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Paul Breen, Madsen Zimbric, Lindsay J. Caverly
PLoS One Infectious Diseases, 11.05.2024
Tilføjet 11.05.2024
by Paul Breen, Madsen Zimbric, Lindsay J. Caverly Increasingly prevalent, nontuberculous mycobacteria (NTM) infections affect approximately 20% of people with cystic fibrosis (CF). Previous studies of CF sputum identified lower levels of the host metabolite itaconate in those infected with NTM. Itaconate can inhibit the growth of M. tuberculosis (MTB) in vitro via the inhibition of the glyoxylate cycle enzyme (ICL), but its impact on NTM is unclear. To test itaconic acid’s (IA) effect on NTM growth, laboratory and CF clinical strains of Mycobacterium abscessus and Mycobacterium avium were cultured in 7H9 minimal media supplemented with 1–10 mM of IA and short-chain fatty acids (SCFA). M. avium and M. abscessus grew when supplemented with SCFAs, whereas the addition of IA (≥ 10 mM) completely inhibited NTM growth. NTM supplemented with acetate or propionate and 5 mM IA displayed slower growth than NTM cultured with SCFA and ≤ 1 mM of IA. However, IA’s inhibition of NTM was pH dependent; as similar and higher quantities (100 mM) of pH adjusted IA (pH 7) did not inhibit growth in vitro, while in an acidic minimal media (pH 6.1), 1 to 5 mM of non-pH adjusted IA inhibited growth. None of the examined isolates displayed the ability to utilize IA as a carbon source, and IA added to M. abscessus isocitrate lyase (ICL) decreased enzymatic activity. Lastly, the addition of cell-permeable 4-octyl itaconate (4-OI) to THP-1 cells enhanced NTM clearance, demonstrating a potential role for IA/itaconate in host defense against NTM infections.
Læs mere Tjek på PubMedOiythip Yasopa, Nontiya Homkham, Pornthip Chompook
PLoS One Infectious Diseases, 11.05.2024
Tilføjet 11.05.2024
by Oiythip Yasopa, Nontiya Homkham, Pornthip Chompook This study was aimed to explore the association between potential factors including public health and social measures and the number of influenza patients in Thailand between 2014–2021. Secondary data from relevant agencies were collected. Generalized Estimating Equation (GEE) and regression coefficient (β) were performed at a significance level of 0.05. We found factors associated with number of influenza patients during the time prior to COVID-19 pandemic were monthly income per household (Adjusted β = -0.02; 95% CI: -0.03, -0.01), population density (Adjusted β = 1.00; 95% CI: 0.82, 1.18), rainy season (Adjusted β = 137.15; 95% CI: 86.17, 188.13) and winter time (Adjusted β = 56.46; 95% CI: 3.21, 109.71). During the time of COVID-19 pandemic, population density (Adjusted β = 0.20; 95% CI: 0.15, 0.26), rainy season (Adjusted β = -164.23; 95% CI: -229.93, -98.52), winter time (Adjusted β = 61.06; 95% CI: 0.71, 121.41), public health control measures (prohibition of entering to into an area with high number of COVID-19 infections (Adjusted β = -169.34; 95% CI: -233.52, -105.16), and restriction of travelling also reduced the number of influenza patients (Adjusted β = -66.88; 95% CI: -125.15, -8.62) were associated with number of influenza patients. This study commends strategies in monitoring influenza patients to focus on the areas with low income, high population density, and in specific seasons. Public health and social measures which can be implemented are prohibition of entering to risk-areas (lock down), and restriction of travelling across provinces which their effectiveness in reducing influenza infections.
Læs mere Tjek på PubMedSusan M. NohJessica UjczoDebra C. AlperinShelby M. JarvisMuna S. M. SolymanRoberta KokuOlalekan C. AkinsulieElizabeth E. Hoffmann1Animal Disease Research Unit, United States Department of Agriculture, Agricultural Research Service, Pullman, Washington, USA2Department of Veterinary Microbiology and Pathology, Washington State University, Pullman, Washington, USA, De'Broski R. Herbert
Infection and Immunity, 10.05.2024
Tilføjet 10.05.2024
Infection, 10.05.2024
Tilføjet 10.05.2024
Abstract Background We aimed to improve the prognosis, treatment, and management of Staphylococcus aureus bacteremia (SAB) by evaluating the association between adherence to quality indicators (QIs) and clinical outcomes in patients with their clinical outcomes. Methods We retrospectively collected clinical and microbiological data on hospitalized patients with SAB from 14 hospitals (three with > 600, two with 401–600, five with 201–400, and four with ≤ 200 beds) in Japan from January to December 2022. The SAB management quality was evaluated using the SAB-QI score (ranging from 0 to 13 points), which consists of 13 QIs (grouped into five categories) based on previous literature. Results Of the 4,448 positive blood culture episodes, 289 patients with SAB (6.5%) were enrolled. The SAB-QI scores ranged from 3 to 13, with a median score of 9 points. The SAB-QI score was highest in middle-sized hospitals with 401–600 beds. Adherence to each of the four QI categories (blood culture, echocardiography, source control, and antibiotic treatment) was significantly higher in survived cases than in fatal cases. Kaplan–Meier curves with log-rank tests demonstrated that higher adherence to SAB-QIs indicated a better prognosis. Logistic regression analysis revealed that age, methicillin resistance, multiple comorbidities (≥ 2), and low SAB-QI score were significantly associated with 30-day mortality in patients with SAB. Conclusions Our study highlights that greater adherence to the SAB-QIs correlates with improved patient outcomes. Management of patients with SAB should follow these recommended indicators to maintain the quality of care, especially for patients with poor prognosticators.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose To assess the prevalence and subtypes of Human Papillomavirus (HPV) in Ocular Surface Squamous Neoplasia (OSSN) in Human Immunodeficiency Virus (HIV) positive and negative patients in South Africa. Basic procedures This study was a single center retrospective cross-sectional study, conducted at Tygerberg Hospital, Western Cape, South Africa. We assessed 63 histopathologically confirmed OSSN formalin-fixed paraffin-embedded (FFPE) tissue blocks from 2015–2023. The presence of HPV was determined using the Hybrispot Direct Flow Chip Kit. Corresponding clinical data was retrieved from the National Health Laboratory Service (NHLS) central data warehouse. Main findings Of the confirmed OSSN samples, 66.7% tested positive for HPV (95% confidence interval [CI] 54–77.3%). Of the 42 HPV positive samples, 38 (90.5%) had one or more known genotypes detected and 4 had unknown genotypes. The most prevalent subtypes were HPV 11, 16 and 18 (found in 61.9%, 52.4% and 33.3% of HPV positive samples respectively). 88.9% of the lesions biopsied were from HIV positive patients, of whom 56.4% had a CD4 + count of
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose Mother-to-child transmission (MTCT) has been the main cause of chronic hepatitis B virus (HBV) infection, particularly in East Asia. Hepatitis B immunoglobulin (HBIG) and vaccination given directly after birth effectively prevents hepatitis B surface antigen (HBsAg)-positive (overt) HBV infection, but occult hepatitis B infection (OBI) may develop despite adequate prophylaxis. The aim of this study was to investigate the long-term outcome in children born to mothers with very high HBV DNA levels with special focus on children discovered in early childhood with OBI. Methods One-year and long-term outcome regarding overt and occult HBV infection were analysed in 66 children born to hepatitis B e antigen (HBeAg)-positive mothers, and were compared with one-year outcome in 69 children born to HBeAg-negative mothers. The children were born between 1998 and 2018. Results Six children born to HBeAg-positive mothers developed overt chronic HBV infection, in two cases after normal pregnancies and despite HBIG and vaccination, but never when nucleotide analogue treatment was given during pregnancy. OBI with HBV DNA detected in serum in the absence of surface antigen (HBsAg) was observed in four children at the age of 1 year. One of them was transiently HBsAg-positive at the age of 7 years. At long-term follow-up, six children had overt chronic infection, one had OBI and six had previous OBI or positive anti-HBc suggesting resolved unidentified infections. Conclusion The results indicate that children born to mothers with high HBV DNA levels have approximately 10% risk to develop OBI despite antiviral treatment, vaccination and HBIG, but that such OBI confers a minimal long-term risk for overt infection, at least in immunocompetent children.
Læs mere Tjek på PubMedInfection, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose The principal objective of this project was to review and thoroughly examine the chemical characteristics, pharmacological activity, and quantification methods associated with contezolid. Methods The article was based on published and ongoing preclinical and clinical studies on the application of contezolid. These studies included experiments on the physicochemical properties of contezolid, in vitro antimicrobial research, in vivo antimicrobial research, and clinical trials in various phases. There were no date restrictions on these studies. Results In June 2021, contezolid was approved for treating complicated skin and soft tissue infections. The structural modification of contezolid has resulted in better efficacy compared to linezolid. It inhibits bacterial growth by preventing the production of the functional 70S initiation complex required to translate bacterial proteins. The current evidence has indicated a substantial decline in myelosuppression and monoamine oxidase inhibition without impairing its antibacterial properties. Contezolid was found to have a more significant safety profile and to be metabolised by flavin monooxygenase 5, reducing the risk of harmful effects due to drug–drug interactions. Adjusting doses is unnecessary for patients with mild to moderate renal or hepatic insufficiency. Conclusion As an oral oxazolidinone antimicrobial agent, contezolid is effective against multi-drug resistant Gram-positive bacteria. The introduction of contezolid provided a new clinical option.
Læs mere Tjek på PubMedChristophe Le TerrierSamanta FreireClément ViguierJacqueline FindlayPatrice NordmannLaurent Poirel1Emerging Antibiotic Resistance, Medical and Molecular Microbiology, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland2Division of Intensive care unit, University hospitals of Geneva, Geneva, Switzerland3Infectious Disease Department, University hospital of Toulouse, Toulouse, France4Swiss National Reference Center for Emerging Antibiotic Resistance (NARA), Fribourg, Switzerland, Alessandra Carattoli
Antimicrobial Agents And Chemotherapy, 10.05.2024
Tilføjet 10.05.2024
Dramane KANIA, Janin NOUHIN, Karine BOLLORE, Richard NJOUOM, Thomas d'Aquin TONI, Almoustapha Issiaka MAIGA, Coumba TOURE-KANE, Nicole NGO-GIANG-HUONG, Anoumou DAGNRA, Duy Hoang Chuong LE, Françoise LUNEL-FABIANI, Joany CASTERA-GUY, Pierre-Alain RUBBO, Amandine PISONI, Jean-Christophe PLANTIER, Edouard TUAILLON
Clinical Microbiology and Infection, 10.05.2024
Tilføjet 10.05.2024
Widespread testing and treatment are essential to eliminate hepatitis B virus (HBV) infection as a public health concern. However, in resource-limited countries, access to HBV PCR is limited. In this study, we developed a quantitative HBV PCR assay on open molecular platforms and evaluate its performance in diagnosing clinically significant HBV DNA thresholds as defined by the World Health Organization (WHO) (2,000 IU/mL, 20,000 IU/mL, and 200,000 IU/mL).
Læs mere Tjek på PubMedDevoogdt, N., De Vrieze, T., Heroes, A.-K., Bechter-Hugl, B., Fieuws, S., Godderis, L., Segers, K., Maleux, G., Deltombe, T., Frippiat, J., Servaes, M., Berners, A., Fosseprez, P., Krug, B., Kayser, F., Falticeanu, A., Randon, C., Monten, C., Van Landuyt, K., De Pypere, B., Degraeve, L., Decorte, T., De Schryver, M., Van Besien, V., Devos, D., Suominen, S., Ayala, J. M., Pons, G., Fourneau, I., Thomis, S.
BMJ Open, 10.05.2024
Tilføjet 10.05.2024
IntroductionLymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life. The first choice of treatment is a conservative treatment, consisting of exercises, skin care, lymph drainage and compression. Reconstructive lymphatic surgery is also often performed, that is, lymphovenous anastomoses, lymph node transfer or a combination. However, robust evidence on the effectiveness of reconstructive lymphatic surgery is missing. Therefore, the objective of this trial is to investigate the added value of reconstructive lymphatic surgery to the conservative treatment in patients with lymphoedema. Methods and analysisA multicentre randomised controlled and pragmatic trial was started in March 2022 in three Belgian university hospitals. 90 patients with arm lymphoedema and 90 patients with leg lymphoedema will be included. All patients are randomised between conservative treatment alone (control group) or conservative treatment with reconstructive lymphatic surgery (intervention group). Assessments are performed at baseline and at 1, 3, 6, 12, 18, 24 and 36 months. The primary outcome is lymphoedema-specific quality of life at 18 months. Key secondary outcomes are limb volume and duration of wearing the compression garment at 18 months. The approach of reconstructive lymphatic surgery is based on presurgical investigations including clinical examination, lymphofluoroscopy, lymphoscintigraphy, lymph MRI or CT angiography (if needed). All patients receive conservative treatment during 36 months, which is applied by the patient’s own physical therapist and by the patient self. From months 7 to 12, the hours a day of wearing the compression garment are gradually decreased. Ethics and disseminationThe study has been approved by the ethical committees of University Hospitals Leuven, Ghent University Hospital and CHU UCL Namur. Results will be disseminated via peer-reviewed journals and presentations. Trial registration numberNCT05064176
Læs mere Tjek på PubMedBabarczy, B., Hajdu, A., Benko, R., Matuz, M., Papp, R., Antoniou, P., Kandelaki, K., Lo Fo Wong, D., Warsi, S. K.
BMJ Open, 10.05.2024
Tilføjet 10.05.2024
ObjectivesInappropriate antibiotic prescribing is a major cause of antimicrobial resistance (AMR). The aim of this study was to explore paediatric general practitioners’ (GP Peds) antibiotic prescription practice in suspected respiratory tract infections (RTIs), using the capability–opportunity–motivation–behaviour framework. DesignThe design is a qualitative study based on individual, semistructured telephone or virtual interviews. SettingPaediatric general practice in Hungary. We applied stratified maximum variation sampling to cover the categories of age, sex and geographical location of participants. ParticipantsWe interviewed 22 GP Peds. Nine were male and 13 were female: 2 of them were less than 40 years old, 14 were between 40 and 60 years, and 6 were above 60 years. 10 worked in low-antibiotic prescription areas, 5 in areas with medium levels of antibiotic prescription, 3 in high-antibiotic prescription areas, and 4 in and around the capital city. ResultsStudy participants had varying antibiotic prescription preferences. Personal experience and physical examination play a central role in GP Peds’ diagnostic and treatment practice. Participants emphasised the need to treat children in their entirety, taking their personal medical record, social background and sometimes parents’ preferences into account, besides the acute clinical manifestation of RTI. Most respondents were confident they apply the most effective therapy even if, in some cases, this meant prescribing medicines with a higher chance of contributing to the development of AMR. Some participants felt antibiotic prescription frequency has decreased in recent years. ConclusionsOur findings suggest that a more prudent attitude toward antibiotic prescribing may have become more common but also highlight relevant gaps in both physicians’ and public knowledge of antibiotics and AMR. To reinforce awareness and close remaining gaps, Hungary should adopt its national AMR National Action Plan and further increase its efforts towards active professional communication and feedback for primary care physicians.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Tuberculosis (TB) poses a major public health challenge, particularly in children. A substantial proportion of children with TB disease remain undetected and unconfirmed. Therefore, there is an urgent need for a highly sensitive point-of-care test. This study aims to assess the performance of serological assays based on various antigen targets and antibody properties in distinguishing children (0–18 years) with TB disease (1) from healthy TB-exposed children, (2) children with non-TB lower respiratory tract infections, and (3) from children with TB infection. Methods The study will use biobanked plasma samples collected from three prospective multicentric diagnostic observational studies: the Childhood TB in Switzerland (CITRUS) study, the Pediatric TB Research Network in Spain (pTBred), and the Procalcitonin guidance to reduce antibiotic treatment of lower respiratory tract infections in children and adolescents (ProPAED) study. Included are children diagnosed with TB disease or infection, healthy TB-exposed children, and sick children with non-TB lower respiratory tract infection. Serological multiplex assays will be performed to identify M. tuberculosis antigen-specific antibody features, including isotypes, subclasses, Fc receptor (FcR) binding, and IgG glycosylation. Discussion The findings from this study will help to design serological assays for diagnosing TB disease in children. Importantly, those assays could easily be developed as low-cost point-of-care tests, thereby offering a potential solution for resource-constrained settings. ClinicalTrials.gov Identifier NCT03044509.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Abstract Background & aims Pyogenic liver abscess (PLA) is a common hepatobiliary infection that has been shown to have an increasing incidence, with biliary surgery being identified as a trigger. Our aim was to investigate the clinical characteristics and treatments of PLA patients with and without a history of biliary surgery (BS). Methods The study included a total of 353 patients with PLA who received treatment at our hospital between January 2014 and February 2023. These patients were categorized into two groups: the BS group (n = 91) and the non-BS group (n = 262). In the BS group, according to the anastomosis method, they were further divided into bilioenteric anastomoses group (BEA, n = 22) and non-bilioenteric anastomoses group (non-BEA, n = 69). Clinical characteristics were recorded and analyzed. Results The percentage of PLA patients with BS history was 25.78%. The BS group exhibited elevated levels of TBIL and activated APTT abnormalities (P = 0.009 and P = 0.041, respectively). Within the BS group, the BEA subgroup had a higher prevalence of diabetes mellitus (P
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Tubal factor infertility (TFI) is common in sub-Saharan Africa and often secondary to pelvic inflammatory disease (PID). Anaerobes associated with bacterial vaginosis (BV) are also found in PIDs widely dominated by Chlamydia trachomatis (C. trachomatis), whose role in TFI is better demonstrated than that of BV. Objectives To determine the prevalence of BV and C. trachomatis and to investigate the association between BV, C. trachomatis and TFI. Methods We included 137 patients treated for infertility between January 2020 and November 2021. Cases were defined as women with infertility aged 18-45 years presenting with TFI (n = 52), and controls as infertile women in the same age groups without TFI (n = 85). Data on social habits, life style and infertility parameters were collected, and we performed screening for BV and C. trachomatis. Multiple regression was used to measure associations. Results The prevalence of BV and C. trachomatis was 42.3% (58/137) and 23.4% (32/137), respectively. BV (61.5% vs 30.6%, p
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Abstract Background Haemophagocytic lymphohistiocytosis (HLH) is a syndrome that occurs in patients with severe systemic hyperinflammation. GATA binding protein 2 (GATA2) is a transcription factor and key component in haematopoiesis and stem cell biology. Case presentation Three patients with HLH, one with Mycobacterium avium infection, one with Epstein–Barr virus (EBV) infection, and one with Mycobacterium kansasii infection, were all subsequently found to have a defect in the GATA2 gene through genetic testing. Conclusions GATA2 deficiency syndrome should be considered in patients with myelodysplastic syndrome, nontuberculous mycobacterium infection and HLH. In addition, the GATA2 gene variant may be a genetic defect that could be the cause of the primary HLH. However, further studies are needed to confirm the role of GATA2 pathogenic variants in the pathogenesis of HLH.
Læs mere Tjek på PubMedBMC Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Abstract Purpose Human adenoviruses (HAdVs) have always been suggested as one of the main causes of gastroenteritis in children. However, no comprehensive report on the global epidemiology of these viruses in pediatric gastroenteritis is available. Methods A systematic search was conducted to obtain published papers from 2003 to 2023 in three main databases PubMed, Scopus, and Web of Science. Results The estimated global pooled prevalence of HAdV infection in children with gastroenteritis was 10% (95% CI: 9-11%), with a growing trend after 2010. The highest prevalence was observed in Africa (20%, 95% CI: 14–26%). The prevalence was higher in inpatients (11%; 95% CI: 8-13%) and patients aged 5 years old and younger (9%; 95% CI: 7-10%). However, no significant difference was observed between male and female patients (P = 0.63). The most prevalent species was found to be the species F (57%; 95% CI: 41-72%). The most common HAdVs observed in children with gastroenteritis were types 40/41, 38, and 2. Analysis of case-control studies showed an association between HAdV and gastroenteritis in children (OR: 2.28, 95% CI; 1.51–3.44). Conclusion This study provided valuable insights into the importance of HAdVs in children with gastroenteritis, especially in hospitalized and younger children. The results can be used in future preventive measurements and the development of effective vaccines.
Læs mere Tjek på PubMedXinhao DuZhenzhen TangLi YanLing ZhangQiao ZhengXianghao ZengQing HuQian TianLanfan LiangXinyu ZhaoJun LiMing ZhaoXiangsheng Fua Department of Gastroenterology, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. Chinab Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, P.R. China
Virulence, 10.05.2024
Tilføjet 10.05.2024
Agustina Taglialegna
Nat Rev Microbiol, 10.05.2024
Tilføjet 10.05.2024
Ivan Sugrue, R. Paul Ross, Colin Hill
Nat Rev Microbiol, 10.05.2024
Tilføjet 10.05.2024
Infectious Disease Modelling, 10.05.2024
Tilføjet 10.05.2024
Publication date: Available online 10 May 2024 Source: Infectious Disease Modelling Author(s): Maryam Rastegar, Mohammad Taghi Shakeri, Vahid Fakoor, Eisa Nazar, Mahshid Nasehi, Saeed Sharafi
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
People who received a SARS-CoV-2 vaccination had a lower risk of heart failure and blood clots in their veins and arteries after COVID-19 infection than those who had not been vaccinated, a recent study involving more than 20 million participants in Estonia, Spain, and the UK found.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
Amid an uptick in measles cases and outbreaks both in the US and abroad, the US Centers for Disease Control and Prevention (CDC) issued an alert on March 18 encouraging clinicians to work with schools and educators to ensure children are up-to-date on their measles-mumps-rubella (MMR) vaccines. As of March 28, 97 measles cases had been reported in 18 US states this year. Most of the cases have been linked to international travel.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
The US Food and Drug Administration (FDA) recently approved resmetirom, marketed as Rezdiffra, for adults with nonalcoholic steatohepatitis (NASH) without cirrhosis. NASH is a progressive fatty liver disease that affects up to 8 million people in the US and can cause liver inflammation and scarring, known as fibrosis. Resmetirom, an oral drug that reduces the accumulation of liver fat, can be used along with diet and exercise, which are the standard care for patients with NASH.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
A vaccine given during pregnancy that prevents respiratory syncytial virus (RSV) in infants was about 66% effective at protecting against RSV-associated respiratory illness, and about 69% effective at protecting against severe disease, according to a study in the New England Journal of Medicine. The data came from a randomized clinical trial involving more than 5000 pregnant people and their infants in 24 countries.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
For some individuals, post–COVID-19 condition, or long COVID, can result in symptoms of autonomic nervous system dysfunction, such as a heart palpitations and lightheadedness that occur when standing up, and fatigue. Together, these symptoms are known as postural orthostatic tachycardia syndrome (POTS).
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
This Medical News article discusses an intervention that uses empathy to address vaccine hesitancy in the clinic.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
Few, indeed, are the physicians who do not now and then advise a patient to make a change of climate. However difficult it might be to justify such a recommendation in every instance, or even in most cases, on the basis of precise physiologic knowledge or strictly scientific therapeutic consideration, the benefits that repeatedly accrue to persons thus ordered to a “change of scene” are often too indisputably real to be gainsaid. Change of climate may mean far more than transport to a place where altitude, regimen, temperature, moisture and other atmospheric conditions are different; it may mean removal from smoke and dust and other noxious agencies in the air; it may bring about new associations and furnish a new personal environment, whereby psychologic influences rather than climatic factors are brought into play in connection with the sick. Such personal features doubtless account for many benefits; they cannot encompass all the good that is often attributable to a new environment. Climatology, from the human standpoint, has not yet reached the dignity of an exact science. It still banks on combinations of tradition, unverified beliefs and empiric deductions. For the north temperate zone it has been alleged more than once that limitations imposed by weather cause many persons to lead unhygienic lives in winter, some individuals almost entering a state of hibernation. For some of these, spring brings a welcomed tonic change; others seek it by removing to a different locality. The meaning of sunshine in the form of direct insolation has become apparent in recent years in connection with various diseases. Tuberculosis and rickets, for example, can testify amply to the health-giving virtues of the direct rays of the sun. A recent writer has accordingly asserted that a study of the benefits obtained from a change of climate becomes more important each year as the systemic changes caused by different climates are better understood.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
The Original Investigation titled “Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection,” published in the June 13, 2023, issue of JAMA, has been corrected to include additional consortium authors and nonauthor collaborator names in a supplement.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
This cohort study characterizes heterogeneity in cardiac function prior to sepsis and describes associations with hospitalization outcomes and mortality.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
The introduction of prostate-specific antigen (PSA)–based screening for prostate cancer in the early 1990s was followed by a nearly 2-decade long decline in prostate cancer metastasis and mortality. However, clinical trial data revealed that screening was associated with substantial harms. Under the traditional clinical approach in which elevated serum PSA triggered prostate biopsy, roughly 1 in 5 screened men underwent biopsies, with more than 75% found to be negative and a majority of positive biopsies harboring low-grade, clinically insignificant cancers. Prostate biopsies are uncomfortable for patients and carry a risk of bleeding and infection requiring hospitalization. Moreover, during a previous era in which a cancer diagnosis was inexorably linked to treatment, overdiagnosis (ie, detection of indolent cancers that would not have been detected during life in the absence of screening) and overtreatment resulted in significantly reduced quality of life. In 2012, the US Preventive Services Task Force (USPSTF) provided a grade D recommendation against the use of PSA screening, concluding that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
In the Editorial titled “Shedding Patterns of Genital Herpes Simplex Virus Infections,” published online on October 22, 2022, and in the November 1, 2022, issue of JAMA, Dr Whitley omitted potential conflict of interest disclosures. The disclosure statement has been corrected to include “serving on the board of directors for Gilead Sciences, Inc, with vested shares in the company at the time of this publication, and as cofounder and investor in Treovir LLC.” This article was corrected online.
Læs mere Tjek på PubMedJournal of the American Medical Association, 10.05.2024
Tilføjet 10.05.2024
In Reply In response to our recent article, Dr Schober and colleagues suggest that reduction of length of stay in the ICU and hospital may not be considered a clinically relevant outcome. However, in the context of stretched resources and ICU bed shortages, we believe this is an important end point, and that improvement in the secondary end points in our trial also advocates for a clinical benefit of the intervention. As acknowledged, the reduced risk of pneumonia in the intervention group was not statistically significant, and we therefore did not make definitive claims about this. However, considering the absolute risk reduction of 7.8% (95% CI, 0.3% to 15.9%), the supposition that withholding intubation could increase the risk of pneumonia is very unlikely. We agree that adverse events unrelated to intubation are important, but they did not appear to contribute significantly to increased morbidity risk.
Læs mere Tjek på PubMedPamplin, Jeremy C.; Veazey, Sena R.; Barczak, Stacie; Fonda, Stephanie J.; Serio-Melvin, Maria L.; Ross, Kevin S.; Colombo, Christopher J.
Critical Care Explorations, 10.05.2024
Tilføjet 10.05.2024
OBJECTIVES: To determine the impact of telementoring on caregiver performance during a high-fidelity medical simulation model (HFMSM) of a critically ill patient in a resource-limited setting. DESIGN: A two-center, randomized, controlled study using a HFMSM of a patient with community-acquired pneumonia complicated by acute respiratory distress syndrome. SETTING: A notional clinic in a remote location staffed by a single clinician and nonmedical assistant. PARTICIPANTS: Clinicians with limited experience managing critically ill patients. INTERVENTIONS: Telemedicine (TM) support. MEASUREMENTS: The primary outcome was clinical performance as measured by accuracy, reliability, and efficiency of care. Secondary outcomes were patient survival, procedural quality, subjective assessment of the HFMSM, and perceived workload. MAIN RESULTS: TM participants (N = 11) performed better than non-TM (NTM, N = 12) in providing expected care (accuracy), delivering care more consistently (reliability), and without consistent differences in efficiency (timeliness of care). Accuracy: TM completed 91% and NTM 42% of expected tasks and procedures. Efficiency: groups did not differ in the mean (± sd) minutes it took to obtain an advanced airway successfully (TM 15.2 ± 10.5 vs. NTM 22.8 ± 8.4, p = 0.10) or decompress a tension pneumothorax with a needle (TM 0.7 ± 0.5 vs. NTM 0.6 ± 0.9, p = 0.65). TM was slower than NTM in completing thoracostomy (22.3 ± 10.2 vs. 12.3 ± 4.8, p = 0.03). Reliability: TM performed 13 of 17 (76%) tasks with more consistent timing than NTM. TM completed 68% and NTM 29% of procedural quality metrics. Eighty-two percent of the TM participants versus 17% of the NTM participants simulated patients survived (p = 0.003). The groups similarly perceived the HFMSM as realistic, managed their patients with personal ownership, and experienced comparable workload and stress. CONCLUSIONS: Remote expertise provided with TM to caregivers in resource-limited settings improves caregiver performance, quality of care, and potentially real patient survival. HFMSM can be used to study interventions in ways not possible with real patients.
Læs mere Tjek på PubMedJennifer B. Glass, Kathrin Rousk
Trends in Microbiology, 10.05.2024
Tilføjet 10.05.2024
Nitrogen is a key element that is essential for the facilitation of biogeochemical processes across varied ecosystems. We now know that nitrogen cycling is incredibly complex in that it is more than just a cycle and comprises various microbe-mediated processes (nitrification, denitrification, etc.). Given the ubiquitousness of many of these processes across terrestrial (agricultural, for instance) and aquatic ecosystems, we have seen cases of cross-disciplinary collaboration whereby lessons learned from one ecosystem can be applied to another.
Læs mere Tjek på PubMedChristopher McCrory, Megan Lenardon, Ana Traven
Trends in Microbiology, 10.05.2024
Tilføjet 10.05.2024
The human gastrointestinal microbiome encompasses bacteria, fungi, and viruses forming complex bionetworks which, for organismal health, must be in a state of homeostasis. An important homeostatic mechanism derives from microbial competition, which maintains the relative abundance of microbial species in a healthy balance. Microbes compete for nutrients and secrete metabolites that inhibit other microbes. Short-chain fatty acids (SCFAs) are one such class of metabolites made by gut bacteria to very high levels. SCFAs are metabolised by microbes and host cells and have multiple roles in regulating cell physiology. Here, we review the mechanisms by which SCFAs regulate the fungal gut commensal Candida albicans. We discuss SCFA’s ability to inhibit fungal growth, limit invasive behaviours and modulate cell surface antigens recognised by immune cells. We review the mechanisms underlying these roles: regulation of gene expression, metabolism, signalling and SCFA-driven post-translational protein modifications by acylation, which contribute to changes in acylome dynamics of C. albicans with potentially large consequences for cell physiology. Given that the gut mycobiome is a reservoir for systemic disease and has also been implicated in inflammatory bowel disease, understanding the mechanisms by which bacterial metabolites, such as SCFAs, control the mycobiome might provide therapeutic avenues.
Læs mere Tjek på PubMedMark W. Smith, Thomas Willis, Elizabeth Mroz, William H. M. James, Megan J. Klaar, Simon N. Gosling, Christopher J. Thomas
Science, 10.05.2024
Tilføjet 10.05.2024
Yuyang Chen, Yiting Xu, Lin Wang, Yilin Liang, Naizhe Li, José Lourenço, Yun Yang, Qiushi Lin, Ligui Wang, He Zhao, Bernard Cazelles, Hongbin Song, Ziyan Liu, Zengmiao Wang, Oliver J. Brady, Simon Cauchemez, Huaiyu Tian
Science, 10.05.2024
Tilføjet 10.05.2024
Leslie Roberts
Science, 10.05.2024
Tilføjet 10.05.2024
Kai Kupferschmidt
Science, 10.05.2024
Tilføjet 10.05.2024
Jon Cohen
Science, 10.05.2024
Tilføjet 10.05.2024
Jess Libow
Lancet, 10.05.2024
Tilføjet 10.05.2024
In her 2013 essay collection, Meaty, the comedian and writer Samantha Irby quips that, “as autoimmune diseases go”, her diagnosis of Crohn\'s disease “is one of the least glamorous of the bunch”. As a patient with Crohn\'s disease myself, I can see why. Those who experience this chronic inflammatory disease of the gastrointestinal tract know all too well the stigmas and shame that can accompany its symptoms. Unsurprisingly, Crohn\'s disease rarely appears in literature not tinged with a self-help ethos.
Læs mere Tjek på PubMedIkechukwu Adigweme, Mohammed Yisa, Michael Ooko, Edem Akpalu, Andrew Bruce, Simon Donkor, Lamin B Jarju, Baba Danso, Anthony Mendy, David Jeffries, Anne Segonds-Pichon, Abdoulie Njie, Stephen Crooke, Elina El-Badry, Hilary Johnstone, Michael Royals, James L Goodson, Mark R Prausnitz, Devin V McAllister, Paul A Rota, Sebastien Henry, Ed Clarke
Lancet, 10.05.2024
Tilføjet 10.05.2024
The safety and immunogenicity data support the accelerated development of the MRV-MNP.
Læs mere Tjek på PubMedSoha El-Shaer, Shaymaa H. Abdel-Rhman, Rasha Barwa, Ramadan Hassan
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Deanna Ware, Sergio Rueda, Michael Plankey, Pamela J. Surkan, Chukwuemeka N. Okafor, Linda Teplin, M. Reuel Friedman
Læs mere Tjek på PubMedSe Ju Lee, Yae Jee Baek, Jin Nam Kim, Ki Hyun Lee, Eun Hwa Lee, Joon Sup Yeom, Jun Yong Choi, Nam Su Ku, Jin Young Ahn, Jung Ho Kim, Su Jin Jeong
PLoS One Infectious Diseases, 10.05.2024
Tilføjet 10.05.2024
by Se Ju Lee, Yae Jee Baek, Jin Nam Kim, Ki Hyun Lee, Eun Hwa Lee, Joon Sup Yeom, Jun Yong Choi, Nam Su Ku, Jin Young Ahn, Jung Ho Kim, Su Jin Jeong
Læs mere Tjek på PubMed