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Attila I. Engloner, Márta Vargha, Péter Kós, Andrea K. Borsodi
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Attila I. Engloner, Márta Vargha, Péter Kós, Andrea K. Borsodi In freshwaters, microbial communities are of outstanding importance both from ecological and public health perspectives, however, they are threatened by the impact of global warming. To reveal how different prokaryotic communities in a large temperate river respond to environment conditions related to climate change, the present study provides the first detailed insight into the composition and spatial and year-round temporal variations of planktonic and epilithic prokaryotic community. Microbial diversity was studied using high-throughput next generation amplicon sequencing. Sampling was carried out monthly in the midstream and the littoral zone of the Danube, upstream and downstream from a large urban area. Result demonstrated that river habitats predominantly determine the taxonomic composition of the microbiota; diverse and well-differentiated microbial communities developed in water and epilithon, with higher variance in the latter. The composition of bacterioplankton clearly followed the prolongation of the summer resulting from climate change, while the epilithon community was less responsive. Rising water temperatures was associated with increased abundances of many taxa (such as phylum Actinobacteria, class Gammaproteobacteria and orders Synechococcales, Alteromonadales, Chitinophagales, Pseudomonadales, Rhizobiales and Xanthomonadales), and the composition of the microbiota also reflected changes of several further environmental factors (such as turbidity, TOC, electric conductivity, pH and the concentration of phosphate, sulphate, nitrate, total nitrogen and the dissolved oxygen). The results indicate that shift in microbial community responding to changing environment may be of crucial importance in the decomposition of organic compounds (including pollutants and xenobiotics), the transformation and accumulation of heavy metals and the occurrence of pathogens or antimicrobial resistant organisms.
Læs mere Tjek på PubMedYuji Yoshida, Masanori Atsukawa, Chisa Kondo, Michika Kitamura, Kaori Shioda-Koyano, Tadamichi Kawano, Hiroki Ono, Korenobu Hayama, Tomomi Okubo, Taeang Arai, Norio Itokawa, Katsuhiko Iwakiri
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Yuji Yoshida, Masanori Atsukawa, Chisa Kondo, Michika Kitamura, Kaori Shioda-Koyano, Tadamichi Kawano, Hiroki Ono, Korenobu Hayama, Tomomi Okubo, Taeang Arai, Norio Itokawa, Katsuhiko Iwakiri Although eliminating HCV can prevent hepatocellular carcinoma (HCC), some patients develop HCC even after obtaining sustained virologic response (SVR). Previously, we developed a new formula to predict advanced liver fibrosis. This study aimed to clarify the usefulness of this formula for predicting HCC after achieving SVR. Among 351 consecutive patients who had been treated with direct-acting antivirals, 299 were included in this study. New formula scores were used as a marker for predicting liver fibrosis and as a predictive model for HCC incidence. The participants were 172 men and 127 women with a median age of 68 years. The median new formula score was -1.291. The cumulative HCC incidence rates were 4.3%, 9.7%, and 12.5% at 1, 3, and 5 years, respectively. The cumulative incidence of HCC was significantly higher in patients with a history of HCC than in those without treatment history of HCC (P = 2.52×10−26). Multivariate analysis revealed that male (HR = 6.584, 95% CI = 1.291–33.573, P = 0.023) and new formula score (HR = 1.741, 95% CI = 1.041–2.911, P = 0.035) were independent factors associated with the development of HCC in patients without a treatment history of HCC. The optimal cutoff value for predicting the development of HCC was -0.214. The cumulative incidence rates of HCC in patients with new formula scores ≥-0.214 were 5.4%, 15.3%, and 15.3% at 1, 3, and 5 years, respectively, whereas the incidence rates of HCC in patients with new formula scores
Læs mere Tjek på PubMedKamila Romanowski, Mohammad Ehsanul Karim, Mark Gilbert, Victoria J. Cook, James C. Johnston
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Kamila Romanowski, Mohammad Ehsanul Karim, Mark Gilbert, Victoria J. Cook, James C. Johnston Background Recent data have demonstrated that healthcare use after treatment for respiratory tuberculosis (TB) remains elevated in the years following treatment completion. However, it remains unclear which TB survivors are high healthcare users and whether any variation exists within this population. Thus, the primary objective of this study was to identify distinct profiles of high healthcare-use TB survivors to help inform post-treatment support and care. Methods Using linked health administrative data from British Columbia, Canada, we identified foreign-born individuals who completed treatment for incident respiratory TB between 1990 and 2019. We defined high healthcare-use TB survivors as those in the top 10% of annual emergency department visits, hospital admissions, or general practitioner visits among the study population during the five-year period immediately following TB treatment completion. We then used latent class analysis to categorize the identified high healthcare-use TB survivors into subgroups. Results Of the 1,240 people who completed treatment for respiratory TB, 258 (20.8%) people were identified as high post- TB healthcare users. Latent class analysis results in a 2-class solution. Class 1 (n = 196; 76.0%) included older individuals (median age 71.0; IQR 59.8, 79.0) with a higher probability of pre-existing hypertension and diabetes (41.3% and 33.2%, respectively). Class 2 (n = 62; 24.0%) comprised of younger individuals (median age 31.0; IQR 27.0, 41.0) with a high probability (61.3%) of immigrating to Canada within five years of their TB diagnosis and a low probability (11.3%) of moderate to high continuity of primary care. Discussion Our findings suggest that foreign-born high healthcare-use TB survivors in a high-resource setting may be categorized into distinct profiles to help guide the development of person-centred care strategies targeting the long-term health impacts TB survivors face.
Læs mere Tjek på PubMedMd. Mahi Imam Mollah
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Md. Mahi Imam Mollah Dorsal switch protein 1 (DSP1) acts as a damage-associated molecular pattern (DAMP) molecule to activate immune responses in Tenebrio molitor. From a previous study in Spodoptera exigua, we found that DSP1 activates Toll immune signalling pathway to induce immune responses by melanisation, PLA2 activity and AMP synthesis. However, the target site of DSP1 in this pathway remains unknown. The objective of this study was to determine the role of spätzle processing enzyme in the DSP1 induced toll immune signalling pathway. To address this, we analyzed spätzle processing enzyme (Tm-SPE) of the three-step serine protease cascade of T. molitor Toll pathway. Tm-SPE expressed in all developmental stages and larval tissues. Upon immune challenge, its expression levels were upregulated but significantly reduced after RNA interference (RNAi). In addition, the induction of immune responses upon immune challenge or recombinant DSP1 injection was significantly increased. Loss of function using RNA interference revealed that the Tm-SPE is involved in connecting DSP1 induced immune responses like hemocyte nodule formation, phenoloxidase (PO) activity, phospholipase A2 (PLA2) activity and antimicrobial peptide (AMP) synthesis. These suggest that Tm-SPE controls the DSP1 induced activation of Toll immune signalling pathway required for both cellular and humoral immune responses. However, to confirm the target molecule of DSP1 in three-step proteolytic cascade, we have to check other upstream serine proteases like Spatzle activating enzyme (SAE) or modular serine protease (MSP).
Læs mere Tjek på PubMedTania Aznielle-Rodríguez, Lídice Galán-García, Marlis Ontivero-Ortega, Karen Aguilar-Mateu, Ana M. Castro-Laguardia, Ana Fernández-Nin, Daysi García-Agustín, Mitchell Valdés-Sosa
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Tania Aznielle-Rodríguez, Lídice Galán-García, Marlis Ontivero-Ortega, Karen Aguilar-Mateu, Ana M. Castro-Laguardia, Ana Fernández-Nin, Daysi García-Agustín, Mitchell Valdés-Sosa Purpose This study aimed to identify the most effective summary cognitive index predicted from spatio-temporal gait features (STGF) extracted from gait patterns. Methods The study involved 125 participants, including 40 young (mean age: 27.65 years, 50% women), and 85 older adults (mean age: 73.25 years, 62.35% women). The group of older adults included both healthy adults and those with Mild Cognitive Impairment (MCI). Participant´s performance in various cognitive domains was evaluated using 12 cognitive measures from five neuropsychological tests. Four summary cognitive indexes were calculated for each case: 1) the z-score of Mini-Mental State Examination (MMSE) from a population norm (MMSE z-score); 2) the sum of the absolute z-scores of the patients’ neuropsychological measures from a population norm (ZSum); 3) the first principal component scores obtained from the individual cognitive variables z-scores (PCCog); and 4) the Mahalanobis distance between the vector that represents the subject’s cognitive state (defined by the 12 cognitive variables) and the vector corresponding to a population norm (MDCog). The gait patterns were recorded using a body-fixed Inertial Measurement Unit while participants executed four walking tasks (normal, fast, easy- and hard-dual tasks). Sixteen STGF for each walking task, and the dual-task costs for the dual tasks (when a subject performs an attention-demanding task and walks at the same time) were computed. After applied Principal Component Analysis to gait measures (96 features), a robust regression was used to predict each cognitive index and individual cognitive variable. The adjusted proportion of variance (adjusted-R2) coefficients were reported, and confidence intervals were estimated using the bootstrap procedure. Results The mean values of adjusted-R2 for the summary cognitive indexes were as follows: 0.0248 for MMSE z-score, 0.0080 for ZSum, 0.0033 for PCCog, and 0.4445 for MDCog. The mean adjusted-R2 values for the z-scores of individual cognitive variables ranged between 0.0009 and 0.0693. Multiple linear regression was only statistically significant for MDCog, with the highest estimated adjusted-R2 value. Conclusions The association between individual cognitive variables and most of the summary cognitive indexes with gait parameters was weak. However, the MDCog index showed a stronger and significant association with the STGF, exhibiting the highest value of the proportion of the variance that can be explained by the predictor variables. These findings suggest that the MDCog index may be a useful tool in studying the relationship between gait patterns and cognition.
Læs mere Tjek på PubMedYongxian Fan, Meng Liu, Guicong Sun
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Yongxian Fan, Meng Liu, Guicong Sun Coronaviruses have affected the lives of people around the world. Increasingly, studies have indicated that the virus is mutating and becoming more contagious. Hence, the pressing priority is to swiftly and accurately predict patient outcomes. In addition, physicians and patients increasingly need interpretability when building machine models in healthcare. We propose an interpretable machine framework(KISM) that can diagnose and prognose patients based on blood test datasets. First, we use k-nearest neighbors, isolated forests, and SMOTE to pre-process the original blood test datasets. Seven machine learning tools Support Vector Machine, Extra Tree, Random Forest, Gradient Boosting Decision Tree, eXtreme Gradient Boosting, Logistic Regression, and ensemble learning were then used to diagnose and predict COVID-19. In addition, we used SHAP and scikit-learn post-hoc interpretability to report feature importance, allowing healthcare professionals and artificial intelligence models to interact to suggest biomarkers that some doctors may have missed. The 10-fold cross-validation of two public datasets shows that the performance of KISM is better than that of the current state-of-the-art methods. In the diagnostic COVID-19 task, an AUC value of 0.9869 and an accuracy of 0.9787 were obtained, and ultimately Leukocytes, platelets, and Proteina C reativa mg/dL were found to be the most indicative biomarkers for the diagnosis of COVID-19. An AUC value of 0.9949 and an accuracy of 0.9677 were obtained in the prognostic COVID-19 task and Age, LYMPH, and WBC were found to be the most indicative biomarkers for identifying the severity of the patient.
Læs mere Tjek på PubMedYu-Sung Chiu, Kuo-Jen Wu, Seong-Jin Yu, Kun-Lieh Wu, Yu-Syuan Wang, Jing Lin, Chia-Ying Chu, Shuchun Chen, Hsi Chen, Shu-Ching Hsu, Yun Wang, Yun-Hsiang Chen
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Yu-Sung Chiu, Kuo-Jen Wu, Seong-Jin Yu, Kun-Lieh Wu, Yu-Syuan Wang, Jing Lin, Chia-Ying Chu, Shuchun Chen, Hsi Chen, Shu-Ching Hsu, Yun Wang, Yun-Hsiang Chen Abnormal accumulation of alpha-synuclein (αSyn) in the remaining nigra dopaminergic neurons is a common neuropathological feature found in patients with Parkinson’s disease (PD). Antibody-based immunotherapy has been considered a potential approach for PD treatment. This study aims to investigate the effectiveness of active immunization against αSyn in a mouse model of PD. Adult mice were immunized with or without a synthetic peptide containing the C-terminal residues of human αSyn and activation epitopes, followed by an intranigral injection of adeno-associated virus vectors for overexpressing human αSyn. Upon the peptide injection, αSyn-specific antibodies were raised, accompanied by degeneration of dopaminergic neurons and motor deficits. Furthermore, the induction of neuroinflammation was postulated by the elevation of astroglial and microglial markers in the immunized mice. Instead of lessening αSyn toxicity, this peptide vaccine caused an increase in the pathogenic species of αSyn. Our data demonstrated the potential adverse effects of active immunization to raise antibodies against the C-terminal fragment of αSyn. This drawback highlights the need for further investigation to weigh the pros and cons of immunotherapy in PD. Applying the αSyn C-terminal peptide vaccine for PD treatment should be cautiously exercised. This study provides valuable insights into the intricate interplay among immune intervention, αSyn accumulation, and neurodegeneration.
Læs mere Tjek på PubMedQuaye Benedicta
PLoS One Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
by Quaye Benedicta The ductus arteriosus is a muscular artery connecting the pulmonary trunk directly to the aorta in fetal circulation in order to by-pass the fluid filled lungs. Post-natally, this vessel is speculated to undergo obliteration, fibrosis and ultimately metamorphosize into a band of ligament, thereby changing name from the ductus arteriosus to the ligamentum arteriosum (LA). Earlier studies into the innervation of the ductus arteriosus reported innervation from the left aortic and vagus nerves. However, information of what becomes of the innervation is scanty and contradictory. I hypothesized that; this fetal shunt still receives innervation even in post-uterine life. To test this, LA of human, pig, and wild-type mice were studied using double-immunofluorescence labeling using antibodies directed against structural and general neuronal marker proteins (Smooth muscle actin and Protein gene product 9.5 (PGP 9.5, respectively). Additionally, TEM studies were performed on mouse LA. Results from the present study demonstrates an extensive innervation of the LA in animals (mice and pigs) and in senescent humans validated by two independent methods, i.e., immunolabeling with antibody directed against PGP 9.5 and TEM. Intense immunoreactivity was clearly visible in samples subjected to PGP-immunolabeling. TEM revealed the presence of nerve terminals with about 30% of all nerve terminals observed less than 1 μm away from smooth muscle cells within the LA. This clearly differs from elastic arteries, where the distance between autonomic terminals and smooth muscle cells is rarely less than 1 μm. Conceivably, these results imply that the so- called LA receives innervation representative of that present within the ductus arteriosus during fetal life. This provides the first reliable study of innervation of the LA and makes room for further investigation into the neurochemistry of this innervation. This is crucial as the presence of nerve terminals may play a role in vessel compliance or impedance of the two great vessels related to this structure. The substances released by these fibers may also have an influence on cells and tissues in the immediate microenvironment of this structure.
Læs mere Tjek på PubMedCody J. HastingsMaya V. KeledjianLaura Palanker MusselmanCláudia N. H. Marques 1 Department of Biological Sciences, Binghamton University, Binghamton, New York, USA 2 Binghamton Biofilm Research Center, Binghamton University, Binghamton, New York, USA , Manuela Raffatellu
Infection and Immunity, 21.09.2023
Tilføjet 21.09.2023
Infection, 21.09.2023
Tilføjet 21.09.2023
Andrea Giacomelli, Roberta Gagliardini, Alessandro Tavelli, Sara De Benedittis, Valentina Mazzotta, Giuliano Rizzardini, Annalisa Mondi, Matteo Augello, Spinello Antinori, Alessandra Vergori, Andrea Gori, Marianna Menozzi, Lucia Taramasso, Francesco Maria Fusco, Andrea De Vito, Giulia Mancarella, Giulia Marchetti, Antonella d'Arminio Monforte, Andrea Antinori, Alessandro Cozzi-Lepri, COVID-19 ICONA study group
International Journal of Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Since the early phase of SARS-CoV-2 pandemic it has been questioned which groups of subjects were at higher risk of worse COVID-19 outcomes. This would have allowed firstly to implement specific preventing interventions, allocate therapeutic resources, and in the later phases of the pandemic prioritize COVID-19 vaccination. Demographic factors shortly appeared to be the main determinants of COVID-19 outcomes, with older age, male sex and social deprivation as strongly associated with hospitalization and death [1].
Læs mere Tjek på PubMedGiuseppe MICELI, Giuliano CASSATARO, Vito VOLPE, Emanuela FERTITTA, Carmelinda CANALE, Lucia TOMAIUOLO, Melania BLASCO, Mariagrazia STELLA, Giuliana RIZZO, Matteo VELARDO, Cesare GREGORETTI, Maurizio RENDA
International Journal of Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Botulism is a rare neurological syndrome causing paralysis [1]. Foodborne botulism is the most common form, resulting from ingesting food contaminated with botulin neurotoxins (BoNT). Symptoms include gastrointestinal disturbances, impaired motor function, and respiratory muscle paralysis. Mechanical ventilation is often required with a reported incidence of around 35% in a Thai outbreak [2]. This study aims to assess blood pressure (BP) alterations caused by BoNT and their role in predicting lung failure requiring ventilation in male patients with botulism.
Læs mere Tjek på PubMedJonathan C. KaganaDivision of Gastroenterology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 21.09.2023
Tilføjet 21.09.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 40, October 2023.
Læs mere Tjek på PubMedRuiqi HuangGabrielle Warner JenkinsYunjeong KimRobyn L. StanfieldAmrinder SinghMaria Martinez-YamoutGerard J. KroonJonathan L. TorresAbigail M. JacksonAbigail KelleyNamir ShaabaniBaisen ZengMichael BacicaWen ChenChristopher WarnerJasmina RadoicicJoongho JohKrishani Dinali PereraHuldah SangTae KimJianxiu YaoFangzhu ZhaoDevin SokDennis R. BurtonJeff AllenWilliam HarrimanWaithaka MwangiDonghoon ChungJohn R. TeijaroAndrew B. WardH. Jane DysonPeter E. WrightIan A. WilsonKyeong-Ok ChangDuncan McGregorVaughn V. SmideraApplied Biomedical Science Institute, San Diego, CA 92127bCollege of Veterinary Medicine, Department of Diagnostic Medicine and Pathobiology, Kansas State University, Manhattan, KS 66506cDepartment of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037dDepartment of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037eOmniAb Inc., Emeryville, CA 94608fLigand Pharmaceuticals, San Diego, CA 92121gSchool of Medicine, Department of Medicine, University of Louisville, Louisville, KY 40202hSchool of Medicine, Department of Microbiology and Immunology, University of Louisville, Louisville, KY 40202iThe Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037jDepartment of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037
Proceedings of the National Academy of Sciences, 21.09.2023
Tilføjet 21.09.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 39, September 2023.
Læs mere Tjek på PubMedMichael GhilaGeosciences Department and Laboratoire de Météorologie Dynamique (CNRS and Institut Pierre-Simon Laplace), École Normale Supérieure and PSL University, 75231 Paris Cedex 05, FrancebDepartment of Atmospheric and Oceanic Sciences, University of California at Los Angeles, Los Angeles, CA 90095-1567cDepartments of Mathematics and of Finance, Imperial College London, London SW7 2BX, United Kingdom
Proceedings of the National Academy of Sciences, 21.09.2023
Tilføjet 21.09.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 39, September 2023.
Læs mere Tjek på PubMedDavid R. Boulware, Christopher J. Lindsell, Thomas G. Stewart, Adrian F. Hernandez, Sean Collins, Matthew William McCarthy, Dushyantha Jayaweera, Nina Gentile, Mario Castro, Mark Sulkowski, Kathleen McTigue, G. Michael Felker, Adit A. Ginde, Sarah E. Dunsmore, Stacey J. Adam, Allison DeLong, George Hanna, April Remaly, Florence Thicklin, Rhonda Wilder, Sybil Wilson, Elizabeth Shenkman, Susanna Naggie
New England Journal of Medicine, 21.09.2023
Tilføjet 21.09.2023
New England Journal of Medicine, Volume 389, Issue 12, Page 1085-1095, September 2023.
Læs mere Tjek på PubMedNaomi P. O’Grady
New England Journal of Medicine, 21.09.2023
Tilføjet 21.09.2023
New England Journal of Medicine, Volume 389, Issue 12, Page 1121-1131, September 2023.
Læs mere Tjek på PubMedBoghuma K. Titanji, Angelia Eick-Cost, Elizabeth S. Partan, Lauren Epstein, Natalie Wells, Shauna L. Stahlman, Poornima Devineni, Brigid Munyoki, Saiju Pyarajan, Abirami Balajee, Jeremy Smith, Chris W. Woods, Mark Holodniy, Victoria J. Davey, Robert A. Bonomo, Yinong Young-Xu, Vincent C. Marconi
New England Journal of Medicine, 21.09.2023
Tilføjet 21.09.2023
New England Journal of Medicine, Volume 389, Issue 12, Page 1147-1148, September 2023.
Læs mere Tjek på PubMedNew England Journal of Medicine, 21.09.2023
Tilføjet 21.09.2023
New England Journal of Medicine, Volume 389, Issue 12, Page 1151-1152, September 2023.
Læs mere Tjek på PubMedLonika Lodha, Ashwini M. Ananda, Arya Ramachandran, Sathya Priya Manuel, Sujatha Valagere Sannaiah, Anita Mahadevan, Reeta S. Mani
Journal of Medical Virology, 21.09.2023
Tilføjet 21.09.2023
Piera d'Angelo, Paola Zelini, Federica Zavaglio, Stefania Piccini, Daniela Cirasola, Alessia Arossa, Arsenio Spinillo, Daniele Lilleri, Fausto Baldanti
Journal of Medical Virology, 21.09.2023
Tilføjet 21.09.2023
Journal of Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Ludwig-Walz, H., Siemens, W., Heinisch, S., Dannheim, I., Loss, J., Bujard, M.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
IntroductionThe implementation of COVID-19 pandemic-related restrictions resulted in limitations for physical activity (PA) opportunities, which may have initiated a longer-term behavioural change. The protocol describes the methodology for a planned systematic review that aims to summarise changes in PA and physical fitness (PF) in children and adolescents in the WHO European Region after the onset of the COVID-19 pandemic. Methods and analysisThe protocol adheres to the ‘Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols’ (PRISMA-P) statement. Using a peer-reviewed search strategy according to the evidence-based checklist ‘Peer Review of Electronic Search Strategies’ (PRESS), we will perform a systematic literature search in seven databases. Inclusion criteria are all primary studies that gathered data on children and adolescents ≤19 years living in the WHO European Region and made a comparison to pre-pandemic data. Primary outcomes are PA and PF. We will assess the risk of bias with the ‘Risk of Bias Instrument for Non-Randomized Studies of Exposures’ (ROBINS-E). The ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) approach will be used for the evaluation of the certainty of evidence. Also, subgroup analyses will be performed (eg, for gender, age, stringency of pandemic restrictions). Ethics and disseminationEthical approval is not required, as primary data will not be collected in this study. The results will be presented in a peer-reviewed publication and at congresses relevant to the research field. PROSPERO registration numberCRD42023395871.
Læs mere Tjek på PubMedUmana, E., Mills, C., Norman-Bruce, H., Wilson, K., Mitchell, H., McFetridge, L., Woolfall, K., Lynn, F. A., McKeeman, G., Foster, S., Barrett, M., Roland, D., Lyttle, M. D., Watson, C., Waterfield, T.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
IntroductionFebrile infants 90 days and younger are at risk of invasive bacterial infections (bacteraemia and meningitis) and urinary tract infections. Together this is previously termed serious bacterial infection with an incidence of approximately 10–20%. The National Institute for Health and Care Excellence guidance advocates a cautious approach with most infants requiring septic screening, parenteral broad-spectrum antibiotics and hospital admission. Internationally, variations exist in the approach to febrile infants, with European and North American guidance advocating a tailored approach based on clinical features and biomarker testing. None of the available international clinical decision aids (CDAs) has been validated in the UK and Irish cohorts. The aim of the Febrile Infant Diagnostic Assessment and Outcome (FIDO) Study is to prospectively validate a range of CDAs in a UK and Irish population including CDAs that use procalcitonin testing. Methods and analysisThe FIDO Study is a prospective multicentre mixed-methods cohort study conducted in UK and Irish hospitals. All infants aged 90 days and younger presenting with fever or history of fever (≥38°C) are eligible for inclusion. Infants will receive standard emergency clinical care without delay. Clinical data and blood samples will be collected, and consent will be obtained at the earliest appropriate opportunity using research without prior consent methodology. The performance and cost-effectiveness of CDAs will be assessed. An embedded qualitative study will explore clinician and caregiver views on different approaches to care and perceptions of risk. Ethics and disseminationThis study was reviewed and approved by the Office for Research Ethics Committees Northern Ireland-Health and Social Care Research Ethics Committee B, Public Benefit and Privacy Panel for Health and Social Care Scotland, and Children’s Health Ireland Research and Ethics Committee Ireland. The results of this study will be presented at academic conferences and in peer-reviewed publications. Trial registration numberNCT05259683.
Læs mere Tjek på PubMedBenova, L., Semaan, A., Afolabi, B. B., Amongin, D., Babah, O. A., Dioubate, N., Harissatou, N., Kikula, A. I., Nakubulwa, S., Ogein, O., Adroma, M., Anzo Adiga, W., Diallo, A., Diallo, I. S., Diallo, L., Cellou Diallo, M., Maomou, C., Mtinangi, N., Sy, T., Delvaux, T., Delamou, A., Nakimuli, A., Pembe, A. B., Banke-Thomas, A. O.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
ObjectivesThe COVID-19 pandemic affected provision and use of maternal health services. This study describes changes in obstetric complications, referrals, stillbirths and maternal deaths during the first year of the pandemic and elucidates pathways to these changes. DesignProspective observational mixed-methods study, combining monthly routine data (March 2019–February 2021) and qualitative data from prospective semi-structured interviews. Data were analysed separately, triangulated during synthesis and presented along three country-specific pandemic periods: first wave, slow period and second wave. SettingSix referral maternities in four sub-Saharan African countries: Guinea, Nigeria, Tanzania and Uganda. Participants22 skilled health personnel (SHP) working in the maternity wards of various cadres and seniority levels. ResultsPercentages of obstetric complications were constant in four of the six hospitals. The percentage of obstetric referrals received was stable in Guinea and increased at various times in other hospitals. SHP reported unpredictability in the number of referrals due to changing referral networks. All six hospitals registered a slight increase in stillbirths during the study period, the highest increase (by 30%–40%) was observed in Uganda. Four hospitals registered increases in facility maternal mortality ratio; the highest increase was in Guinea (by 158%), which had a relatively mild COVID-19 epidemic. These increases were not due to mortality among women with COVID-19. The main pathways leading to these trends were delayed care utilisation and disruptions in accessing care, including sub-optimal referral linkages and health service closures. ConclusionsMaternal and perinatal survival was negatively affected in referral hospitals in sub-Saharan Africa during COVID-19. Routine data systems in referral hospitals must be fully used as they hold potential in informing adaptations of maternal care services. If combined with information on women’s and care providers’ needs, this can contribute to ensuring continuation of essential care provision during emergency.
Læs mere Tjek på PubMedIhnatiuk, A. P., Shapoval, A. Y., Kazanzhy, A. P., Kuzin, I. V., Riabokon, S. V., Shotorbani, S., McDowell, M. R., Golden, M. R., Puttkammer, N. H.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
ObjectivesThe effectiveness of HIV index testing (IT) in Eastern Europe has not been described. This study reports the performance of a scaled IT programme in Ukraine. DesignThis observational study included clients enrolled in IT services in 2020, and used routinely collected data from programme registers and the national electronic health record system. SettingThe study covered 39 public-sector health facilities where IT services were integrated into medical visits for persons living with HIV (PLHIV) already enrolled in HIV care. ParticipantsParticipants included PLHIV with both recent (
Læs mere Tjek på PubMedKnutsen Glette, M., Ludlow, K., Wiig, S., Bates, D. W., Austin, E. E.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
ObjectiveTo identify, review and synthesise qualitative literature on healthcare professionals’ adaptations to changes and challenges resulting from the COVID-19 pandemic. DesignSystematic review with meta-synthesis. Data sourcesAcademic Search Elite, CINAHL, MEDLINE, PubMed, Science Direct and Scopus. Eligibility criteriaQualitative or mixed-methods studies published between 2019 and 2021 investigating healthcare professionals’ adaptations to changes and challenges resulting from the COVID-19 pandemic. Data extraction and synthesisData were extracted using a predesigned data extraction form that included details about publication (eg, authors, setting, participants, adaptations and outcomes). Data were analysed using thematic analysis. ResultsForty-seven studies were included. A range of adaptations crucial to maintaining healthcare delivery during the COVID-19 pandemic were found, including taking on new roles, conducting self and peer education and reorganising workspaces. Triggers for adaptations included unclear workflows, lack of guidelines, increased workload and transition to digital solutions. As challenges arose, many health professionals reported increased collaboration across wards, healthcare teams, hierarchies and healthcare services. ConclusionHealthcare professionals demonstrated significant adaptive capacity when faced with challenges imposed by the COVID-19 pandemic. Several adaptations were identified as beneficial for future organisational healthcare service changes, while others exposed weaknesses in healthcare system designs and capacity, leading to dysfunctional adaptations. Healthcare professionals’ experiences working during the COVID-19 pandemic present a unique opportunity to learn how healthcare systems rapidly respond to changes, and how resilient healthcare services can be built globally.
Læs mere Tjek på PubMedTan, M. Z. Y., Prager, G., McClelland, A., Dark, P.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
ObjectivesThe COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered ‘resilient’ have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building. DesignSystematic review and synthesis of reviews using a meta-narrative approach. SettingHealthcare organisations and systems. Primary and secondary outcome measuresDefinitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience. ResultsThe main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an ‘all-hazards’ approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework. ConclusionResilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. PROSPERO registration numberCRD42022314729.
Læs mere Tjek på PubMedZuo, X., Li, Y., Rong, X., Yang, X., Zhu, Y., Pan, D., Li, H., Shen, Q.-Y., Tang, Y.
BMJ Open, 21.09.2023
Tilføjet 21.09.2023
IntroductionRadiotherapy-related neuropathic pain (RRNP) is one of the most distressing complications after radiotherapy for head and neck cancers. Drug therapy is not sufficiently effective and has limitations in terms of dose titration period and side effects. Transcutaneous auricular vagus nerve stimulation (taVNS), which stimulates the auricular branches of the vagus nerve through electrical impulses, has been proven to have analgesic effects in certain diseases. However, it is unknown whether taVNS can relieve RRNP. Methods and analysisThis is a multicentre, randomised, double-blind, parallel, sham-controlled trial. We will include adult patients newly diagnosed with neuropathic pain after radiotherapy for head and neck cancers. One hundred and sixteen individuals will be recruited and randomly assigned in a 1:1 ratio to receive taVNS or sham stimulation. The interventions will last for 7 days, twice daily for 30 min each. The primary efficacy outcome is pain reduction on day 7. The secondary outcomes are changes in functional interference, psychological distress, fatigue, quality of life and serum inflammatory factors. The study may provide a new early intervention strategy for RRNP among patients with head and neck cancers. Ethics and disseminationThis study has been approved by the Medical Research Ethics Committee of Sun Yat-sen University (SYSKY-2022-109-01) and will be conducted in strict accordance with the Declaration of Helsinki. Ethical approvals will be obtained separately for all centres involved in the study. Study results will be published in peer-reviewed academic journals. The database of the study will be available from the corresponding author on reasonable request. Trial registration numberNCT05543239
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Despite the fact that prison inmates are a population at higher risk than other groups of suffering from intestinal parasite infections in relation to their living conditions, information about these diseases in prison environments is still scarce. Herein, we analyze the status of intestinal parasite infections in a Spanish prison. Methods A cross-sectional study involving 528 inmates was conducted from April to June 2022 among inmates at Centro Penitenciario Picassent (Valencia, Spain). Stool specimens were examined using the direct wet mount technique, the formol-ether concentration technique, and the Ziehl-Neelsen staining method. We used STATA 16.1 for data analysis. We consider a p-value less than 0.05 significant at a 95% confidence level. Results Of the 528 inmates (471 men and 57 women; a mean age of 41.94 years) enrolled in the study, 83 (15.7%) were infected. Only six species of protozoa were detected. The gut potential microeukaryotic pathobiont Blastocystis sp. was the predominant parasite, accounting for 37 (44.6%) of the infections. Gut parasite amebas (6.6%) and pathobionts (5.3%) were more prevalent than flagellates (2.3%). The prevalence of infection with pathogenic species (8.9%) was similar to that of non-pathogenic species (8.7%). Infection among men (15.2%) was higher than in women (0.6%) (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Dialister pneumosintes is an anaerobic, Gram negative bacillus, found in the human oral cavity and associated with periodontitis. It has also been isolated from gastric mucosa and stool samples. Recent case reports implicate D. pneumosintes in local infection such as dental root canals, sinusitis, Lemierres syndrome and brain abscesses, as well as distal infections of the liver and lung through haematogenous spread. Case presentation We present a novel case of aortic graft infection and aortoenteric fistula (AEF) in a 75 year old Caucasian male, associated with D. pneumosintes bacteraemia. Microbiological evaluation of septic emboli in the lower limbs revealed other gastrointestinal flora. This suggests either AEF leading to graft infection and subsequent distal emboli and bacteraemia, or a dental origin of infection which seeded to the graft, resulting in AEF and systemic infection. To our knowledge this is the first report of D. pneumosintes associated aortic graft infection. The patient underwent surgical explantation, oversew of the aorta and placement of extra-anatomical bypass graft in conjunction with antimicrobial therapy, making a good recovery with discharge home after a 35-day hospital admission. Conclusion We report a case of Dialister pneumosintes bacteraemia associated with aortic graft infection. To our knowledge, vascular graft-associated infection with D. pneumosintes has not been reported before.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Transgender (TG) people are key drivers for sexually transmitted infections (STIs) all over the world. There is substantial evidence that STIs are associated with an increased likelihood of risky sexual behavior however little is known about the prevalence of STIs (HIV, HBV, HCV, and Syphilis) among HIV infected transgender population in Pakistan. Methods The current study investigated the seroprevalence of four STIs and associated socio-demographic risk factors among TGs of Punjab, Pakistan from July 2019 to June 2021. The samples were tested serologically and final confirmation was done through PCR for HIV, HBV, and HCV. Results A total of 1,562 transgenders cross-sectional descriptive records of the Punjab AIDS Control Program (PACP) were reviewed during the period from July 2019 to June 2021. The serological results evidenced that 533 (34.1%) had one pathogen, 309 (19.8%) had two or more (multiple) infections. The most predominant mono-infection among the transgender population was Syphilis 324 (20.7%) followed by HCV 114 (7.3%), HIV 69 (4.4%), and HBV 26 (1.7%). The highest proportions of Infections were found in TG residing in urban areas (68.6%) as compared to rural areas (31.4%). The seropositivity of all STIs was predominantly increased in Sex worker TGs i-e 55%, 46.5%, 38.5%, and 41.8% in HIV, HBV, HCV, and Syphilis respectively. Among 280 HIV-infected Transgender, 177 (63.2%) had Syphilis co-infections. While 87 (31%) and 47 (16.8%) HIV-infected individuals had HC and HBV co-infection respectively. Conclusion Transgender is neglected population group in society. All STIs were predominantly common among sex worker transgenders, Illiterate educational groups, and TGs residing in urban areas. There is a need to spread awareness about STIs, preventive strategies, and facilitation to health care programs in this high-risk population group.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract The objective of the study was to analyze the spatial distribution of vaccination coverage of bacterial meningitis vaccine: A, C, W and Y (menacwy) and identify the association between socioeconomic and social environment factors with menacwy vaccine coverage among adolescents in the state of Minas Gerais (MG), Brazil. This is an ecological, mixed study, conducted with secondary data from the 853 municipalities of the State of MG, Brazil, from 2020 to 2022, provided by the information system of the National Immunization Program. For spatial statistical analysis, spatial dependence and the presence of spatial clusters formed by municipalities with high and low vaccination coverage of Menacwy were evaluated. In the year 2021, MG presented the largest vaccination coverage (60.58%) since the introduction of the Menacwy vaccine by the PNI. Regarding the analysis of global regressions, it is observed that for the year 2020, as the MG Index of Social Responsibility-Health increased and MG Index of Social Responsibility—Public Security increased, increased the vaccination coverage of the municipalities of the Menacwy vaccine. Finally, compared to 2021, similar association was observed in relation to the proportion of the population served by the Family Health Strategy of the municipalities of the state of MG and per capita spending on education activities: as this indicator increased, with increased coverage of the Vaccine of the Menacwy vaccine of the state municipalities. They reinforce the importance of assessing the quality-of-care management and health surveillance system, professional training, and damage reduction to populations, especially adolescents.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background The gastrointestinal tract contains a massive microbiota, and targeting the gut could be a potential intervention for sepsis. However, the interaction between sepsis and the intestinal microbiota is defined as an “incompletely understood bidirectional relationship”. Methods This retrospective observational cohort study investigated the fecal microbiota of sepsis patients admitted to the Department of Critical Care Medicine of the Central Hospital of Wuhan, China, from May 2019 to January 2020. 14 septic patients were divided into the non-severe group and the severe group according to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Herein, fecal samples were serially collected on admission, the third, fourth, and fifth days, and ICU discharge. The fecal microbiota was analyzed by 16S rRNA gene sequencing and its correlation with clinical parameters was evaluated. Results Bacteroidetes, Firmicutes, and Proteobacteria were dominant phyla at ICU admission, and fecal biodiversity was not significantly different between the non-severe group (APACHE II 15). However, the diversity of the gut microbiota was significantly lower at ICU discharge than that at ICU admission with the extension of treatment time. Further significant difference flora analysis (LEfSe) showed that the genera Veillonella and Ruminococcus were the most discriminant biomarkers at ICU admission in non-severe and severe patients, respectively, while Enterococcus was the most discriminant biomarker at ICU discharge in all septic patients. Of note, liver function tests, including ALT, AST, TBIL, and DBIL correlated with the prevalence of various bacterial genera. Conclusions The diversity of the gut microbiota in patients with sepsis decreases dramatically during ICU stay, and there are distinct dynamic changes in gut microbiota among patients with different severity in sepsis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background While anaemia following liver transplant is common, anaemia in the context of BK viraemia is not a commonly recognised phenomenon. Case presentation We present the case of 59-year old gentleman with severe anaemia in the context of BK viraemia and nephropathy following ABO incompatible liver transplant. Severity of anaemia appeared to correlate with high titres of BK virus in the serum. Bone marrow biopsy revealed hypocellular marrow with normal cytogenetics. Anaemia improved with treatment with cidofovir, intravenous immunoglobulin, reduction in immunosuppression and erythropoietin stimulating agent. Conclusion To our knowledge, this is the first case of anaemia post liver transplant contributed to by BK viraemia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background The course of monkeypox can be severe. Our aim was to retrospectively compare the risk of hospital admission, the need for ventilation, sepsis, pneumonitis and death between the recent outbreak and historical outbreaks. Materials and Methods Cases of monkeypox were retrieved from the TriNetX database and assigned to either cohort I (recent outbreak between May 1st and September 16th, 2022) and cohort II (historical outbreaks before May 1st, 2022). After matching for age distribution, statistical analysis was performed. Results Of 640 patients with monkeypox 81 subjects per cohort remained after matching (mean age±standard deviation = 36.1±18.3 years). Within 56 days after diagnosis 10 patients per cohort were hospitalized (12.4%) and/or developed sepsis (12.4%). The risk of ventilation and pneumonitis were significantly lower among cohort I compared with cohort II (0 vs. 10 cases; risk difference = 12.4%; p = 0.001; Log-Rank test). No cases of death were recorded. Conclusion Even though monkeypox provides a risk of severe courses, the infection is self-limiting in most cases. Unlike past outbreaks, the risk of ventilation and pneumonitis may be relatively low among recent outbreaks.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Tuberculosis, along with HIV, is the leading cause of mortality and morbidity globally. Despite the fact that several primary studies have been conducted on the incidence rate of tuberculosis in HIV-infected people in Sub-Saharan Africa, the regional-level tuberculosis incidence rate remains unknown. The objective of this study is to determine the tuberculosis incidence rate and its associated factors in HIV-infected people in Sub-Saharan Africa. Methods A systematic review and meta-analysis were conducted by searching four databases for studies published in English between January 1, 2000, and November 25, 2022. The study was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. To assess the quality of the studies, the Joanna Briggs Institute critical appraisal checklist was used. A random-effects model meta-analysis was used to determine the pooled incidence of tuberculosis using STATA version 15. The I2 heterogeneity test was used to assess heterogeneity. Subgroup and sensitivity analyses were performed. Funnel plots and Egger’s regression tests were used to investigate publication bias. The pooled estimate predictors of tuberculosis incidence rate with a 95% confidence interval were also determined using the hazard ratio of each factor (HR). Results Out of a total of 3339 studies, 43 were included in the analysis. The overall pooled incidence rate of tuberculosis in HIV-infected people was 3.49 per 100 person-years (95% CI: 2.88–4.17). In the subgroup analysis, the pooled incidence rate of tuberculosis in HIV-infected children was 3.42 per 100 person-years (95% CI: 1.78, 5.57), and it was 3.79 per 100 person-years (95% CI: 2.63, 5.15) in adults. A meta-analysis revealed that underweight (AHR = 1.79, 95% CI: 1.61–1.96), low CD4 count (AHR = 1.23, 95% CI: 1.13–1.35), male gender (AHR = 1.43, 95% CI: 1.22–1.64), advanced WHO clinical stages (AHR = 2.29, 95% CI: 1.34–3.23), anemia (AHR = 1.73, 95% CI: 1.34–2.13), bedridden or ambulatory (AHR = 1.87, 95%), lack of isoniazid preventive therapy (AHR = 3.32, 95% CI: 1.08–2.28), and lack of cotrimoxazole (AHR = 1.68, 95% CI: 1.08–2.28) were risk factors for tuberculosis incidence. HIV patients who received antiretroviral therapy had a 0.53 times higher risk of acquiring tuberculosis than HIV patients who did not receive antiretroviral therapy (AHR = 0.53; 95% CI: 0.3–0.77). Conclusion In this systematic review and meta-analysis study, the incidence rate of tuberculosis among HIV-positive people was higher than the WHO 2022 Africa regional estimated report. To reduce the incidence of tuberculosis among HIV patients, HIV patients should take isoniazid prevention therapy (IPT), cotrimoxazole prophylaxis, and antiretroviral therapy (ART) without interruption, as well as increase the frequency and diversity of their nutritional intake. Active tuberculosis screening should be increased among HIV-infected people.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Severe community-acquired pneumonia (SCAP) is commonly treated with an empiric combination therapy, including a macrolide, or a quinolone and a β-lactam. However, the risk of Legionella pneumonia may lead to a prolonged combination therapy even after negative urinary antigen tests (UAT). Methods We conducted a retrospective cohort study in a French intensive care unit (ICU) over 6 years and included all the patients admitted with documented SCAP. All patients received an empirical combination therapy with a β-lactam plus a macrolide or quinolone, and a Legionella UAT was performed. Macrolide or quinolone were discontinued when the UAT was confirmed negative. We examined the clinical and epidemiological features of SCAP and analysed the independent factors associated with ICU mortality. Results Among the 856 patients with documented SCAP, 26 patients had atypical pneumonia: 18 Legionella pneumophila (LP) serogroup 1, 3 Mycoplasma pneumonia (MP), and 5 Chlamydia psittaci (CP). UAT diagnosed 16 (89%) Legionella pneumonia and PCR confirmed the diagnosis for the other atypical pneumonia. No atypical pneumonia was found by culture only. Type of pathogen was not associated with a higher ICU mortality in the multivariate analysis. Conclusion Legionella pneumophila UAT proved to be highly effective in detecting the majority of cases, with only a negligible percentage of patients being missed, but is not sufficient to diagnose atypical pneumonia, and culture did not provide any supplementary information. These results suggest that the discontinuation of macrolides or quinolones may be a safe option when Legionella UAT is negative in countries with a low incidence of Legionella pneumonia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Malaria cases in non-endemic zero-indigenous case areas are most likely to have been imported whatever of the route of importation. In countries recently declared malaria-free and now without local transmission, imported cases remain a threat to re-introduction of the disease and a burden on the health system. Case presentation Three days after returning from a long trip to malaria- endemic countries; Abyei-Sudan, Chad and Uganda, a 41-year-old male resident from Jericho, Palestine, suffered paroxysms of fever, general fatigue, myalgia, arthralgia, headache, and a strong desire to vomit. Thin and thick Giemsa-stained blood smears were prepared and examined microscopically using oil immersion. Immature trophozoites (ring forms) were seen to parasitize approximately 10% of the erythrocytes revealing hyperparasitemia equivalent to > 100,000 parasites/ µl indicating severe malaria [1, 2]. The double chromatin configuration (headphones) and accolé (applique) position are both indicative of Plasmodium falciparum infection. The 18S rRNA- PCR targeting the rPLU6-rPLU5 region was used to confirm the diagnosis. The next-generation sequencing (NGS) method was carried out according to the manufacturer’s instructions (Illumina® DNA Prep, (M) Tagmentation kit (20060060), Illumina) to identify Plasmodium spp. Furthermore, NGS produced a whole-genome sequence of 22.8Mbp of the 14 chromosomes and 25Kbp of the apicoplast. A BLAST search of the apicoplast DNA and selected chromosomal DNA revealed that P. falciparum was the causative agent. The merozoite surface protein-1 (msp-1) was used to construct a phylogenetic tree of 26 P. falciparum, including the one isolated from the patient from Jericho, which clustered with the Sudanese isolate indicating genetic relatedness between the two. Conclusion The travel history together with signs and symptoms of malaria, followed by prompt diagnosis using conventional microscopic inspection of Giemsa-stained films together with molecular DNA tracking tools like msp-1 were key means in tracking the place of origin of infection in the case of travel to multiple destination.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Introduction Acute uncomplicated urinary tract infections are common in outpatient settings but are not treated optimally. Few studies of the outpatient use of antibiotics for specific diagnoses have been done in sub-Saharan Africa, so little is known about the prescribing patterns of medical officers in the region. Methods Aga Khan University has 16 outpatient clinics throughout the Nairobi metro area with a medical officer specifically assigned to that clinic. A baseline assessment of evaluation and treatment of suspected UTI was performed from medical records in these clinics. Then the medical officer from each of the 16 clinics was recruited from each clinic was recruited with eight each randomized to control vs. feedback groups. Both groups were given a multimodal educational session including locally adapted UTI guidelines and emphasis on problems identified in the baseline assessment Each record was scored using a scoring system that was developed for the study according to adequacy of history, physical examination, clinical diagnosis matching recorded data, diagnostic workup and treatment. Three audits were done for both groups; baseline (audit 1), post-CME (audit 2), and a final audit, which was after feedback for the feedback group (audit 3). The primary analysis assessed overall guideline adherence in the feedback group versus the CME only group. Results The overall scores in both groups showed significant improvement after the CME in comparison to baseline and for each group, the scores in most domains also improved. However, audit 3 showed persistence of the gains attained after the CME but no additional benefit from the feedback. Some deficiencies that persisted throughout the study included lack of workup of possible STI and excess use of non-UTI laboratory tests such as CBC, stool culture and H. pylori Ag. After the CME, the use of nitrofurantoin rose from only 4% to 8% and cephalosporin use increased from 49 to 67%, accompanied by a drop in quinolone use. Conclusion The CME led to modest improvements in patient care in the categories of history taking, treatment and investigations, but feedback had no additional effect. Future studies should consider an enforcement element or a more intensive feedback approach.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Public health depends largely on people’s knowledge, beliefs, or behaviors regarding their health and medical treatments. Although works based on the health belief model have shown that public beliefs about medical treatments affect willingness to take the treatments, little is known about the effects of changes in beliefs on attitudes toward treatment. How one’s past experiences relate to one’s beliefs about a given medical treatment is worth considering. Methods We implemented an online panel survey in February 2021 and March 2022 in Japan before and after COVID-19 vaccines were administered to the public within the country. We exploited delayed localized hypersensitivity reactions to COVID-19 vaccines, namely, “COVID arm”, as an exogenous shock to investigate the relationship between past negative experiences and current beliefs about medical treatments or science. “COVID arm” was an unexpected side effect and thus likely caused updated beliefs about the vaccine. Out of the nonprobability sample of 15,000 respondents in the first wave in February 2021, 9,668 respondents also responded to the second wave conducted in March 2022. Outcome variables were whether experiencing “COVID arm” affected the respondents’ 1) confidence in vaccine safety, 2) willingness to take the next dose of COVID-19 vaccines, 3) acknowledgment of the importance of vaccination, and 4) confidence in science. We measured the impact of experience with “COVID arm” on changes in the probability that survey respondents would respond affirmatively to questions posed about the issues listed above. Results Experiencing “COVID arm” significantly lowered confidence in the safety of vaccination by 4.3 percentage points, which was approximately 6% of the sample mean for the first wave, and lowered the probability of taking a second dose of the COVID-19 vaccine by 1.5 percentage points. These adverse impacts were observed after conditioning background characteristics and prior confidence in vaccination. Experiencing “COVID arm” affected neither the acknowledged importance of vaccination nor confidence in science in a statistically significant way. Conclusions An unexpected and uncomfortable shock regarding beliefs about a treatment decreases willingness to take the treatment. An appropriate public health policy should account for this effect. Trial registration The survey was preregistered with the American Economic Association’s RCT Registry (Fukai et al., 2022).
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Omicron variant of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has rapidly become a global threat to public health. Numerous asymptomatic and mild cases had been admitted in shelter hospitals to quickly win the fight against Omicron pandemic in Shanghai. However, little is known about influencing factors for deterioration and length of stay (LOS) in hospitals among these non-severe cases. Methods This study included 12,555 non-severe cases with COVID-19 in largest shelter hospital of Shanghai, aiming to explore prognostic factors and build effective models for prediction of LOS. Results Data showed that 75.0% of participants were initially asymptomatic. In addition, 94.6% were discharged within 10 days, only 0.3% with deterioration in hospitals. The multivariate analysis indicated that less comorbidities (OR = 1.792, P = 0.012) and booster vaccination (OR = 0.255, P = 0.015) was associated with the decreased risk of deterioration. Moreover, age (HR = 0.991, P
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
BMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background The development of scoring systems to predict the short-term mortality and the length of hospital stay (LOS) in patients with bacteraemia is essential to improve the quality of care and reduce the occupancy variance in the hospital bed. Methods Adults hospitalised with community-onset bacteraemia in the coronavirus disease 2019 (COVID-19) and pre-COVID-19 eras were captured as the validation and derivation cohorts in the multicentre study, respectively. Model I incorporated all variables available on day 0, Model II incorporated all variables available on day 3, and Models III, IV, and V incorporated the variables that changed from day 0 to day 3. This study adopted the statistical and machine learning (ML) methods to jointly determine the prediction performance of these models in two study cohorts. Results A total of 3,639 (81.4%) and 834 (18.6%) patients were included in the derivation and validation cohorts, respectively. Model IV achieved the best performance in predicting 30-day mortality in both cohorts. The most frequently identified variables incorporated into Model IV were deteriorated consciousness from day 0 to day 3 and deteriorated respiration from day 0 to day 3. Model V achieved the best performance in predicting LOS in both cohorts. The most frequently identified variables in Model V were deteriorated consciousness from day 0 to day 3, a body temperature ≤ 36.0 °C or ≥ 39.0 °C on day 3, and a diagnosis of complicated bacteraemia. Conclusions For hospitalised adults with community-onset bacteraemia, clinical variables that dynamically changed from day 0 to day 3 were crucial in predicting the short-term mortality and LOS.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Objective To investigate the risk factors associated with the peripheral venous catheter-related complication and infection in children with bronchopneumonia. Methods A total of 185 patients were divided into case group (n = 114) and control group (n = 71) according to the presence of catheter-related infection and complications related to indwelling needle. We performed a multivariate logistic regression analysis to explore the risk factors associated with the infection. Results Age was divided into 4 categories (0
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Severe COVID-19 is a disease characterized by profound dysregulation of the innate immune system. There is a need to identify highly reliable prognostic biomarkers that can be rapidly assessed in body fluids for early identification of patients at higher risk for hospitalization and/or death. This study aimed to assess whether differential gene expression of immune response molecules and cellular enzymes, detected in saliva samples of COVID-19 patients, occurs according to disease severity staging. Methods In this cross-sectional study, subjects with a COVID-19 diagnosis were classified as having mild, moderate, or severe disease based on clinical features. Transcripts of genes encoding 6 biomarkers, IL-1β, IL-6, IL-10, C-reactive protein, IDO1 and ACE2, were measured by RT‒qPCR in saliva samples of patients and COVID-19-free individuals. Results The gene expression levels of all 6 biomarkers in saliva were significantly increased in severe disease patients compared to mild/moderate disease patients and healthy controls. A significant strong inverse relationship between oxemia and the level of expression of the 6 biomarkers (Spearman’s correlation coefficient between -0.692 and -0.757; p
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.09.2023
Tilføjet 21.09.2023
Abstract Background Mycoplasma hominis is a facultative anaerobic bacterium commonly present in the urogenital tract. In recent years, M. hominis has increasingly been associated with extra-urogenital tract infections, particularly in immunosuppressed patients. Detecting M. hominis in a diagnostic laboratory can be challenging due to its slow growth rate, absence of a cell wall, and the requirements of specialized media and conditions for optimal growth. Consequently, it is necessary to establish guidelines for the detection of this microorganism and to request the appropriate microbiological work-up of immunosuppressed patients. Case Presentation We hereby present two cases of solid organ transplant patients who developed M. hominis infection. Microscopic examination of the bronchial lavage and pleural fluid showed no microorganisms. However, upon inoculating the specimens onto routine microbiology media, the organism was successfully identified and confirmation was performed using 16S rDNA sequencing. Both patients received appropriate treatment resulting in the resolution of M. hominis infection. Conclusions The prompt detection of M. hominis in a clinical specimen can have a significant impact on patient care by allowing for early intervention and ultimately resulting in more favorable clinical outcomes, especially in transplant patients.
Læs mere Tjek på PubMedAndré B.B. Wilke, Ni-Bin Chang, John Townsend, Giovanni Benelli, Marco Ajelli
Trends in Parasitology, 21.09.2023
Tilføjet 21.09.2023
Cities across the USA are implementing urban policies to mitigate unwanted effects of urbanization. These policies may inadvertently promote the proliferation of mosquito vectors. Limited evidence exists regarding how urban policies impact arbovirus transmission risk. Models can evaluate public health interventions aimed at reducing arbovirus-related risks caused by urban policies.
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