced, contributing to poverty reduction, food security, and economic development.
Læs mere Tjek på PubMedBrandon W. Yan, Maya Shashoua, Jose F. Figueroa
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Brandon W. Yan, Maya Shashoua, Jose F. Figueroa
The COVID pandemic disrupted health care spending and utilization, and the Medicare Shared Savings Program (MSSP), Medicare’s largest value-based payment model with 11.2 million assigned beneficiaries, was no exception. Despite COVID, the 513 accountable care organizations (ACO) in MSSP returned a program record $1.9 billion in net savings to Medicare in 2020. To understand the extent of COVID’s impact on MSSP cost and quality, we describe how ACO spending changed in 2020 and further analyze changes in measured quality and utilization. We found that non-COVID per capita spending in MSSP fell by 8.3 percent from $11,496 to $10,537 (95% confidence interval(CI),-1,223.8 to-695.4, p<0.001), driven by 14.6% and 7.5% reductions in per capita acute inpatient and outpatient spending, respectively. Utilization fell across inpatient, emergency, and outpatient settings. On quality metrics, preventive screening rates remained stable or improved, while control of diabetes and blood pressure worsened. Large reductions in non-COVID utilization helped ACOs succeed financially in 2020, but worsening chronic disease measures are concerning. The appropriateness of the benchmark methodology and exclusion of COVID-related spending, especially as the virus approaches endemicity, should be revisited to ensure bonus payments reflect advances in care delivery and health outcomes rather than COVID-related shifts in spending and utilization patterns.
Læs mere Tjek på PubMedGeoffrey Pagès, Meike Hammer, Jean-Guillaume Grand, Iban Irubetagoyena
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Geoffrey Pagès, Meike Hammer, Jean-Guillaume Grand, Iban Irubetagoyena
Objectives To evaluate long-term outcome using the BioMedtrix™ TPLO Curve® plate in dogs with cranial cruciate ligament disease (CrCLd) treated by tibial plateau leveling osteotomy (TPLO). Study design Retrospective case study. Animals Dogs (n = 323, 337 stifles). Methods Medical records were searched for dogs presented with CrCLd and treated by TPLO with the BioMedtrix™ TPLO Curve® plate for 3.5 mm screws between March 2018 and December 2020. Tibial plateau angles (TPA) were measured on preoperative, postoperative, and follow-up radiographs. Changes in TPA between postoperative and follow-up radiographs (ModTPA) were calculated. Radiographic bone healing was scored. Complications were evaluated. Surgical site infections (SSI) were compared to a control group of dogs treated with the Synthes™ TPLO plate between January and December 2017. Owners of both groups were contacted by telephone at least 1 year postoperatively. Results The BioMedtrix™ group was composed of 237 dogs (248 stifles), the control group was composed of 86 dogs (89 stifles). In the BioMedtrix™ group, radiographic follow-up was performed at a median of 48 days. Average ModTPA was 1.2°. Bone healing was graded as complete, good, poor, and none in 18%, 62%, 20%, and 0%, respectively. At a median of 786 days postoperatively, minor and major postoperative complications were observed in 6 (2.4%) and 32 (12.9%) cases in this group, respectively. During the first year following the surgery, 23 (9.3%) and 12 (13.5%) cases suffered a SSI, of which 12 (4.8%) and 7 (7.9%) had their implant explanted in the BioMedtrix™ group and the control group, respectively. There was no significant difference between groups for SSI and implant explantations (p = 0.31 and p = 0.29, respectively). Conclusion The BioMedtrix™ TPLO Curve® plate provided a reliable fixation system for osteotomy healing after TPLO. Bone healing and long-term complication rates were similar to previous studies using other implants. SSI rates were similar between the BioMedtrix™ group and the control group. The antimicrobial HyProtect® coating of the plate did not reduce SSI in this study. Clinical significance The BioMedtrix™ TPLO Curve® plate can be safely used for TPLO. The value of the antimicrobial HyProtect® coating of the plate may be questioned, as SSI rate was not lower in this study compared to the control group or previous reports.
Læs mere Tjek på PubMedOlivier Schorr, Sarah Blach, Christine Thurnheer, Christian Ruis, Jean-Francois Dufour
PLoS One Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
by Olivier Schorr, Sarah Blach, Christine Thurnheer, Christian Ruis, Jean-Francois Dufour
Aims of the study Since 2014, the Swiss Hepatitis Strategy (SHS) has targeted the elimination of Hepatitis C Virus (HCV) in Switzerland. The epidemiology of HCV is diverse across Swiss cantons, therefore cantonal-level screening and treatment strategies should be developed. This study aimed to identify scenarios to achieve HCV elimination in the canton of Bern by 2030. Methods A preexisting Markov disease burden model was populated with data for Bern, and used to forecast the current and future prevalence of HCV, annual liver-related deaths (LRDs), and incidence of hepatocellular carcinoma and decompensated cirrhosis until 2030. Scenarios were developed to assess the current standard of care and potential long-term impact of the COVID-19 crisis on the HCV infected population. Additionally, potential scenarios for achieving the WHO 2030 targets and the SHS 2025 and 2030 targets (reduction of new cases of HCV, HCV-related mortality and viremic HCV cases) were identified. Results In 2019, there were an estimated 4,600 (95% UI: 3,330–4,940) viremic infections in the canton of Bern and 57% (n = 2,600) of viremic cases were diagnosed. This modelling forecasted a 10% increase in LRDs (28 in 2020 to 31 in 2030) with the current standard of care and a 50% increase in LRDs in a scenario assuming long-term delays. To achieve the WHO and SHS targets, the canton of Bern needs to increase the annual number of patients diagnosed (from 90 in 2019 to 250 per year in 2022–2024 [WHO], or 500 per year in 2022–2025 [SHS]) and treated (from 130 in 2019 to 340 per year in 2022–2024 [WHO] or 670 per year in 2022–2025 [SHS]). Conclusions The SHS goals and the WHO targets for HCV elimination can be achieved in the Swiss canton of Bern by 2030; however, not at the current pace of screening, linkage to care and treatment.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.08.2022
Tilføjet 12.08.2022
Abstract
Background
Neisseria gonorrhoeae, the causative agent for sexually transmitted infection (STI) gonorrhoea, has emerged with a significant public health impact on acquiring resistance to antimicrobials available for treatment. The resistance of N. gonorrhoeae limit treatment options and contributed to high morbidity associated with gonorrhoea. Data on antimicrobial resistance (AMR) profiles in N. gonorrhoeae is scares in Zambia. This study aimed to determine the antibiotic susceptibilities in N. gonorrhoeae isolates from Lusaka, Zambia.
Methods
A prospective cross-sectional study was conducted on 630 STI patients who presented with urethral or vaginal discharge from 2019 to 2020. Urethral and endocervical secretions were cultured on Modified Thayer Martin agar and incubated at 36 °C ± 1 °C in 5% CO2 for 24 h. Identification of N. gonorrhoeae isolates was achieved by Gram stain, oxidase, nitrocefin disk, BactiCard Neisseria, and Viteck® Compact. The AMR profiles were determined using E-test. Statistical significant was determined by Pearson’s Chi-square test, Mann-Whitney U test, or logistic regression with p-values of < 0.05 indicating significance.
Results
A total of 630 patients were recruited of which 46% (290/630) with the median of 29 years and interquartile range (IQR) of 19–39 years were male. The median of the females was 26 years and IQR of 15–37 years. Neisseria gonorrhoeae was isolated from 19.4% (122/630) patients of which 72.9% (89/122) were male, with highest prevalence of isolation in the age category of 25–34 years. The prevalence of resistance was high to penicillin (85.2%), tetracycline (68.9%) and ciprofloxacin (59.8%) with MIC90 of 32 µg/mL, 8 µg/mL, and 8 µg/mL respectively. The isolates had reduced susceptibility to cefixime (1.6%), spectinomycin (4.9%) and (4.9%) for azithromycin. All isolates were susceptible to ceftriaxone. Risk factors associated with AMR were douching in females (AOR 6.69, 95% CI; 1.11–40.31, p = 0.039), female gender (AOR 7.64, 95% CI; 1.11–52.33, p = 0.048), HIV-positivity (AOR 26.59, 95% CI; 3.67–192.7, p = 0.005), no condom use or unprotected sex (AOR 5.48, 95% CI; 1.17–22.75 p = 0.026), sex trading (AOR 4.19, 95% CI; 1.55–11.33, p = 0.010), and over-counter treatment of ciprofloxacin (AOR 3.44, 95% CI; 1.17–22.75, p = 0.023).
Conclusion
The N. gonorrhoeae resistance to penicillin, tetracycline and ciprofloxacin was high necessitating revision of the treatment guidelines. However, no resistance to ceftriaxone was detected. Therefore, monitoring of antibiotic resistance remains critical in Zambia.
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Irith De Baetselier, Christophe Van Dijck, Chris Kenyon, Jasmine Coppens, Johan Michiels, Tessa de Block, Hilde Smet, Sandra Coppens, Fien Vanroye, Joachim Jakob Bugert, Philipp Girl, Sabine Zange, Laurens Liesenborghs, Isabel Brosius, Johan van Griensven, Philippe Selhorst, Eric Florence, Dorien Van den Bossche, Kevin K. Ariën, Antonio Mauro Rezende, Koen Vercauteren, Marjan Van Esbroeck, Irith De Baetselier, Christophe Van Dijck, Tessa de Block, Kadrie Ramadan, Tom Platteau, Karin Van Looveren, Jolien Baeyens, Cindy Van Hoyweghen, Marianne Mangelschots, Leo Heyndrickx, Anne Hauner, Betty Willems, Johan van Griensven, Emmanuel Bottieau, Patrick Soentjens, Nicole Berens, Saskia Van Henten, Stefanie Bracke, Thibaut Vanbaelen, Leen Vandenhove, Jacob Verschueren, Dorien Van den Bossche, Marie Laga, Jef Vanhamel, Bea Vuylsteke, Marjan Van Esbroeck
Nature, 12.08.2022
Tilføjet 12.08.2022
Nature Medicine, Published online: 12 August 2022; doi:10.1038/s41591-022-02004-wFindings of unrecognized or asymptomatic monkeypox (MPXV) virus infections with replication-competent virus in humans suggest a lack of recognized, clinical symptoms could play a role in virus transmission and the magnitude of the 2022 MPXV outbreak.
Læs mere Tjek på PubMedNature, 12.08.2022
Tilføjet 12.08.2022
Nature Medicine, Published online: 12 August 2022; doi:10.1038/s41591-022-01954-5A large cohort of non-hospitalized adults with confirmed SARS-CoV-2 infection and matched controls were studied to investigate the symptoms of long COVID. SARS-CoV-2 infection was associated with 62 symptoms (three clusters) that persisted beyond 12 weeks, and with a range of risk factors.
Læs mere Tjek på PubMedImmunity, 26.10.2022
Tilføjet 12.08.2022
Publication date: Available online 12 August 2022Source: ImmunityAuthor(s): Carina Saggau, Gabriela Rios Martini, Elisa Rosati, Silja Meise, Berith Messner, Ann-Kristin Kamps, Nicole Bekel, Johannes Gigla, Ruben Rose, Mathias Voß, Ulf M. Geisen, Hayley M. Reid, Melike Sümbül, Florian Tran, Dennis K. Berner, Yascha Khodamoradi, Maria J.G.T. Vehreschild, Oliver Cornely, Philipp Koehler, Andi Krumbholz
Læs mere Tjek på PubMedInfection, 12.08.2022
Tilføjet 12.08.2022
Abstract
Berlin is amongst the cities most affected by the current monkeypox outbreak. Here, we report clinical characteristics of the first patients with confirmed monkeypox admitted to our center. We analyzed anamnestic, clinical, and laboratory data. Within a period of 2 weeks, six patients were hospitalized in our unit. All were MSM and had practiced condomless receptive anal intercourse in the weeks preceding admission. The chief complaint in all patients but one was severe anal pain unprecedented in severity. Investigations revealed proctitis, as well as anal and rectal ulcers with detection of monkeypox virus. Our findings support the hypothesis that sexual transmission plays a role in the current outbreak.
Læs mere Tjek på PubMedM.J. Piotrowska, K. Sakowski, J. Horn, R. Mikolajczyk, A. Karch
Clinical Microbiology and Infection, 11.08.2022
Tilføjet 12.08.2022
The introduction of MDR-E by colonized patients transferred from high-prevalence countries has led to several large outbreaks of MDR-E in low-prevalence countries with the risk of propagated spread to the community. The goal of this study is to derive a strategy to counteract MDR-E spread at the regional healthcare network level.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 11.08.2022
Tilføjet 12.08.2022
AbstractBackgroundThe trajectory of liver fibrosis is not well understood in the contemporary era of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) therapy.MethodsWe assessed the Enhanced Liver Fibrosis (ELF) score, aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) in 116 women with HIV/HCV coinfection over a 4-year period. Random-effects linear regression models examined the rate of fibrosis change 1–2 years before starting HCV treatment, within 1 year before starting (peri-HCV treatment), within 1 year after and 1–2 years post-HCV treatment in unadjusted and adjusted models including age, race, and changes from pretreatment of factors that might affect fibrosis (eg, alcohol, integrase strand inhibitor [INSTI] use, waist circumference, CD4 count).ResultsINSTI use nearly doubled from pre- to peri-HCV treatment. In unadjusted analysis, there was a 3.3% rate of rise in ELF pre-HCV treatment, 2.2% and 3.6% rate of decline during the peri- and 1-year post-HCV treatment period, respectively, followed by a 0.3% rise. Similar findings were observed for APRI and FIB-4. There was little effect on the estimated fibrosis trajectories after adjustment.ConclusionsThe apparent lack of decline in biomarkers of liver fibrosis beyond 1 year after HCV cure suggests that continued monitoring of liver fibrosis and interventions to mitigate progression in people with HIV after HCV cure remains essential.
Læs mere Tjek på PubMedClinical Infectious Diseases, 9.08.2022
Tilføjet 12.08.2022
AbstractBackgroundCervicovaginal CD4+ T cells are preferential targets for human immunodeficiency virus (HIV) infection and have consequently been used as a proxy measure for HIV susceptibility. The ECHO randomized trial offered a unique opportunity to consider the association between contraceptives and Th17-like cells within a trial designed to evaluate HIV risk. In a mucosal substudy of the ECHO trial, we compared the impact of initiating intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper-IUD, and the levonorgestrel (LNG) implant on cervical T cells.MethodsCervical cytobrushes from 58 women enrolled in the ECHO trial were collected at baseline and 1 month after contraceptive initiation. We phenotyped cervical T cells using multiparameter flow cytometry, characterized the vaginal microbiome using 16s sequencing, and determined proteomic signatures associated with Th17-like cells using mass spectrometry.ResultsUnlike the LNG implant or copper-IUD, DMPA-IM was associated with higher frequencies of cervical Th17-like cells within 1 month of initiation (P = .012), including a highly susceptible, activated population co-expressing CD38, CCR5, and α4β7 (P = .003). After 1 month, women using DMPA-IM also had more Th17-like cells than women using the Cu-IUD (P = .0002) or LNG implant (P = .04). Importantly, in women using DMPA-IM, proteomic signatures signifying enhanced mucosal barrier function were associated with the increased abundance of Th17-like cells. We also found that a non–Lactobacillus-dominant microbiome at baseline was associated with more Th17-like cells post–DMPA-IM (P = .03), although this did not influence barrier function.ConclusionsOur data suggest that DMPA-IM–driven accumulation of HIV-susceptible Th17-like cells might be counteracted by their role in maintaining mucosal barrier integrity.
Læs mere Tjek på PubMedClinical Infectious Diseases, 8.08.2022
Tilføjet 12.08.2022
AbstractBackgroundMany interventional in-patient COVID-19 trials assess primary outcomes through day 28 post-randomization. Since a proportion of patients experience protracted disease or relapse, such follow-up period may not fully capture the course of the disease, even when randomization occurs a few days after hospitalization.MethodsAmong adults hospitalized with COVID-19 in Eastern Denmark from March 18, 2020 - January 12, 2021 we assessed: all-cause mortality, recovery and sustained recovery 90 days after admission, and readmission and all-cause mortality 90 days after discharge. Recovery was defined as hospital discharge and sustained recovery as recovery and alive without readmissions for 14 consecutive days.ResultsAmong 3,386 patients included in the study 2,796 (82.6%) reached recovery and 2,600 (77.0%) achieved sustained recovery. Of those discharged from hospital, 556 (19.9%) were readmitted, and 289 (10.3%) died. Overall, the median time to recovery was 6 days (Interquartile range (IQR), 3-10), and 19 days (IQR, 11-33) among patients in intensive care in the first two days of admission.ConclusionsPost-discharge readmission and mortality rates were substantial. Therefore, sustained recovery should be favored to recovery outcomes in clinical COVID-19 trials. A 28-day follow-up period may be too short the critically ill.
Læs mere Tjek på PubMedKevin H M Kuo, D Mark Layton, Ashutosh Lal, Hanny Al-Samkari, Joy Bhatia, Penelope A Kosinski, Bo Tong, Megan Lynch, Katrin Uhlig, Elliott P Vichinsky
Lancet, 13.08.2022
Tilføjet 12.08.2022
These efficacy and safety results support the continued investigation of mitapivat for the treatment of both α-thalassaemia and β-thalassaemia.
Læs mere Tjek på PubMedMichelle M Mello, Douglas J Opel, Regina M Benjamin, Timothy Callaghan, Renee DiResta, Jad A Elharake, Lisa C Flowers, Alison P Galvani, Daniel A Salmon, Jason L Schwartz, Noel T Brewer, Alison M Buttenheim, Richard M Carpiano, Chelsea Clinton, Peter J Hotez, Rekha Lakshmanan, Yvonne A Maldonado, Saad B Omer, Joshua M Sharfstein, Arthur Caplan
Lancet, 9.07.2022
Tilføjet 12.08.2022
Many high-income countries have rapidly pivoted from hard decisions about who may receive COVID-19 vaccines, due to shortages, to equally hard decisions about who must receive them. As lasting containment of COVID-19 remains elusive, many nations—from Costa Rica, to Austria, to Turkmenistan—are turning to vaccination mandates of various kinds.1 Mandates, however, are controversial in many countries. Austria's proposed mandate for adults, for example, provoked mass protests. Some objectors argue mandates represent undue encroachment on individual liberty.
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