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47 ud af 47 tidsskrifter valgt, søgeord (urin) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
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Anthony K. Nkyi, Bridgette Baaba
PLoS One Infectious Diseases, 30.01.2024
Tilføjet 30.01.2024
by Anthony K. Nkyi, Bridgette Baaba The aim of this study is to investigate coping strategies, health anxiety and stress among healthcare professionals in selected hospitals in the Cape Coast Metropolis during the Covid 19 pandemic. This study adopted the Descriptive survey design. The Multistage sampling technique was used to select 322 health professionals. The health professionals included Medical Officers, Physician Assistants and Nurses. Data were gathered using the Health Anxiety Inventory (HAI-SF), Perceived Stress Scale (PSS), and the Brief-COPE Inventory. Analyses were conducted using mean and standard deviation, ANOVA as well as Independent Samples t-test. Results indicate that Health professionals adopted diverse coping strategies ranging from positive to negative coping style to overcome the negative impact of the COVID-19 pandemic. Results also indicate that coping strategies significantly influenced health anxiety levels of health professionals, and that Active Coping is a significant determinant of stress among health professionals. Male health professionals had significantly more health anxiety than females. However, gender was not a significant factor in the experiences of stress. Lastly, age of health professionals does not determine the type of coping strategy they adopted during the pandemic.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 29.01.2024
Tilføjet 29.01.2024
In pregnant people with prior SARS-CoV-2 infection, hybrid immunity (infection plus vaccination) before delivery provided more durable maternally-derived antibody responses than infection or vaccination alone in infants through 6 months of age.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 29.01.2024
Tilføjet 29.01.2024
Abstract Background Transcriptomics has been used to evaluate immune responses during malaria in diverse cohorts worldwide. However, the high heterogeneity of cohorts and poor generalization of transcriptional signatures reported in each study limit their potential clinical applications.Methods We compiled 28 public datasets containing 1,556 whole blood or peripheral blood mononuclear cells (PBMC) transcriptome samples. We estimated effect sizes with Hedges´ g and DerSimonian-Laird random effects model for meta-analyses of uncomplicated malaria. Random forest models identified gene signatures that discriminate malaria from bacterial infections or malaria severity. Parasitological, hematological, immunological, and metabolomics data were used for validation.Results We identified three gene signatures denominated the uncomplicated Malaria Meta-Signature (uMMS), which discriminates P. falciparum malaria from uninfected controls; the Malaria or Bacteria Signature (MoBS), that distinguishes malaria from sepsis and enteric fever; and the cerebral Malaria Meta-Signature (cMMS), which characterizes individuals with cerebral malaria. These signatures correlate with clinical hallmark features of malaria. Blood transcription modules (BTM) indicate immune regulation by glucocorticoids, whereas cell development and adhesion are associated with cerebral malaria.Conclusion Transcriptional meta-signatures reflecting immune cell responses provide potential biomarkers for translational innovation and suggest critical roles for metabolic regulators of inflammation during malaria.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 29.01.2024
Tilføjet 29.01.2024
Abstract Background Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) bloodstream infections are associated with high mortality. We studied clinical bloodstream KPC-Kp isolates to investigate mechanisms of resistance to complement, a key host defense against bloodstream infection.Methods We tested growth of KPC-Kp isolates in human serum. In serial isolates from a single patient, we performed whole genome sequencing and tested for complement resistance and binding by mixing study, direct ELISA, flow cytometry, and electron microscopy. We utilized an isogenic deletion mutant in phagocytosis assays and an acute lung infection model.Results We found serum resistance in 16 of 59 (27%) KPC-Kp clinical bloodstream isolates. In five genetically-related bloodstream isolates from a single patient, we noted a loss-of-function mutation in the capsule biosynthesis gene, wcaJ. Disruption of wcaJ was associated with decreased polysaccharide capsule, resistance to complement-mediated killing, and surprisingly, increased binding of complement proteins. Furthermore, an isogenic wcaJ deletion mutant exhibited increased opsono-phagocytosis in vitro and impaired in vivo control in the lung after airspace macrophage depletion in mice.Conclusions Loss of function in wcaJ led to increased complement resistance, complement binding, and opsono-phagocytosis, which may promote KPC-Kp persistence by enabling co-existence of increased bloodstream fitness and reduced tissue virulence.
Læs mere Tjek på PubMedMalaria Journal, 28.01.2024
Tilføjet 28.01.2024
Abstract Background Sri Lanka after eliminating malaria in 2012, is in the prevention of re-establishment (POR) phase. Being a tropical country with high malariogenic potential, maintaining vigilance is important. All malaria cases are investigated epidemiologically and followed up by integrated drug efficacy surveillance (iDES). Occasionally, that alone is not adequate to differentiate Plasmodium falciparum reinfections from recrudescences. This study evaluated the World Health Organization and Medicines for Malaria Venture (MMV) recommended genotyping protocol for the merozoite surface proteins (msp1, msp2) and the glutamate-rich protein (glurp) to discriminate P. falciparum recrudescence from reinfection in POR phase. Methods All P. falciparum patients detected from April 2014 to December 2019 were included in this study. Patients were treated and followed up by iDES up to 28 days and were advised to get tested if they develop fever at any time over the following year. Basic socio-demographic information including history of travel was obtained. Details of the malariogenic potential and reactive entomological and parasitological surveillance carried out by the Anti Malaria Campaign to exclude the possibility of local transmission were also collected. The msp1, msp2, and glurp genotyping was performed for initial and any recurrent infections. Classification of recurrent infections as recrudescence or reinfection was done based on epidemiological findings and was compared with the genotyping outcome. Results Among 106 P. falciparum patients, six had recurrent infections. All the initial infections were imported, with a history of travel to malaria endemic countries. In all instances, the reactive entomological and parasitological surveillance had no evidence for local transmission. Five recurrences occurred within 28 days of follow-up and were classified as recrudescence. They have not travelled to malaria endemic countries between the initial and recurrent infections. The other had a recurrent infection after 105 days. It was assumed a reinfection, as he had travelled to the same malaria endemic country in between the two malaria attacks. Genotyping confirmed the recrudescence and the reinfection. Conclusions The msp1, msp2 and glurp genotyping method accurately differentiated reinfections from recrudescence. Since reinfection without a history of travel to a malaria endemic country would mean local transmission, combining genotyping outcome with epidemiological findings will assist classifying malaria cases without any ambiguity.
Læs mere Tjek på PubMedGuoqin Zhang, Xianhui Sun, Joy Fleming, Fanlei Ran, Jianjun Luo, Hong Chen, Hanfang Ju, Zhirui Wang, Hui Zhao, Chunhua Wang, Fan Zhang, Xiaowei Dai, Xinyu Yang, Chuanyou Li, Yi Liu, Yaguo Wang, Xilin Zhang, Yuan Jiang, Zhilong Wu, Lijun Bi, Hongtai Zhang
Clinical Microbiology and Infection, 27.01.2024
Tilføjet 27.01.2024
We elucidated the factors, evolution, and compensation of antimicrobial resistance (AMR) in Mycobacterium tuberculosis (MTB) isolates under dual pressure from the intra-host environment and anti-tuberculosis (anti-TB) drugs.
Læs mere Tjek på PubMedInfection, 27.01.2024
Tilføjet 27.01.2024
Abstract Purpose In this pilot study, we investigated the cardiac autonomic activity of coronavirus disease 2019 (COVID-19)-infected hospitalized patients. COVID-19 is characterized by cough, fever, and dyspnea, which in some severe cases can lead to hypoxia, respiratory failure, and shock. Since breathing disorders and pulmonary diseases are tightly linked to autonomic dysfunction, we analyzed the cardiac autonomic activity by measuring the deceleration capacity (DC) in COVID-19 patients. Methods In 14 adults (4 men and 10 women) with a median age of 63.5 years and positive for SARS-CoV-2 by polymerase chain reaction (PCR) with severe symptoms requiring hospital treatment, a high-resolution digital 30 min electrocardiogram (ECG) in Frank leads configuration was performed in a resting supine position within the first 48 h after hospital admission. DC was assessed using validated software and associated with several markers of inflammation and clinical course. Results The study revealed a significant association between reduced DC (≤ 2.5 ms) and older age (74 years) in COVID-19 patients, compared to those with a higher DC > 2.5 ms (56.5 years). However, the duration of hospitalization was similar for both groups. There was a nonsignificant trend towards a higher maximum viral load in patients with reduced DC. Further, patients with a DC ≤ 2.5 ms showed higher levels of inflammatory markers such as C-reactive protein (CRP) and procalcitonin (PCT), as well as leukocytosis, compared to patients with a DC > 2.5 ms. Also, the COVID-19-severity marker ferritin was significantly elevated in patients with lower DC. Other markers associated with COVID-19, such as lactate dehydrogenase (LDH) and creatine kinase (CK), exhibited comparable levels in both groups. Conclusions Reduced DC (≤ 2.5 ms) was significantly associated with older age, increased inflammatory markers, and elevated ferritin in patients with COVID-19. These findings suggest that DC might serve as a valuable indicator for predicting the risk of severe inflammation in COVID-19 and possibly complications associated with this disease, such as heart failure. Further studies are needed to confirm these observations and clarify the clinical significance of DC in COVID-19 and other infectious diseases.
Læs mere Tjek på PubMedGarnacho-Montero, José; Gordillo-Escobar, Elena; Trenado, Josep; Gordo, Federico; Fisac, Lourdes; García-Prieto, Emilio; López-Martin, Cristina; Abella, Ana; Jiménez, Juan Ramón; García-Garmendia, José Luis; and the Intubation Prospective (INTUPROS) Study Investigators.
Critical Care Medicine, 27.01.2024
Tilføjet 27.01.2024
Objectives: Our aims were to explore current intubation practices in Spanish ICUs to determine the incidence and risk factors of peri-intubation complications (primary outcome measure: major adverse events), the rate and factors associated with first-pass success, and their impact on mortality as well as the changes of the intubation procedure observed in the COVID-19 pandemic. Design: Prospective, observational, and cohort study. Setting: Forty-three Spanish ICU. Patients: A total of 1837 critically ill adult patients undergoing tracheal intubation. The enrollment period was six months (selected by each center from April 16, 2019, to October 31, 2020). Interventions: None. Measurement and Main Results : At least one major adverse peri-intubation event occurred in 40.4 % of the patients (973 major adverse events were registered) the most frequent being hemodynamic instability (26.5%) and severe hypoxemia (20.3%). The multivariate analysis identified seven variables independently associated with a major adverse event whereas the use of neuromuscular blocking agents (NMBAs) was associated with reduced odds of major adverse events. Intubation on the first attempt was achieved in 70.8% of the patients. The use of videolaryngoscopy at the first attempt was the only protective factor (odds ratio 0.43; 95% CI, 0.28–0.66; p < 0.001) for first-attempt intubation failure. During the COVID-19 pandemic, the use of videolaryngoscopy and NMBAs increased significantly. The occurrence of a major peri-intubation event was an independent risk factor for 28-day mortality. Cardiovascular collapse also posed a serious threat, constituting an independent predictor of death. Conclusions: A major adverse event occurred in up to 40% of the adults intubated in the ICU. Peri-intubation hemodynamic instability but not severe hypoxemia was identified as an independent predictor of death. The use of NMBAs was a protective factor for major adverse events, whereas the use of videolaringoscopy increases the first-pass success rate of intubation. Intubation practices changed during the COVID-19 pandemic.
Læs mere Tjek på PubMedHonarmand, Kimia; Sirimaturos, Michael; Hirshberg, Eliotte L.; Bircher, Nicholas G.; Agus, Michael S. D.; Carpenter, David L.; Downs, Claudia R.; Farrington, Elizabeth A.; Freire, Amado X.; Grow, Amanda; Irving, Sharon Y.; Krinsley, James S.; Lanspa, Michael J.; Long, Micah T.; Nagpal, David; Preiser, Jean-Charles; Srinivasan, Vijay; Umpierrez, Guillermo E.; Jacobi, Judith
Critical Care Medicine, 27.01.2024
Tilføjet 27.01.2024
Rationale: Maintaining glycemic control of critically ill patients may impact outcomes such as survival, infection, and neuromuscular recovery, but there is equipoise on the target blood levels, monitoring frequency, and methods. Objectives: The purpose was to update the 2012 Society of Critical Care Medicine and American College of Critical Care Medicine (ACCM) guidelines with a new systematic review of the literature and provide actionable guidance for clinicians. Panel Design: The total multiprofessional task force of 22, consisting of clinicians and patient/family advocates, and a methodologist applied the processes described in the ACCM guidelines standard operating procedure manual to develop evidence-based recommendations in alignment with the Grading of Recommendations Assessment, Development, and Evaluation Approach (GRADE) methodology. Conflict of interest policies were strictly followed in all phases of the guidelines, including panel selection and voting. Methods: We conducted a systematic review for each Population, Intervention, Comparator, and Outcomes question related to glycemic management in critically ill children (≥ 42 wk old adjusted gestational age to 18 yr old) and adults, including triggers for initiation of insulin therapy, route of administration, monitoring frequency, role of an explicit decision support tool for protocol maintenance, and methodology for glucose testing. We identified the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the GRADE approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak or as a good practice statement. In addition, “In our practice” statements were included when the available evidence was insufficient to support a recommendation, but the panel felt that describing their practice patterns may be appropriate. Additional topics were identified for future research. Results: This guideline is an update of the guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. It is intended for adult and pediatric practitioners to reassess current practices and direct research into areas with inadequate literature. The panel issued seven statements related to glycemic control in unselected adults (two good practice statements, four conditional recommendations, one research statement) and seven statements for pediatric patients (two good practice statements, one strong recommendation, one conditional recommendation, two “In our practice” statements, and one research statement), with additional detail on specific subset populations where available. Conclusions: The guidelines panel achieved consensus for adults and children regarding a preference for an insulin infusion for the acute management of hyperglycemia with titration guided by an explicit clinical decision support tool and frequent (≤ 1 hr) monitoring intervals during glycemic instability to minimize hypoglycemia and against targeting intensive glucose levels. These recommendations are intended for consideration within the framework of the patient’s existing clinical status. Further research is required to evaluate the role of individualized glycemic targets, continuous glucose monitoring systems, explicit decision support tools, and standardized glycemic control metrics.
Læs mere Tjek på PubMedLorenz, Marco; Baum, Felix; Kloss, Philipp; Langer, Nadine; Arsene, Vanessa; Warner, Linus; Panelli, Alessandro; Hartmann, Frederike V.; Fuest, Kristina; Grunow, Julius J.; Enghard, Philipp; Schaller, Stefan J.
Critical Care Medicine, 27.01.2024
Tilføjet 27.01.2024
Objectives: The COVID-19 pandemic significantly impacted global healthcare systems, particularly in managing critically ill mechanically ventilated patients. This study aims to assess the feasibility of robotic-assisted mobilization in COVID-19 patients. Design: Randomized controlled pilot study. Setting: Four COVID-19 specialized ICUs at Charité-Universitätsmedizin Berlin (March 2021 to February 2022). Patients: Twenty critically ill COVID-19 patients expected to require greater than 24 hours of ventilation. Interventions: A 5-day intervention phase with bid robotic-assisted mobilization greater than or equal to 20 minutes and follow-up at day 180, compared with standard care. Measurements and Main Results: Intervention sessions were conducted in 98.9% according to protocol, with one session missing due to staff shortage. Primary outcome was the mobilization level measured with the ICU Mobility Scale (IMS) and Surgical ICU Optimal Mobilization Score (SOMS), assessed until day 5 or extubation. Safety events were recorded during mobilization. The median IMS and SOMS were 0 (0–0.16) and 1 (1–1.03) in the intervention group, and 0 (0–0.15) (p = 0.77) and 0.8 (0.65–1.20) (p = 0.08) in the standard care group, respectively. Significant secondary outcomes included average number of mobilization sessions (intervention: 8.5 [7.75–10] vs. standard care: 4.5 [3.5–5]; p = 0.001), total mobilization time (intervention: 232.5 min [187.25–266.5 min] vs. standard care: 147.5 min [107.5–167.5 min]; p = 0.011), and healthcare providers per session (intervention: 2 [2–2] vs. standard care: 1 [1–1.4]; p = 0.001) during intervention. Four safety events (hypertension and agitation, n = 2 each) in the intervention group and none in the standard care group were reported. Conclusions: Robotic-assisted mobilization in mechanically ventilated COVID-19 patients appears to be safe and feasible.
Læs mere Tjek på PubMedTsitsi Masiyiwa, Moses John Bockarie
International Journal of Infectious Diseases, 26.01.2024
Tilføjet 26.01.2024
This year\'s World Neglected Tropic Diseases (NTD) Day (30 January 2024) comes during a moment of renewed momentum to eliminate NTDs. Two of the NTDs targeted for elimination – lymphatic filariasis (LF) and onchocerciasis (River blindness) – are seeing renewed investment, innovation and importantly, support for local implementing partners.
Læs mere Tjek på PubMedChris Wortley
Lancet Infectious Diseases, 26.01.2024
Tilføjet 26.01.2024
In The public health approach: population thinking from the Black Death to COVID-19, distinguished physician and epidemiologist Alfredo Morabia, advocates eloquently for what he terms a public health approach. Citing the 200 million Americans who were vaccinated at least once during the USA\'s COVID-19 vaccination campaign and the rarity of harmful effects from the vaccines, Morabia describes the response, despite its “insufficient aspects”, as a historical success for public health.
Læs mere Tjek på PubMedVytenis Kalibatas, Lina Kalibatienė, Dulat Imashpayev
PLoS One Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
by Vytenis Kalibatas, Lina Kalibatienė, Dulat Imashpayev The coronavirus disease (COVID-19) pandemic has significantly affected blood donors worldwide. It is important for the blood service to return to its pre-pandemic level as soon as possible and to perform its functions fully. This study compared the donation and demographic profiles of blood and its component donors one year before and during three pandemic years in Lithuania. All blood and blood component donations (n = 413,358) and demographic characteristics of all donors from April 1, 2019, to March 31, 2023, were analyzed. All data were obtained from annual publications, and statistics were obtained from the Blood Donor Register. Data were analyzed using descriptive statistics. Following a 9.41 percent decrease in the first year of the pandemic, the quantity of blood and blood component donations increased by 3.49 percent in the third year compared to the pre-pandemic year. Throughout the three years of the pandemic, a statistically significant decrease in the proportion of first-time blood and blood component donations was observed. Both the number and proportion of donations by donors under 25 years old decreased during the pandemic. The proportion of pre-donation deferrals for all attempts to donate significantly decreased during the pandemic. There was a statistically significant lower prevalence of all positive transfusion-transmitted infectious (TTI) markers among all donations compared to the pre-pandemic year for all three pandemic years. The odds for hepatitis B virus, hepatitis C virus, and all TTI markers during the second and third pandemic years were significantly lower than those in the pre-pandemic year. In conclusion, most dimensions of blood and its component donations and donor characteristics have returned to pre-pandemic levels or show positive trends. However, the major concern is the remaining decrease in donations from first-time and donors under 25 years old.
Læs mere Tjek på PubMedEli Fritz McDonald, Kathryn E. Oliver, Jonathan P. Schlebach, Jens Meiler, Lars Plate
PLoS One Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
by Eli Fritz McDonald, Kathryn E. Oliver, Jonathan P. Schlebach, Jens Meiler, Lars Plate Variants in the cystic fibrosis transmembrane conductance regulator gene (CFTR) result in cystic fibrosis–a lethal autosomal recessive disorder. Missense variants that alter a single amino acid in the CFTR protein are among the most common cystic fibrosis variants, yet tools for accurately predicting molecular consequences of missense variants have been limited to date. AlphaMissense (AM) is a new technology that predicts the pathogenicity of missense variants based on dual learned protein structure and evolutionary features. Here, we evaluated the ability of AM to predict the pathogenicity of CFTR missense variants. AM predicted a high pathogenicity for CFTR residues overall, resulting in a high false positive rate and fair classification performance on CF variants from the CFTR2.org database. AM pathogenicity score correlated modestly with pathogenicity metrics from persons with CF including sweat chloride level, pancreatic insufficiency rate, and Pseudomonas aeruginosa infection rate. Correlation was also modest with CFTR trafficking and folding competency in vitro. By contrast, the AM score correlated well with CFTR channel function in vitro–demonstrating the dual structure and evolutionary training approach learns important functional information despite lacking such data during training. Different performance across metrics indicated AM may determine if polymorphisms in CFTR are recessive CF variants yet cannot differentiate mechanistic effects or the nature of pathophysiology. Finally, AM predictions offered limited utility to inform on the pharmacological response of CF variants i.e., theratype. Development of new approaches to differentiate the biochemical and pharmacological properties of CFTR variants is therefore still needed to refine the targeting of emerging precision CF therapeutics.
Læs mere Tjek på PubMedTakuya Yamanaka, Mary Christine Castro, Julius Patrick Ferrer, Juan Antonio Solon, Sharon E. Cox, Yoko V. Laurence, Anna Vassall
PLoS One Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
by Takuya Yamanaka, Mary Christine Castro, Julius Patrick Ferrer, Juan Antonio Solon, Sharon E. Cox, Yoko V. Laurence, Anna Vassall Objective Diabetes is a risk factor for TB mortality and relapse. The Philippines has a high TB incidence with co-morbid diabetes. This study assessed the pre- and post-TB diagnosis costs incurred by people with TB and diabetes (TB-DM) and their households in the Philippines. Methods Longitudinal data was collected for costs, income, and coping mechanisms of TB-affected households in Negros Occidental and Cebu, the Philippines. Data collection was conducted four times during TB treatment. The data collection tools were developed by adapting WHO’s cross-sectional questionnaire in the Tuberculosis Patient Cost Surveys: A Handbook into a longitudinal study design. Demographic and clinical characteristics, self-reported household income, number of facility visits, patient costs, the proportion of TB-affected households facing catastrophic costs due to TB (>20% of annual household income before TB), coping mechanisms, and social support received were compared by diabetes status at the time of TB diagnosis. Results 530 people with TB were enrolled in this study, and 144 (27.2%) had TB-DM based on diabetes testing at the time of TB diagnosis. 75.4% of people with TB-DM were more than 45 years old compared to 50.3% of people with TB-only (p
Læs mere Tjek på PubMedInfection, 25.01.2024
Tilføjet 25.01.2024
Abstract Purpose Emerging SARS-CoV-2 variants have impacted the in vitro activity of sotrovimab, with variable fold changes in neutralization potency for the Omicron BA.2 sublineage and onward. The correlation between reduced in vitro activity and clinical efficacy outcomes is unknown. A systematic literature review (SLR) evaluated the effectiveness of sotrovimab on severe clinical outcomes during Omicron BA.2 predominance. Methods Electronic databases were searched for peer-reviewed journals, preprint articles, and conference abstracts published from January 1–November 3, 2022. Results Five studies were included, which displayed heterogeneity in study design and population. Two UK studies had large samples of patients during BA.2 predominance: one demonstrated clinical effectiveness vs molnupiravir during BA.1 (adjusted hazard ratio [aHR] 0.54, 95% CI 0.33–0.88; p = 0.014) and BA.2 (aHR 0.44, 95% CI 0.27–0.71; p = 0.001); the other reported no difference in the clinical outcomes of sotrovimab-treated patients when directly comparing sequencing-confirmed BA.1 and BA.2 cases (HR 1.17, 95% CI 0.74–1.86). One US study showed a lower risk of 30-day all-cause hospitalization/mortality for sotrovimab compared with no treatment during the BA.2 surge in March (adjusted relative risk [aRR] 0.41, 95% CI 0.27–0.62) and April 2022 (aRR 0.54, 95% CI 0.08–3.54). Two studies from Italy and Qatar reported low progression rates but were either single-arm descriptive or not sufficiently powered to draw conclusions on the effectiveness of sotrovimab. Conclusion This SLR showed that the effectiveness of sotrovimab was maintained against Omicron BA.2 in both ecological and sequencing-confirmed studies, by demonstrating low/comparable clinical outcomes between BA.1 and BA.2 periods or comparing against an active/untreated comparator.
Læs mere Tjek på PubMedInfection, 25.01.2024
Tilføjet 25.01.2024
Abstract Purpose In this pilot study, we investigated the cardiac autonomic activity of coronavirus disease 2019 (COVID-19)-infected hospitalized patients. COVID-19 is characterized by cough, fever, and dyspnea, which in some severe cases can lead to hypoxia, respiratory failure, and shock. Since breathing disorders and pulmonary diseases are tightly linked to autonomic dysfunction, we analyzed the cardiac autonomic activity by measuring the deceleration capacity (DC) in COVID-19 patients. Methods In 14 adults (4 men and 10 women) with a median age of 63.5 years and positive for SARS-CoV-2 by polymerase chain reaction (PCR) with severe symptoms requiring hospital treatment, a high-resolution digital 30 min electrocardiogram (ECG) in Frank leads configuration was performed in a resting supine position within the first 48 h after hospital admission. DC was assessed using validated software and associated with several markers of inflammation and clinical course. Results The study revealed a significant association between reduced DC (≤ 2.5 ms) and older age (74 years) in COVID-19 patients, compared to those with a higher DC > 2.5 ms (56.5 years). However, the duration of hospitalization was similar for both groups. There was a nonsignificant trend towards a higher maximum viral load in patients with reduced DC. Further, patients with a DC ≤ 2.5 ms showed higher levels of inflammatory markers such as C-reactive protein (CRP) and procalcitonin (PCT), as well as leukocytosis, compared to patients with a DC > 2.5 ms. Also, the COVID-19-severity marker ferritin was significantly elevated in patients with lower DC. Other markers associated with COVID-19, such as lactate dehydrogenase (LDH) and creatine kinase (CK), exhibited comparable levels in both groups. Conclusions Reduced DC (≤ 2.5 ms) was significantly associated with older age, increased inflammatory markers, and elevated ferritin in patients with COVID-19. These findings suggest that DC might serve as a valuable indicator for predicting the risk of severe inflammation in COVID-19 and possibly complications associated with this disease, such as heart failure. Further studies are needed to confirm these observations and clarify the clinical significance of DC in COVID-19 and other infectious diseases.
Læs mere Tjek på PubMedA. Jantine VAN VOORDEN, Christianne J.M. DE GROOT, Carrie RIS-STALPERS, Gijs B. AFINK, Elisabeth VAN LEEUWEN
International Journal of Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
The safety of vaccination against coronavirus disease 2019 (COVID-19) during pregnancy continues to be a topic of concern. Pregnant women are still hesitant to undergo COVID-19 vaccination out of fear for short and long-term complications for their offspring. However, pregnant women infected by SARS-CoV-2 have been more at risk of intensive care unit admission and mechanical ventilation than age-matched non-pregnant women in previous outbreaks [1,2], emphasizing the importance of vaccination in these women.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
Research - Multiple Introductions of Yersinia pestis during Urban Pneumonic Plague Epidemic, Madagascar, 2017
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.01.2024
Tilføjet 25.01.2024
Abstract Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the peripheral nerves, resulting in sensory and motor deficits in the feet. Foot ulcers and imbalances are frequent manifestations in leprosy, often correlating with diminished sensitivity. While clinical scales and monofilament esthesiometers are conventionally utilized to evaluate foot sensitivity and balance in these patients, their discriminatory power is limited and their effectiveness is greatly dependent on the examiner’s proficiency. In contrast, baropodometry and posturography offer a more comprehensive evaluation, aiming to preempt potential damage events. This study aimed was to assess the correlation between baropodometry and force plate measurements in leprosy patients and control participants, to improve the prevention and treatment of foot ulcers and complications associated with leprosy. Methodology This cross-sectional study was conducted during 2022 and enrolled 39 participants (22 patients with multibacillary leprosy and 17 non-leprosy controls). Demographic data were collected, and a monofilament esthesiometer was used to assess sensory deficits. In addition, physical examinations and balance and plantar pressure tests were conducted. The Student’s t-test was used to compare mean and maximum plantar pressures between groups. For most COP variables, a Mann-Whitney Wilcoxon test was used, except for AP amplitude which was analyzed with the Student’s t-test due to its normal distribution. The relationship between foot pressure and balance control was assessed using Spearman’s correlation, focusing on areas with significant pressure differences between groups. Principal findings Leprosy patients showed increased pressure in forefoot areas (T1, M1, T2-T5, and M2) and decreased pressure in hindfoot regions (MH and LH) compared to controls. These patients also displayed higher AP and ML amplitudes, suggesting poorer COP control. Correlation analyses between the two groups revealed that foot plantar pressures significantly impact balance control. Specifically, increased T1 region pressures correlated with greater sway in balance tasks, while decreased MH region pressures were linked to reduced COP control. Conclusions/significance The findings suggest a joint disturbance of plantar pressure distribution and static balance control in leprosy patients. These alterations may increase the risk of tissue injuries, including calluses and deformities, as well as falls.
Læs mere Tjek på PubMedNur Fathiah Rosilan, Muhamad Arif Mohamad Jamali, Siti Aishah Sufira, Khor Waiho, Hanafiah Fazhan, Noraznawati Ismail, Yeong Yik Sung, Zeti-Azura Mohamed-Hussein, Azzmer Azzar Abdul Hamid, Nor Afiqah-Aleng
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Nur Fathiah Rosilan, Muhamad Arif Mohamad Jamali, Siti Aishah Sufira, Khor Waiho, Hanafiah Fazhan, Noraznawati Ismail, Yeong Yik Sung, Zeti-Azura Mohamed-Hussein, Azzmer Azzar Abdul Hamid, Nor Afiqah-Aleng Shrimp aquaculture contributes significantly to global economic growth, and the whiteleg shrimp, Penaeus vannamei, is a leading species in this industry. However, Vibrio parahaemolyticus infection poses a major challenge in ensuring the success of P. vannamei aquaculture. Despite its significance in this industry, the biological knowledge of its pathogenesis remains unclear. Hence, this study was conducted to identify the interaction sites and binding affinity between several immune-related proteins of P. vannamei with V. parahaemolyticus proteins associated with virulence factors. Potential interaction sites and the binding affinity between host and pathogen proteins were identified using molecular docking and dynamics (MD) simulation. The P. vannamei-V. parahaemolyticus protein-protein interaction of Complex 1 (Ferritin-HrpE/YscL family type III secretion apparatus protein), Complex 2 (Protein kinase domain-containing protein-Chemotaxis CheY protein), and Complex 3 (GPCR-Chemotaxis CheY protein) was found to interact with -4319.76, -5271.39, and -4725.57 of the docked score and the formation of intermolecular bonds at several interacting residues. The docked scores of Complex 1, Complex 2, and Complex 3 were validated using MD simulation analysis, which revealed these complexes greatly contribute to the interactions between P. vannamei and V. parahaemolyticus proteins, with binding free energies of -22.50 kJ/mol, -30.20 kJ/mol, and -26.27 kJ/mol, respectively. This finding illustrates the capability of computational approaches to search for molecular binding sites between host and pathogen, which could increase the knowledge of Vibrio spp. infection on shrimps, which then can be used to assist in the development of effective treatment.
Læs mere Tjek på PubMedKatherine Stumpf, Priya Sharma, L. Steven Brown, Luc P. Brion, Julie Mirpuri
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Katherine Stumpf, Priya Sharma, L. Steven Brown, Luc P. Brion, Julie Mirpuri Introduction Our aim was to determine if maternal body mass index (BMI) is associated with necrotizing enterocolitis (NEC) in a large urban delivery center. Methods This single center retrospective case-control study included 291 infants under gestational age of 33 weeks admitted to the neonatal intensive care unit (NICU) during a 10-year period. Cases of stage 2 and 3 NEC were matched at a ratio of 2 controls (n = 194) to 1 case (n = 97). Maternal BMI was categorized as normal (≤24.9), overweight (25–29.9) and obese (≥30). Chi-square and stepwise logistic regression were used for analysis. A power analysis was performed to determine if sample size was sufficient to detect an association. Results Stepwise logistic regression demonstrated no association between NEC and maternal obesity. Maternal hypertension, pre-eclampsia, premature rupture of membranes, maternal exposure to antibiotics, placental abruption and gestational diabetes were not associated with NEC. Power analysis showed the sample size was sufficient to detect an association of NEC with maternal BMI in three groups analyzed. In this case-control study, there was an association between NEC and maternal overweight but not obesity at delivery. Discussion Our results did not show a significant association of NEC with maternal obesity. The percent of overweight and obese mothers prior to pregnancy and at delivery was significantly higher in our population than the national average and may be responsible for the limited ability to reveal any association between maternal obesity and NEC.
Læs mere Tjek på PubMedIván Ochoa-Moreno, Ravita Taheem, Kathryn Woods-Townsend, Debbie Chase, Keith M. Godfrey, Neena Modi, Mark Hanson
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Iván Ochoa-Moreno, Ravita Taheem, Kathryn Woods-Townsend, Debbie Chase, Keith M. Godfrey, Neena Modi, Mark Hanson Background The prevalence of overweight and obesity in young children rose sharply during the COVID-19 pandemic. Here we estimate the potential future health and economic effects of these trends in England. Methods Using publicly available annual Body Mass Index (BMI) data from 2006–2022, we calculated the increase in overweight/obesity prevalence (BMI ≥85th reference percentile) during the COVID-19 pandemic among children aged 4–5 and 10–11, and variation by deprivation and ethnicity. We projected the impact of child BMI trends on adult health measures to estimate added lifelong medical and social costs. Results During 2020–2021 there were steep increases in overweight and obesity prevalence in children. By 2022, overweight and obesity prevalence in children aged 4–5 returned to expected levels based on pre-pandemic trends. However, overweight and obesity prevalence in children aged 10–11 persisted and was 4 percentage points (p
Læs mere Tjek på PubMedMalaria Journal, 24.01.2024
Tilføjet 24.01.2024
Abstract Background Seasonal malaria chemoprevention (SMC) is an effective intervention to prevent malaria in children in locations where the burden of malaria is high and transmission is seasonal. There is growing evidence suggesting that SMC with sulfadoxine–pyrimethamine and amodiaquine can retain its high level of effectiveness in East and Southern Africa despite resistance concerns. This study aims to generate evidence on the effectiveness of SMC when delivered under programmatic conditions in an area with an unknown anti-malarial drug resistance profile in the Northern Bahr el-Ghazal region of South Sudan. Methods A non-randomized quasi experimental study was conducted to compare an intervention county with a control county. Five monthly SMC cycles were delivered between July and November 2022, targeting about 19,000 children 3–59 months old. Data were obtained from repeated cross-sectional household surveys of caregivers of children aged 3–59 months using cluster sampling. Wave 1 survey took place in both counties before SMC implementation; Waves 2 and 3 took place after the second and fourth monthly SMC cycles. Difference-in-differences analyses were performed by fitting logistic regression models with interactions between county and wave. Results A total of 2760 children were sampled in the study across the three survey waves in both study counties. Children in the intervention arm had 70% lower odds of caregiver-reported fever relative to those in the control arm during the one-month period prior to Wave 2 (OR: 0.30, 95% CI 0.12–0.70, p = 0.003), and 37% lower odds in Wave 3 (OR: 0.63, 95% CI 0.22–1.59, p = 0.306) after controlling for baseline difference between counties in Wave 1. Odds of caregiver-reported RDT-confirmed malaria were 82% lower in the previous 1-month period prior to Wave 2 (OR: 0.18, 95% CI 0.07–0.49, p = 0.001) and Wave 3 (OR: 0.18, 95% CI 0.06–0.54, p = 0.003). Conclusion These results show high effectiveness of SMC using SPAQ in terms of reducing malaria disease during the high transmission season in children 3–59 month. Despite the promising results, additional evidence and insights from chemoprevention efficacy cohort studies, and analyses of relevant resistance markers, are required to assess the suitability of SMC for this specific context.
Læs mere Tjek på PubMedInfection, 24.01.2024
Tilføjet 24.01.2024
Abstract Background and purpose The need for dose adjustment of caspofungin in patients with hepatic impairment is controversial, especially for those with Child–Pugh B or C cirrhosis. The purpose of this study was to investigate the safety and efficacy of standard-dose caspofungin administration in Child–Pugh B and C cirrhotic patients in a real-world clinical setting. Patients and methods The electronic medical records of 258 cirrhotic patients, including 67 Child–Pugh B patients and 191 Child–Pugh C patients, who were treated with standard-dose of caspofungin at the Second Affiliated Hospital of Chongqing Medical University, China, from March 2018 to June 2023 were reviewed retrospectively. The white blood cells (WBC), hepatic, renal and coagulation function results before administration and post administration on days 7, 14 and 21 were collected, and the efficacy was assessed in all patients at the end of caspofungin therapy. Results Favorable responses were achieved in 137 (53.1%) patients while 34 (13.2%) patients died. We observed that some patients experienced an increase of prothrombin time (PT) or international normalized ratio (INR), or a decrease of WBC, but no exacerbation of hepatic or renal dysfunction were identified and no patient required dose interruption or adjustment because of an adverse drug reaction during treatment with caspofungin. Conclusions Standard-dose of caspofungin can be safely and effectively used in patients with Child–Pugh B or C cirrhosis, and we appealed to re-assess the most suitable dosing regimen in this population to avoid a potential subtherapeutic exposure.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
Abstract Background Tuberculosis (TB) treatment-related adverse drug reactions (TB-ADR) can negatively affect adherence and treatment success rates.Methods We developed prediction models for TB-ADR, considering drug-susceptible pulmonary TB participants who initiated standard TB therapy. TB-ADR were determined by the physician attending the participant, assessing causality to TB drugs, the affected organ system, and grade. Potential baseline predictors of TB-ADR included concomitant medication (CM)-use, HIV-status, glycated hemoglobin (HbA1c), age, body mass index (BMI), sex, substance use, and TB drug metabolism variables (NAT2 acetylator profiles). The models were developed through bootstrapped backwards selection. Cox regression was used to evaluate TB-ADR risk.Results There were 156 TB-ADR among 102 (11%) of the 945 participants included. Most TB-ADR were hepatic (n = 82; 53%), of moderate severity (grade 2; n = 121; 78%) and occurred in NAT2 slow acetylators (n = 62; 61%). The main prediction model included CM-use, HbA1c, alcohol-use, HIV-seropositivity, BMI, and age, with robust performance (c-statistic = 0.79, 95% confidence interval (CI): 0.74-0.83) and fit (optimism corrected-slope and intercept of -0.09 and 0.94, respectively). An alternative model replacing BMI with NAT2 had similar performance. HIV-seropositivity (hazard ratio (HR) 2.68, 95%CI 1.75-4.09) and CM-use (HR 5.26, 95%CI 2.63-10.52) increased TB-ADR risk.Conclusions The models, with clinical variables and with NAT2, were highly predictive of TB-ADR.
Læs mere Tjek på PubMedKarthik HullahalliKatherine G. DaileyYuko HasegawaWelkin E. JohnsonMatthew K. WaldoraDepartment of Microbiology, Harvard Medical School, Boston, MA 02115bDivision of Infectious Disease, Brigham and Women’s Hospital, Boston, MA 02115cBiology Department, Boston College, Chestnut Hill, MA 02467
Proceedings of the National Academy of Sciences, 24.01.2024
Tilføjet 24.01.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 4, January 2024.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
Abstract Purpose We aimed to analyze the clinical features of COVID-19-associated pulmonary aspergillosis (CAPA) during the SARS-CoV-2 Omicron variant pandemic and to reveal the risk factors for CAPA and death. Methods A retrospective cohort study was conducted on 168 CAPA patients from December 8, 2022 to January 31, 2023. 168 COVID-19 patients without secondary fungal infection during this period were matched 1:1 using propensity score matching as controls. Results The incidence of CAPA was 3.8% (168/4421). Compared with patients without fungal infection, CAPA patients had a higher mortality (43.5% vs. 10.1%, P
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
Abstract Background An increase in patients with multidrug-resistant organisms and associated outbreaks during the COVID-19 pandemic have been reported in various settings, including low-endemic settings. Here, we report three distinct carbapenem-resistant Acinetobacter baumannii (CRAB) outbreaks in five intensive care units of a university hospital in Berlin, Germany during the COVID-19 pandemic. Methods A case-control study was conducted with the objective of identifying risk factors for CRAB acquisition in outbreak situations. Data utilized for the case-control study came from the investigation of three separate CRAB outbreaks during the COVID-19 pandemic (August 2020– March 2021). Cases were defined as outbreak patients with hospital-acquired CRAB. Controls did not have any CRAB positive microbiological findings and were hospitalized at the same ward and for a similar duration as the respective case. Control patients were matched retrospectively in a 2:1 ratio. Parameters routinely collected in the context of outbreak management and data obtained retrospectively specifically for the case-control study were included in the analysis. To analyze risk factors for CRAB acquisition, univariable and multivariable analyses to calculate odds ratios (OR) and 95% confidence intervals (CI) were performed using a conditional logistic regression model. Results The outbreaks contained 26 cases with hospital-acquired CRAB in five different intensive care units. Two exposures were identified to be independent risk factors for nosocomial CRAB acquisition by the multivariable regression analysis: Sharing a patient room with a CRAB patient before availability of the microbiological result was associated with a more than tenfold increase in the risk of nosocomial CRAB acquisition (OR: 10.7, CI: 2.3–50.9), while undergoing bronchoscopy increased the risk more than six times (OR: 6.9, CI: 1.3–38.1). Conclusions The risk factors identified, sharing a patient room with a CRAB patient and undergoing bronchoscopy, could point to an underperformance of basic infection control measure, particularly hand hygiene compliance and handling of medical devices. Both findings reinforce the need for continued promotion of infection control measures. Given that the outbreaks occurred in the first year of the COVID-19 pandemic, our study serves as a reminder that a heightened focus on airborne precautions should not lead to a neglect of other transmission-based precautions.
Læs mere Tjek på PubMedKatarzyna Bialas, Felipe Diaz-Griffero
Trends in Microbiology, 24.01.2024
Tilføjet 24.01.2024
Cleavage and polyadenylation specificity factor subunit 6 (CPSF6, also known as CFIm68) is a 68 kDa component of the mammalian cleavage factor I (CFIm) complex that modulates mRNA alternative polyadenylation (APA) and determines 3′ untranslated region (UTR) length, an important gene expression control mechanism. CPSF6 directly interacts with the HIV-1 core during infection, suggesting involvement in HIV-1 replication. Here, we review the contributions of CPSF6 to every stage of the HIV-1 replication cycle. Recently, several groups described the ability of HIV-1 infection to induce CPSF6 translocation to nuclear speckles, which are biomolecular condensates. We discuss the implications for CPSF6 localization in condensates and the potential role of condensate-localized CPSF6 in the ability of HIV-1 to control the protein expression pattern of the cell.
Læs mere Tjek på PubMedMarêva Bleuzé, Jean-Pierre Lavoie, Christian Bédard, Marcelo Gottschalk, Mariela Segura
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Marêva Bleuzé, Jean-Pierre Lavoie, Christian Bédard, Marcelo Gottschalk, Mariela Segura The porcine pathogen and zoonotic agent Streptococcus suis induces an exacerbated inflammation in the infected hosts that leads to sepsis, meningitis, and sudden death. Several virulence factors were described for S. suis of which the capsular polysaccharide (CPS) conceals it from the immune system, and the suilysin exhibits cytotoxic activity. Although neutrophils are recruited rapidly upon S. suis infection, their microbicidal functions appear to be poorly activated against the bacteria. However, during disease, the inflammatory environment could promote neutrophil activation as mediators such as the granulocyte colony-stimulating factor granulocyte (G-CSF) and the granulocyte-macrophages colony-stimulating factor (GM-CSF) prime neutrophils and enhance their responsiveness to bacterial detection. Thus, we hypothesized that CPS and suilysin prevent an efficient activation of neutrophils by S. suis, but that G-CSF and GM-CSF rescue neutrophil activation, leading to S. suis elimination. We evaluated the functions of porcine neutrophils in vitro in response to S. suis and investigated the role of the CPS and suilysin on cell activation using isogenic mutants of the bacteria. We also studied the influence of G-CSF and GM-CSF on neutrophil response to S. suis by priming the cells with recombinant proteins. Our study confirmed that CPS prevents S. suis-induced activation of most neutrophil functions but participates in the release of neutrophil-extracellular traps (NETs). Priming with G-CSF did not influence cell activation, but GM-CSF strongly promote IL-8 release, indicating its involvement in immunomodulation. However, priming did not enhance microbicidal functions. Studying the interaction between S. suis and neutrophils–first responders in host defense–remains fundamental to understand the immunopathogenesis of the infection and to develop therapeutical strategies related to neutrophils’ defense against this bacterium.
Læs mere Tjek på PubMedJeffrey Letourneau, LaShawndra Walker, Se Hyang Han, Lawrence A. David, Noelle Younge
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Jeffrey Letourneau, LaShawndra Walker, Se Hyang Han, Lawrence A. David, Noelle Younge The infant gut microbiome is a crucial factor in health and development. In preterm infants, altered gut microbiome composition and function have been linked to serious neonatal complications such as necrotizing enterocolitis and sepsis, which can lead to long-term disability. Although many studies have described links between microbiome composition and disease risk, there is a need for biomarkers to identify infants at risk of these complications in practice. In this pilot study, we obtained stool samples from preterm infant participants longitudinally during the first postnatal months, and measured pH and redox, as well as SCFA content and microbiome composition by 16S rRNA gene amplicon sequencing. These outcomes were compared to clinical data to better understand the role of pH and redox in infant gut microbiome development and overall health, and to assess the potential utility of pH and redox as biomarkers. We found that infants born earlier or exposed to antibiotics exhibited increased fecal pH, and that redox potential increased with postnatal age. These differences may be linked to changes in SCFA content, which was correlated with pH and increased with age. Microbiome composition was also related to birth weight, age, pH, and redox. Our findings suggest that pH and redox may serve as biomarkers of metabolic state in the preterm infant gut.
Læs mere Tjek på PubMedMalaria Journal, 24.01.2024
Tilføjet 24.01.2024
Abstract Background Despite Ethiopia’s concerted efforts to eliminate malaria by 2030, the disease continues to pose a significant public health and socioeconomic challenge in the country. The year 2021 witnessed 2.78 million malaria cases and 8041 associated deaths, emphasizing the persistent threat. Monitoring the prevalence trend of malaria is crucial for devising effective control and elimination strategies. This study aims to assess the trend of malaria prevalence at the Metehara Health Centre in the East Shoa Zone, Ethiopia. Methods A retrospective study, spanning from February to September 2023, utilized malaria registration laboratory logbooks at Metehara Health Centre to evaluate the prevalence of malaria from 2017/18 to 2022/23. Malaria and related data were collected using a pre-designed data collection sheet. Descriptive statistics were employed for data summarization, presented through graphs and tables. Results Out of 59,250 examined blood films, 17.4% confirmed the presence of Plasmodium infections. Among the confirmed cases, 74.3%, 23.8%, and 1.84% were attributed to Plasmodium falciparum, Plasmodium vivax, and mixed infections, respectively. The trend of malaria exhibited a steady decline from 2017/18 to 2021/22, reaching 9.8% prevalence. However, an abrupt increase to 26.5% was observed in 2022/23. Males accounted for a higher proportion (66%) of cases compared to females (34%). The age group 15–24 years experienced the highest malaria incidence at 42%. Notably, malaria cases peaked during autumn (September to November) at 43% and reached the lowest percentage during spring (March to May) at 13%. Conclusion Malaria persists as a significant health challenge in and around Metehara, central Ethiopia, predominantly driven by Plasmodium falciparum. The five-year declining trend was interrupted by a notable upsurge in 2022/23, indicating a resurgence of malaria in the study area. It is imperative to adopt a reverse strategy to sustain the progress achieved by the national malaria control plan.
Læs mere Tjek på PubMedManuel Leitner, Gloria Pötz, Martin Berger, Maria Fellner, Stephan Spat, Marisa Koini
PLoS One Infectious Diseases, 23.01.2024
Tilføjet 23.01.2024
by Manuel Leitner, Gloria Pötz, Martin Berger, Maria Fellner, Stephan Spat, Marisa Koini Background COVID-19 infection and its associated consequence, known as long-COVID, lead to a significant burden on the global healthcare system and limitations in people’s personal and work lives. This study aims to provide further insight into the impact of acute and ongoing COVID-19 symptoms and investigates the role of patients’ gender and vaccination status. Methods 416 individuals (73.9% female) between the ages of 16 and 80 years (M = 44.18, SD = 12.90) with self-reported symptoms of long-COVID participated in an online survey conducted between March and May 2022. Results 6.0%, 74.3%, and 19.7% of all respondents reported having had an asymptomatic, mild, or severe acute illness, respectively. Out of all participants, 7.8% required hospitalization. The most prevalent symptoms during the acute infection (Mdn = 23.50 symptoms, IQR = 13–39) included fatigue, exhaustion, cough, brain fog, and memory problems. The median long-COVID disease duration was 12.10 months (IQR = 2.8–17.4). Among 64 inquired long-COVID symptoms (Mdn = 17.00 symptoms, IQR = 9–27), participants reported fatigue, exhaustion, memory problems, brain fog, and dyspnea as the most common ongoing symptoms, which were generally experienced as fluctuating and deteriorating after physical or cognitive activity. Common consequences of long-COVID included financial losses (40.5%), changes in the participants’ profession (41.0%), stress resistance (87.5%), sexual life (38.1%), and mood (72.1%), as well as breathing difficulties (41.3%), or an increased drug intake (e.g., medicine, alcohol; 44.6%). In addition, vaccinated individuals exhibited a shorter acute illness duration and an earlier onset of long-COVID symptoms. In general, women reported more long-COVID symptoms than men. Conclusion Long-COVID represents a heterogeneous disease and impacts multiple life aspects of those affected. Tailored rehabilitation programs targeting the plurality of physical and mental symptoms are needed.
Læs mere Tjek på PubMedThanin Methiyothin, Insung Ahn
PLoS One Infectious Diseases, 23.01.2024
Tilføjet 23.01.2024
by Thanin Methiyothin, Insung Ahn The coronavirus disease (COVID-19) pandemic has considerably impacted public health, including the transmission patterns of other respiratory pathogens, such as the 2009 pandemic influenza (H1N1). COVID-19 and influenza are both respiratory infections that started with a lack of vaccination-based immunity in the population. However, vaccinations have been administered over time, resulting in a transition of the status of both diseases from a pandemic to an endemic. In this study, unsupervised clustering techniques were used to identify clusters of disease trends in Thailand. The analysis incorporated three distinct surveillance datasets: the pandemic influenza outbreak, influenza in the endemic stage, and the early stages of COVID-19. The analysis demonstrated a significant difference in the distribution of provinces between Cluster -1, representing those with unique transmission patterns, and the other clusters, indicating provinces with similar transmission patterns among their members. Specifically, for Pandemic Influenza, the ratio was 61:16, while for Pandemic COVID-19, it was 65:12. In contrast, Endemic Influenza exhibited a ratio of 46:31, with a notable emergence of more clustered provinces in the southern, western, and central regions. Furthermore, a pair of provinces with highly similar spreading patterns were identified during the pandemic stages of both influenza and COVID-19. Although the similarity decreased slightly for endemic influenza, they still belonged to the same cluster. Our objective was to identify the transmission patterns of influenza and COVID-19, with the aim of providing quantitative and spatial information to aid public health management in preparing for future pandemics or transitioning into an endemic phase.
Læs mere Tjek på PubMedRomanus A. Osabohien, Amar Hisham Jaaffar, Joshua Ibrahim, Ojonugwa Usman, Amechi E. Igharo, Adeleke Abdulrahman Oyekanmi
PLoS One Infectious Diseases, 23.01.2024
Tilføjet 23.01.2024
by Romanus A. Osabohien, Amar Hisham Jaaffar, Joshua Ibrahim, Ojonugwa Usman, Amechi E. Igharo, Adeleke Abdulrahman Oyekanmi Africa has been known to experience series of problems among which are poverty, food insecurity, lack of access to energy, lack of infrastructure among others. These problems were exacerbated by the COVID-19 pandemic, which has had a severe impact on the socioeconomic status of households in Africa. This paper examines the relationship between socioeconomic shocks, social protection, and household food security during the pandemic in Nigeria, the Africa’s largest economy. Using the World Bank’s COVID-19 national longitudinal baseline phone survey (2020) for the analysis and applied the multinomial logit regression, the study finds that socioeconomic shocks resulting from the pandemic have led to an increased level of food insecurity. Social protection programmes have played a crucial role in mitigating the impact of these shocks on households. However, the study also highlights the need for more targeted and effective social protection policies to ensure that vulnerable households are adequately protected from the adverse effects of the pandemic. The findings of this study have important implications for policymakers and stakeholders in Africa’s largest economy, as they seek to address the challenges posed by the pandemic and promote household food security for the actualisation the United Nations (UN) Sustainable Development Goal (SDG) of food and nutrition security (SDG2). The study, therefore, recommends that efforts be made to preserve food supply chains by mitigating the pandemic’s effect on food systems, increasing food production, and looking forward beyond the pandemic by building resilient food systems with the use of social protection interventions.
Læs mere Tjek på PubMedMalaria Journal, 23.01.2024
Tilføjet 23.01.2024
Abstract Background The emergence of insecticide resistance and outdoor transmission in malaria-endemic areas underlines the urgent need to develop innovative tools, such as spatial repellents (SR), that may circumvent this residual transmission. With limited options for effective insecticides, regular resistance monitoring is warranted for selecting and using appropriate tools. This study evaluates the pyrethroid knockdown resistance (kdr) allele before and after implementing a transfluthrin-based spatial repellent (SR) intervention in placebo-treated clusters. Methods This study looks at the frequency distribution of the kdr allele in Sumba Island from June 2015 to August 2018. Insecticide susceptibility tests were carried out on female Anopheles sp. aged 3–5 days against permethrin 21.5 μg/ml, deltamethrin 12.5 μg/ml, and transfluthrin 10 μg/ml using CDC bottle assay. PCR sequencing of representative samples from adult mosquito collections and insecticide tests revealed the presence of kdr mutations (L1014F and L1014S) in the VGSC gene. Results A total of 12 Anopheles species, Anopheles tesselatus, Anopheles. aconitus, Anopheles barbirostris, Anopheles kochi, Anopheles annularis, Anopheles maculatus, Anopheles sundaicus, Anopheles flavirostris, Anopheles balabacensis, Anopheles indefinitus, Anopheles subpictus, and Anopheles vagus were analysed. Anopheles vagus and An. sundaicus predominated in the larval populations. Susceptibility assays for all insecticides identified fully susceptible phenotypes in all species examined. Anopheles increasing frequency of kdr mutant alleles during the 3 year SR deployment was observed in both SR-treated and placebo areas, a statistically significant increase occurred in each arm. However, it is unclear how significant SR is in causing the increase in mutant alleles. The L1014S, knockdown resistance east type (kdr-e) allele was detected for the first time among the mosquito samples in this study. The L1014F, knockdown resistance west type (kdr-w) allele and heteroduplex form (wild-type—mutant) were found in almost all Anopheles species examined, including An. vagus, An. aconitus, An. subpictus, An. tesselatus, An. annularis, An. flavirostris and An. sundaicus. Conclusion The presence of fully susceptible phenotypes over time, along with an increase in the frequency distribution of the L1014F/S mutations post-intervention, suggest drivers of resistance external to the study, including pyrethroid use in agriculture and long-lasting insecticidal nets (LLINs). However, this does not negate possible SR impacts that support resistance. More studies that enable the comprehension of possible SR-based drivers of resistance in mosquitoes need to be conducted.
Læs mere Tjek på PubMedYasutoshi Takashima, Hidetaka Kawamura, Kazuo Okadome, Satoko Ugai, Koichiro Haruki, Kota Arima, Kosuke Mima, Naohiko Akimoto, Jonathan A. Nowak, Marios Giannakis, Wendy S. Garrett, Cynthia L. Sears, Mingyang Song, Tomotaka Ugai, Shuji Ogino
Clinical Microbiology and Infection, 22.01.2024
Tilføjet 22.01.2024
Data support that enterotoxigenic Bacteroides fragilis (ETBF) harbouring the Bacteroides fragilis toxin (bft) gene may promote colorectal tumourigenesis through the serrated neoplasia pathway. We hypothesised that ETBF may be enriched in colorectal carcinoma subtypes with high-level CpG island methylator phenotype (CIMP-high), BRAF mutation, and high-level microsatellite instability (MSI-high).
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
Abstract Background Group A Rotaviruses (RVA) is one of the most common causes of severe diarrhoea in infants and children under 5 years of age. Unlike many countries in the world where RVA surveillance/control is active, in Chad , there is currently no applied RVA immunization program and surveillance strategy. The present study aims to determine the prevalence and associated risk factors of RVA gastroenteritis among children under five years of age in N’Djamena. Method This study comprised two parts: (1) A cross-sectional study carried in four hospitals in N’Djamena between August and November 2019, to determine infection risk factors and evidence of RVA infection among children aged five and below, consulted or hospitalized for diarrhea. An ELISA based RVA VP6 protein detection was used to determine RVA infection prevalence. Infection results and sociodemographic data were statistically analysed to determine RVA infection risk factors. (2) A retrospective study that consisted of analysing the records of stool examinations of the period from January 2016 to December 2018, to determine the prevalence of infectious gastroenteritis among the target population. Results For the cross-sectional study, RVA infection prevalence was 12.76% (18/141) with males (61.11%) being more affected (sex ratio: 1.57). Children below 12 months were the most affected age group (44.44%) and 44.4% were malnourished. The mean Vesikari score shows that 38.8% of children have a high severity level and 41.1% have a moderate level. For the retrospective study, 2,592 cases of gastroenteritis hospitalization were analysed; 980 out of 2,592 cases (37.81%) of hospitalization due to diarrhoea were due to diarrhoeagenic pathogens including Emtamoeba hystolitica, Gardia lamblia, Trichomonas hominis, Hymenolepis nana, Escherichia coli, Shigella spp, Proteus mirabilis, and Klebsiella oxytoca. Cases of diarrhoea with negative pathogen search were 1,612 cases (62.19%). The diarrhoea peak was observed during the dry seasons, and the age group under 11 months was the most affected was (57.3%). Conclusion This study describes the evidence of RVA infection among diarrhoeic children below five years of age in N’Djamena, thus indicates a serious health burden. Malnourishment younger age was the higher risk factor. Further studies are needed to determine the circulating strains prior to considering introduction of RVA vaccine and setup a routine rotavirus surveillance in Chad.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
Abstract Background The healthcare system in Iran appears to overlook Mediterranean spotted fever (MSF) as an endemic disease, particularly in pediatric cases, indicating the need for greater attention and awareness. Case presentation A six-year-old patient with fever, abdominal pain, headache, skin rashes, diarrhea, vomiting, and black eschar (tache noire) from southeast Iran was identified as a rickettsiosis caused by Rickettsia conorii subsp. israelensis through clinical and laboratory assessments, including IFA and real-time PCR. The patient was successfully treated with doxycycline. Conclusions Symptoms like rash, edema, eschar, and abdominal pain may indicate the possibility of MSF during the assessment of acute febrile illness, IFA and real-time PCR are the primary diagnostic methods for this disease.
Læs mere Tjek på PubMedCaitlin M. Wolfe, Abbie Barry, Adriana Campos, Bridget Farham, Dorothy Achu, Elizabeth Juma, Akpaka Kalu, Benido Impouma
International Journal of Infectious Diseases, 22.01.2024
Tilføjet 22.01.2024
Neglected tropical diseases (NTDs) represent a group of diseases and conditions occurring most commonly in settings of extreme poverty [1,2]. These chronic, disabling, and sometimes disfiguring diseases historically receive less attention compared to other diseases occurring in the same regions [3]. The World Health Organization (WHO) African region bears the greatest burden of NTDs, accounting for 40% of global cases as of 2022, excluding chagas disease [4], and with the most countries experiencing a high NTD burden per million inhabitants [5].
Læs mere Tjek på PubMedJournal of Infectious Diseases, 21.01.2024
Tilføjet 21.01.2024
Abstract Background Carbapenemase-producing Enterobacterales (CPE) are challenging in healthcare, with resistance to multiple classes of antibiotics. This study describes the emergence of IMP-encoding CPE amongst diverse Enterobacterales species between 2016 and 2019 across a London regional network.Methods We performed a network analysis of patient pathways, using electronic health records, to identify contacts between IMP-encoding CPE positive patients. Genomes of IMP-encoding CPE isolates were overlayed with patient contacts to imply potential transmission events.Results Genomic analysis of 84 Enterobacterales isolates revealed diverse species (predominantly Klebsiella spp, Enterobacter spp, E. coli); 86% (72/84) harboured an IncHI2 plasmid carrying blaIMP and colistin resistance gene mcr-9 (68/72). Phylogenetic analysis of IncHI2 plasmids identified three lineages showing significant association with patient contacts and movements between four hospital sites and across medical specialities, which was missed on initial investigations.Conclusions Combined, our patient network and plasmid analyses demonstrate an interspecies, plasmid-mediated outbreak of blaIMPCPE, which remained unidentified during standard investigations. With DNA sequencing and multi-modal data incorporation, the outbreak investigation approach proposed here provides a framework for real-time identification of key factors causing pathogen spread. Plasmid-level outbreak analysis reveals that resistance spread may be wider than suspected, allowing more interventions to stop transmission within hospital networks.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 21.01.2024
Tilføjet 21.01.2024
Abstract Infectious disease outbreaks have become increasingly common and require global partnership for adequate preparedness and response. During outbreaks, medical countermeasures (MCMs)—vaccines, therapeutics, and diagnostics—need to reach patients quickly.BARDA utilizes public-private partnerships to support advanced development of MCMs through U.S. FDA approval against a variety of threats within its mission space. MCM preparedness and response must be approached as an integrated life cycle, not as independent steps. Recent filovirus outbreaks in Africa exemplify that collaborative relationships are critical for emergency response, and products with regulatory approval can expand access and reach patients quicker than investigational products.Unfortunately, insufficient funding globally and differences in funders’ prioritization puts gains and future efforts at risk. Of primary concern is a) lack of a feasible regulatory path and clinical capability to achieve regulatory approval for new MCMs for many diseases; and b) the need for partners with the mandate, funding, and capabilities to support the life cycle activities following development—long-term sustainment of manufacturing capability and stockpiling of licensed products to support international outbreaks.Finding partners that complement BARDA’s mission and support the MCM life cycle will be a key component in deciding which MCM development efforts can be supported. Without collaboration, the global community runs the risk of losing the capabilities built through years of investment and being underprepared to combat future threats. Synergies between funders that have different roles and responsibilities within the MCM life cycle are critical to MCM availability and create long-term sustainment of products to ensure access.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.01.2024
Tilføjet 21.01.2024
Abstract Background Actinomyces turicensis is rarely responsible of clinically relevant infections in human. Infection is often misdiagnosed as malignancy, tuberculosis, or nocardiosis, therefore delaying the correct identification and treatment. Here we report a case of a 55-year-old immunocompetent adult with brain abscess caused by A. turicensis. A systematic review of A. turicensis infections was performed. Methods A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases MEDLINE, Embase, Web of Science, CINAHL, Clinicaltrials.gov and Canadian Agency for Drugs and Technology in Health (CADTH) were searched for all relevant literature. Results Search identified 47 eligible records, for a total of 67 patients. A. turicensis infection was most frequently reported in the anogenital area (n = 21), causing acute bacterial skin and skin structure infections (ABSSSI) including Fournier’s gangrene (n = 12), pulmonary infections (n = 8), gynecological infections (n = 6), cervicofacial district infections (n = 5), intrabdominal or breast infections (n = 8), urinary tract infections (n = 3), vertebral column infections (n = 2) central nervous system infections (n = 2), endocarditis (n = 1). Infections were mostly presenting as abscesses (n = 36), with or without concomitant bacteremia (n = 7). Fever and local signs of inflammation were present in over 60% of the cases. Treatment usually involved surgical drainage followed by antibiotic therapy (n = 51). Antimicrobial treatments most frequently included amoxicillin (+clavulanate), ampicillin/sulbactam, metronidazole or cephalosporins. Eighty-nine percent of the patients underwent a full recovery. Two fatal cases were reported. Conclusions To the best of our knowledge, we hereby present the first case of a brain abscess caused by A. turicensis and P. mirabilis. Brain involvement by A. turicensis is rare and may result from hematogenous spread or by dissemination of a contiguous infection. The infection might be difficult to diagnose and therefore treatment may be delayed. Nevertheless, the pathogen is often readily treatable. Diagnosis of actinomycosis is challenging and requires prompt microbiological identification. Surgical excision and drainage and antibiotic treatment usually allow for full recovery.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.01.2024
Tilføjet 20.01.2024
Abstract Background Bacterial infections are not prevalent among patients hospitalized with COVID-19, while unnecessary prescription of antibiotics was commonly observed. This study aimed to determine the impact of procalcitonin testing on antibiotics prescription in the real-world setting. Methods We performed a territory-wide retrospective cohort study involving all laboratory-confirmed patients hospitalized in public hospitals in Hong Kong in 2020 with COVID-19. We determined the prevalence of bacterial co-infections (documented infections within 72 h of admission) and secondary bacterial infections (infections after 72 h of admission) and antibiotics consumption, and the correlation between procalcitonin testing and antibiotics prescription. Results The cohort included 8666 patients, with mean age 45.3 ± 19.9 years, 48.5% male, and comorbidities in 26.9%. Among 2688 patients with bacterial cultures performed, 147 (5.5%) had bacterial co-infections, and 222 (8.3%) had secondary bacterial infections. Antibiotics were prescribed for 2773 (32.0%) patients during the hospital admission. Procalcitonin tests were performed for 2543 (29.3%) patients. More patients with procalcitonin testing received antibiotics (65.9% vs. 17.9%, p
Læs mere Tjek på PubMedMinh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le
PLoS One Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
by Minh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le Background The Coronavirus disease of 2019 (COVID-19) pandemic and the corresponding mitigation measures have had a discernible impact on drug utilization among outpatients. However, limited research exists on the prescription trends in the elderly population during the pandemic period in Viet Nam. Objectives This study aims to analyze the effects of COVID-19 on outpatient drug utilization patterns at a national geriatric hospital in Ho Chi Minh City before and after the early onset of the pandemic. Methods Data was collected from the prescriptions and administration claims, encompassing the period from January 2016 to December 2022. The dataset was divided into two periods: Period 1: January 2016 to December 2020 and Period 2: January 2021 to December 2022. The drug utilization was measured using DDD/1000P (defined daily doses–DDD per 1000 prescriptions) on a monthly basis. The analysis employed interrupted time series using Autoregressive Integrated Moving Average (ARIMA) to detect changes in drug use levels and rates. Results A total of 1,060,507 and 644,944 outpatient prescriptions from Thong Nhat Hospital were included in Period 1 and Period 2, respectively. The median age of the patients were 58 in Period 1 and 67 years old in Period 2. The most common comorbidities were dyslipidemia, hypertension, and diabetes mellitus. In terms of medication utilization, cardiovascular drugs were the most frequently prescribed, followed by drugs active on the digestive and hormonal systems. The study observed significant surges in the number of prescriptions and the average number of drugs per prescription. However, there were no significant changes in the overall consumption of all drugs. Among the drug groups related to the cardiovascular system, three subgroups experienced a sudden and significant increase: cardiac therapy, beta-blocking agents, and antihypertensives, with increasing consumption levels of 1,177.73 [CI 95%: 79.29; 2,276.16], 73.32 [CI 95%: 28.18; 118.46], and 36.70 [CI 95%: 6.74; 66.66] DDD/1000P, respectively. On the other hand, there was a significant monthly decrease of -31.36 [CI 95%: -57.02; -5.70] DDD/1000P in the consumption of anti-inflammatory and antirheumatic products. Interestingly, there was a significant increase of 74.62 [CI 95%: -0.36; 149.60] DDD/1000P in the use of antigout preparations. Conclusion COVID-19 resulted in a sudden, non-significant increase in overall drug consumption levels among outpatients. Notably, our findings highlight significant increases in the utilization of three drug groups related to the cardiovascular system, specifically cardiac therapy, beta-blocking agents, and antihypertensives. Intriguingly, there was a statistically significant increase in the consumption of antigout preparations, despite a decline in the monthly consumption rate of non-steroidal anti-flammatory drugs (NSAIDs). Further studies in the following years are necessary to provide a more comprehensive understanding of the impact of COVID-19 on outpatient drug utilization patterns.
Læs mere Tjek på PubMedAnfeng Zhu, Jun Hao, Xu Gang, Hao Zhang, Xiaoyu Long, Luyao Wang
PLoS One Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
by Anfeng Zhu, Jun Hao, Xu Gang, Hao Zhang, Xiaoyu Long, Luyao Wang The extraction of roadways from remote sensing imagery constitutes a pivotal task, with far-reaching implications across diverse domains such as urban planning, management of transportation systems, emergency response initiatives, and environmental monitoring endeavors. Satellite images captured during daytime have customarily served as the primary resource for this extraction process. However, the emergence of Nighttime Light (NTL) remote sensing data introduces an innovative dimension to this arena. The exploration of NTL data for road extraction remains in its nascent stage, and this study seeks to bridge this gap. We present a refined U-Net model (CA U-Net) integrated with Cross-Attention Mechanisms, meticulously designed to extract roads from Yangwang-1 NTL images. This model incorporates several enhancements, thereby improving its proficiency in identifying and delineating road networks. Through extensive experimentation conducted in the urban landscape of Wenzhou City, the model delivers highly accurate results, achieving an F1 score of 84.46%. These outcomes significantly surpass the performance benchmarks set by Support Vector Machines (SVM) and the Optimal Threshold (OT) method. This promising development paves the way towards maximizing the utility of NTL data for comprehensive mapping and analysis of road networks. Furthermore, the findings underscore the potential of utilizing Yangwang-1 data as a reliable source for road extraction and reaffirm the viability of deploying deep learning frameworks for road extraction tasks utilizing NTL data.
Læs mere Tjek på PubMedGil Joon Suh, Taegyun Kim, Kyung Su Kim, Woon Yong Kwon, Hayoung Kim, Heesu Park, Gaonsorae Wang, Jaeheung Park, Sungmoon Hur, Jaehoon Sim, Kyunghwan Kim, Jung Chan Lee, Dong Ah Shin, Woo Sang Cho, Byung Jun Kim, Soyoon Kwon, Ye Ji Lee
PLoS One Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
by Gil Joon Suh, Taegyun Kim, Kyung Su Kim, Woon Yong Kwon, Hayoung Kim, Heesu Park, Gaonsorae Wang, Jaeheung Park, Sungmoon Hur, Jaehoon Sim, Kyunghwan Kim, Jung Chan Lee, Dong Ah Shin, Woo Sang Cho, Byung Jun Kim, Soyoon Kwon, Ye Ji Lee Background Recently, we developed a chest compression device that can move the chest compression position without interruption during CPR and be remotely controlled to minimize rescuer exposure to infectious diseases. The purpose of this study was to compare its performance with conventional mechanical CPR device in a mannequin and a swine model of cardiac arrest. Materials and methods A prototype of a remote-controlled automatic chest compression device (ROSCER) that can change the chest compression position without interruption during CPR was developed, and its performance was compared with LUCAS 3 in a mannequin and a swine model of cardiac arrest. In a swine model of cardiac arrest, 16 male pigs were randomly assigned into the two groups, ROSCER CPR (n = 8) and LUCAS 3 CPR (n = 8), respectively. During 5 minutes of CPR, hemodynamic parameters including aortic pressure, right atrial pressure, coronary perfusion pressure, common carotid blood flow, and end-tidal carbon dioxide partial pressure were measured. Results In the compression performance test using a mannequin, compression depth, compression time, decompression time, and plateau time were almost equal between ROSCER and LUCAS 3. In a swine model of cardiac arrest, coronary perfusion pressure showed no difference between the two groups (p = 0.409). Systolic aortic pressure and carotid blood flow were higher in the LUCAS 3 group than in the ROSCER group during 5 minutes of CPR (p < 0.001, p = 0.008, respectively). End-tidal CO2 level of the ROSCER group was initially lower than that of the LUCAS 3 group, but was higher over time (p = 0.022). A Kaplan-Meier survival analysis for ROSC also showed no difference between the two groups (p = 0.46). Conclusion The prototype of a remote-controlled automated chest compression device can move the chest compression position without interruption during CPR. In a mannequin and a swine model of cardiac arrest, the device showed no inferior performance to a conventional mechanical CPR device.
Læs mere Tjek på PubMedMalaria Journal, 19.01.2024
Tilføjet 19.01.2024
Abstract Background In children with cerebral malaria (CM) admission blood lactate has previously guided intravenous fluid therapy and been validated as a prognostic biomarker associated with death. The usefulness of post-admission measurements of blood lactate in children with CM is less clear. The strength of association between blood lactate and neurological sequelae in CM survivors, as well as the optimal duration of post-admission measurements of blood lactate to identify children at higher risk of adverse outcomes is unknown. Methods A retrospective cohort study of 1674 Malawian children with CM hospitalized from 2000 to 2018 who had blood lactate measurements every 6 h for the first 24 h after admission was performed. The strength of association between admission lactate or values measured at any time point in the first 24 h post-admission and outcomes (mortality and neurological morbidity in survivors) was estimated. The duration of time after admission that lactate remained a valid prognostic biomarker was assessed. Results When lactate is analysed as a continuous variable, children with CM who have higher values at admission have a 1.05-fold higher odds (95% CI 0.99–1.11) of death compared to those with lower lactate values. Children with higher blood lactate at 6 h have 1.16-fold higher odds (95% CI 1.09–1.23) of death, compared to those with lower values. If lactate levels are dichotomized into hyperlactataemic (lactate > 5.0 mmol/L) or not, the strength of association between admission lactate and mortality increases (OR = 2.49, 95% CI 1.47–4.22). Blood lactate levels obtained after 18 h post-admission are not associated with outcomes. Similarly, the change in lactate concentrations through time during the first 24 h of hospital admission is not associated with outcomes. Blood lactate during hospitalization is not associated with adverse neurologic outcomes in CM survivors. Conclusions In children with CM, blood lactate is associated with death but not neurologic morbidity in survivors. To comprehensively estimate prognosis, blood lactate in children with CM should be assessed at admission and for 18 h afterwards.
Læs mere Tjek på PubMedMalaria Journal, 19.01.2024
Tilføjet 19.01.2024
Abstract Background Malaria remains a significant public health concern in Niger, with the number of cases increasing from 592,334 in 2000 to 3,138,696 in 2010. In response, a concerted campaign against the disease has been initiated. However, the implementation of these malaria interventions and their association with epidemiological behaviour remains unclear. Methods A time-series study was conducted in Niger from 2010 to 2019. Multiple data sources concerning malaria were integrated, encompassing national surveillance data, Statistic Yearbook, targeted malaria control interventions, and meteorological data. Incidence rate, mortality rate, and case fatality ratio (CFR) by different regions and age groups were analysed. Joinpoint regression models were used to estimate annual changes in malaria. The changes in coverage of malaria interventions were evaluated. Results Between 2010 to 2019, the incidence rate of malaria decreased from 249.43 to 187.00 cases per 1,000 population in Niger. Niamey had a high annual mean incidence rate and the lowest CFR, while Agadez was on the contrary. Joinpoint regression analysis revealed a declining trend in malaria incidence for all age groups except the 10–24 years group, and the mortality rate and the CFR initially decreased followed by an increase in all age groups. Niger has implemented a series of malaria interventions, with the major ones being scaled up to larger populations during the study period. Conclusions The scale-up of multi-interventions in Niger has significantly reduced malaria incidence, but the rise in mortality rate and CFR addresses the challenges in malaria control and elimination. Malaria endemic countries should enhance surveillance of malaria cases and drug resistance in Plasmodium, improve diagnosis and treatment, expand the population coverage of insecticide-treated bed nets and seasonal malaria chemoprevention, and strengthen the management of severe malaria cases.
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