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BMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Mycetoma is the most common neglected disease in humans. It is a chronic, progressive, and destructive disease primarily caused by fungi or bacteria characterized by formation of dark pale grains commonly involve skin, soft tissue and rarely bone.
Case presentation
A 19 year old male patient with chronic right ankle pain, swelling and abscess formation for more than 1 year, patient was treated repeatedly with incision and drainage without any success. No X-ray, biopsy or swab for culture and sensitivity had been considered through the course of presentation. Patient was referred to Omdurman hospital where osteomyelitis secondary euomycetoma infection has been confirmed based on radiological and pathological assessment. Patient was treated surgically with aggressive debridement and bone curettage plus postoperative Itraconazole for 1 year.
Conclusion
Clinicians must consider osteomyelitis as important differential diagnosis during initial assessment Eumycetoma infection in adults. Aggressive bone curettage followed by regular X-ray follow up can be limb saving procedure in such cases.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Meningitis retention syndrome (MRS) is a rare condition that presents with acute urinary retention as a complication of aseptic meningitis. Cases of MRS due to varicella zoster virus (VZV) infection without a rash are rare. We report the case of a patient who had no signs of meningitis or VZV infection, including a rash.
Case presentation
A 58-year-old man presented with dysesthesia of the lower limbs and acute urinary retention. He had fever but no rash and no signs of meningitis. He was diagnosed to have VZV infection based on the detection of VZV DNA in the cerebrospinal fluid. He responded satisfactorily to a course of intravenous acyclovir and experienced no sequelae during a 2-year follow-up period.
Conclusion
MRS due to aseptic meningitis of viral origin should be considered in the differential diagnosis of acute urinary retention even in the absence of specific signs and symptoms of meningitis or a suggestive rash.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Coronavirus disease 2019 (COVID-19) has a broad spectrum from respiratory and nasopharyngeal symptoms, cerebrovascular diseases, impaired consciousness, and skeletal muscle injury. Emerging evidence has indicated the neural spread of this novel coronavirus. Restless legs syndrome (RLS) is a common neurological, sensorimotor disorder, but highly under diagnosis disorder. Restless anal syndrome as restless legs syndrome variant associated with COVID-19 has been previously not published. We report a case presenting with restless anal syndrome following COVID-19.
Case presentation
Although a 77-year-old male with COVID-19 improved to normal respiratory function 21 days after admission and treatment of favipiravir 200 mg per day for 14 days and dexamethasone 6.6 mg per day for 5 days, the insomnia and anxiety symptoms remained. Several weeks after discharge, he gradually began to experience restless, deep anal discomfort, approximately 10 cm from the perineal region. The following features were observed in the anal region; urge to move is essential, with worsening with rest, improvement with exercise, and worsening at evening. Colonoscopy revealed internal haemorrhoids without other rectal lesions. Neurological findings including deep tendon reflex, perineum loss of sensory and spinal cord injury, revealed no abnormalities. Diabetes militias, kidney dysfunction and iron deficiency status were not confirmed. Family history of RLS and periodic limb movements were not observed. Clonazepam at 1.5 mg per day resulted in the alleviation restless anal discomfort.
Conclusions
We reported a case presenting with restless anal syndrome following affection of COVID-19 as restless legs syndrome variant. This case fulfilled 4 essential features of RLS, urge to move, worsening with rest, improvement with exercise, and worsening at evening. To date, no case of restless anal syndrome associated with COVID-19 has been previously published. This case report may reflect the associative impacts of COVID-19 on the neuropsychiatric state. The long-term outcomes of neuropsychiatric conditions should continue to be monitored.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Infections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. Further, few cases have been reported in humans because of the difficulty in identifying the bacteria. Herein, we report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia.
Case presentation
A 57-year-old male patient with alcoholic cirrhosis and neurogenic bladder presented with fever and chills that had persisted for 3 days. Physical examination revealed tenderness of the right costovertebral angle. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. The patient was treated successfully with intravenous ampicillin followed by oral linezolid for a total of three weeks.
Conclusion
The literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease. However, mortality is not common because of the high antimicrobial susceptibility of E. hirae. With the advancements in MALDI-TOF MS, the number of reports of E. hirae infections has also increased, and clinicians need to consider E. hirae as a possible causative pathogen of urinary tract infections in patients with known risk factors.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. There have been reports that long-term SARS-CoV-2 RNA shedding and re-infection of COVID-19 patients existed. However, the specific mechanism, diagnosis, and treatment of COVID-19 are still unclarified.
Case presentation
In this case, we reported a 64-year-old patient who had a long-term course of COVID-19 for 174 days with two retests of SARS-CoV-2 RNA positive after discharging from the hospital. The patient’s serum immunoglobulin G (IgG) of SARS-CoV-2 tested positive after the initial infection. And during treatment, the CD4 + T cell count and ratio to peripheral blood mononuclear cell (PBMC) were in dynamic change.
Conclusions
Our results suggested that the host immune system responded with IgG production after SARS-CoV-2 infection, but was not protective enough for the patient. The reemergence of SARS-CoV-2 could be related to the cell count and proportion of CD4 + T cells in PBMC. And the increase of CD4 + T cells after treatment may help to clear the virus.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Urinary tract infections (UTIs) are a common cause of prescribing antibiotics in family medicine. In Germany, about 40% of UTI-related prescriptions are second-line antibiotics, which contributes to emerging resistance rates. To achieve a change in the prescribing behaviour among family physicians (FPs), this trial aims to implement the guideline recommendations in German family medicine.
Methods/design
In a randomized controlled trial, a multimodal intervention will be developed and tested in family practices in four regions across Germany. The intervention will consist of three elements: information on guideline recommendations, information on regional resistance and feedback of prescribing behaviour for FPs on a quarterly basis. The effect of the intervention will be compared to usual practice. The primary endpoint is the absolute difference in the mean of prescribing rates of second-line antibiotics among the intervention and the control group after 12 months. To detect a 10% absolute difference in the prescribing rate after one year, with a significance level of 5% and a power of 86%, a sample size of 57 practices per group will be needed. Assuming a dropout rate of 10%, an overall number of 128 practices will be required. The accompanying process evaluation will provide information on feasibility and acceptance of the intervention.
Discussion
If proven effective and feasible, the components of the intervention can improve adherence to antibiotic prescribing guidelines and contribute to antimicrobial stewardship in ambulatory care.
Trial registration DRKS, DRKS00020389, Registered 30 January 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020389.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Actinomyces odontolyticus is not commonly recognized as a causative microbe of liver abscess. The detection and identification of A. odontolyticus in laboratories and its recognition as a pathogen in clinical settings can be challenging. However, in the past decades, knowledge on the clinical relevance of A. odontolyticus is gradually increasing. A. odontolyticus is the dominant oropharyngeal flora observed during infancy [Li et al. in Biomed Res Int 2018:3820215, 2018]. Herein we report a case of severe infection caused by A. odontolyticus in an immunocompromised patient with disruption of the gastrointestinal (GI) mucosa.
Case presentation
We present a unique case of a patient with human immunodeficiency virus infection who was admitted due to liver abscess and was subsequently diagnosed as having coinfection of A. odontolyticus, Streptococcus constellatus, and Candida albicans during the hospital course. The empirical antibiotics metronidazole and ceftriaxone were replaced with the intravenous administration of fluconazole and ampicillin. However, the patient’s condition deteriorated, and he died 3 weeks later.
Conclusion
This report is one of the first to highlight GI tract perforation and its clinical relevance with A. odontolyticus infection. A. odontolyticus infection should be diagnosed early in high-risk patients, and increased attention should be paid to commensal flora infection in immunocompromised individuals.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Human Cytomegalovirus (HCMV) still represents a crucial concern in solid organ transplant recipients (SOTRs) and the use of antiviral therapy are limited by side effects and the selection of viral mutations conferring antiviral drug resistance.
Case presentation
Here we reported the case of an HCMV seronegative patient with common variable immunodeficiency (CVID), multiple hepatic adenomatosis, hepatopulmonary syndrome and portal hypertension who received a liver transplant from an HCMV seropositive donor. The patient was treated with Valganciclovir (vGCV) and then IV Ganciclovir (GCV) at 5 week post-transplant for uncontrolled HCMV DNAemia. However, since mutation A594V in UL97 gene conferring resistance to ganciclovir was reported, GCV therapy was interrupted. Due to the high toxicity of Foscarnet (FOS) and Cidofovir (CDV), Letermovir (LMV) monotherapy at the dosage of 480 mg per day was administered, with a gradual viral load reduction. However, a relapse of HCMV DNAemia revealed the presence of mutation C325Y in HCMV UL56 gene conferring resistance to LMV.
Conclusions
In conclusion, even if LMV is an effective and favorable safety molecule it might have a lower genetic barrier to resistance. A warning on the use of LMV monotherapy as rescue treatments for HCMV GCV-resistant infections in transplant recipients is warranted.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Nonrandom multiple respiratory virus (RV) detection provides evidence for viral interference among respiratory viruses. However, little is known as to whether it occurs randomly.
Methods
The prevalence of dual RV detection (DRVD) in patients with acute respiratory illnesses (ARIs) at 4 academic medical centers was investigated; data about the prevalence of 8 RVs were collected from the Korean national RV surveillance dataset. Linear regression analysis was performed to assess the correlation between observed and estimated prevalence of each type of DRVD.
Results
In total, 108 patients with ARIs showing DRVD were included in this study between 2011 and 2017. In several types of regression analysis, a strong correlation was observed between the observed and estimated prevalence of each type of DRVD. Excluding three DRVD types (influenza/picornavirus, influenza/human metapneumovirus, and adenovirus/respiratory syncytial virus), the slope of the regression line was higher than that of the line of random occurrence (1.231 > 1.000) and the 95% confidence interval of the regression line was located above the line of random occurrence.
Conclusions
Contrary to the results of previous epidemiologic studies, most types of DRVD occur more frequently than expected from the prevalence rates of individual RV, except for three underrepresented pairs above.
Læs mere Tjek på PubMedRustom Antia, M. Elizabeth Halloran
Immunity, 23.09.2021
Tilføjet 24.09.2021
The emergence of severe acute respiratory syndrome coronavirus 2 (CoV-2) and its associated disease, COVID-19, has caused a devastating pandemic worldwide. Here, we explain basic concepts underlying the transition from an epidemic to an endemic state, where a pathogen is stably maintained in a population. We discuss how the number of infections and the severity of disease change in the transition from the epidemic to the endemic phase, and consider the implications of this transition in the context of COVID-19.
Læs mere Tjek på PubMedAung, Su; Hardy, Nicole; Chrysanthopoulou, Stavroula A.; Kyaw, Aung; San Tun, Min; Aung, Khaymar Win; Rana, Aadia; Kantor, Rami
Journal of Acquired Immune Deficiency Syndromes, 17.09.2021
Tilføjet 24.09.2021
Introduction:
Understanding social and structural barriers that determine antiretroviral therapy (ART) adherence can improve care. Assessment of such factors is limited in Myanmar, a country with high HIV prevalence and increasing number of people living with HIV (PLWH) initiating ART.
Methods:
Questionnaires were administered to adults with HIV across four Myanmar cities to estimate adherence and its potential determinants, including HIV knowledge, social support, barriers to care (BTC), enacted and internalized stigma, and engagement in peer-to-peer HIV counseling (PC). Associations were determined using logistic mixed-effects modeling.
Results:
Among 956 participants, mean age was 39 years, 52% were female, 36% had CD4
Læs mere Tjek på PubMedKathryn M. Hastie Haoyang Li Daniel Bedinger Sharon L. Schendel S. Moses Dennison Kan Li Vamseedhar Rayaprolu Xiaoying Yu Colin Mann Michelle Zandonatti Ruben Diaz Avalos Dawid Zyla Tierra Buck Sean Hui Kelly Shaffer Chitra Hariharan Jieyun Yin Eduardo Olmedillas Adrian Enriquez Diptiben Parekh Milite Abraha Elizabeth Feeney Gillian Q. Horn CoVIC-DB team Yoann Aldon Hanif Ali Sanja Aracic Ronald R. Cobb Ross S. Federman Joseph M. Fernandez Jacob Glanville Robin Green Gevorg Grigoryan Ana G. Lujan Hernandez David D. Ho Kuan-Ying A. Huang John Ingraham Weidong Jiang Paul Kellam Cheolmin Kim Minsoo Kim Hyeong Mi Kim Chao Kong Shelly J. Krebs Fei Lan Guojun Lang Sooyoung Lee Cheuk Lun Leung Junli Liu Yanan Lu Anna MacCamy Andrew T. McGuire Anne L. Palser Terence H. Rabbitts Zahra Rikhtegaran Tehrani Mohammad M. Sajadi Rogier W. Sanders Aaron K. Sato Liang Schweizer Jimin Seo Bingqing Shen Jonne J. Snitselaar Leonidas Stamatatos Yongcong Tan Milan T. Tomic Marit J. van Gils Sawsan Youssef Jian Yu Tom Z. Yuan Qian Zhang Bjoern Peters Georgia D. Tomaras Timothy Germann Erica Ollmann Saphire
Science, 23.09.2021
Tilføjet 24.09.2021
Abdihamid Warsame, Farah Bashiir, Terri Freemantle, Chris Williams, Yolanda Vazquez, Chris Reeve, Ahmed Aweis, Mohamed Ahmed, Francesco Checchi, Abdirisak Dalmar
International Journal of Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
As a result of three decades of protracted conflict and state fragility Somalia's health system is considered very weak and reports some of the worst health indicators in the world (Directorate of National Statistics Federal Government of Somalia, 2020). The emergence of the COVID-19 pandemic has exacerbated the effects of ongoing humanitarian crises due to natural disasters and conflict (UNDP, 2020; UNSC, 2020).
Læs mere Tjek på PubMedMehdi Bamorovat, Iraj Sharifi, Mohammad Reza Aflatoonian, Ali Karamoozian, Amirhossein Tahmouresi, Abdollah Jafarzadeh, Amireh Heshmatkhah, Fatemeh Sharifi, Ehsan Salarkia, Tabandeh Khaleghi, Ahmad Khosravi, Maryam Nooshadokht, Mehdi Borhani Zarandi, Maryam Barghi
International Journal of Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Vannesa Yue May Teng, Yan Ting Chua, Eunice En Ni Lai, Shilpa Mukherjee, Jessica Michaels, Chen Seong Wong, Liang Shen, Yee Sin Leo, Barnaby Young, Sophia Archuleta, Catherine W.M. Ong
International Journal of Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
The World Health Organisation estimates 10 million new patients with active tuberculosis (TB) disease is diagnosed globally every year, of whom a considerable proportion are among people living with HIV (WHO, 2020a). People living with HIV are more susceptible to active TB disease as HIV infection increases the risks of developing TB by 16-27 times compared to those without HIV (WHO, 2021b). TB remains a leading cause of death in the HIV population worldwide even though TB is both preventable and treatable.
Læs mere Tjek på PubMedPedro Zitko, Martin Hojman, Sofía Sabato, Pablo Parenti, Rosana Cuini, Liliana Calanni, Jorge Contarelli, Rosa Teran, Valeria Araujo, Ioannis Bakolis, Jorge Chaverri, Miguel Morales, Ana-Belen Arauz, Wendy Moncada, Mónica Thormann, Carlos Beltrán, in behalf of the Latin American Workshop Study Group
International Journal of Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
Elizabeth Rowley, Nanthalile Mugala
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
The call for more gender-equitable tuberculosis programming, informed by systematically collected and analysed sex-disaggregated and age-disaggregated data, has intensified in recent years.1,2 Gender-equitable programming purposefully addresses inequities that are strongly affected by cultural and socially defined expectations, roles, responsibilities, norms, and power relationships based on sex, gender identity, or gender expression. For tuberculosis programmes, this means examining the intersectional gender context driving poor tuberculosis outcomes for men, women, and non-binary individuals (of all gender identities) and creating evidence-based strategies to address differential disease risk and service utilisation.
Læs mere Tjek på PubMedGBD 2019 Tuberculosis Collaborators
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis.
Læs mere Tjek på PubMedIrina Isakova-Sivak, Victoria Matyushenko
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
The H3N2 influenza subtype has been highly researched due to its rapid mutational variability, which allows it to escape a preexisting immune response, meaning that the effectiveness of the H3N2 vaccine component has been extremely low over the past few seasons, since the 2014–15 season.1 It is therefore not surprising that in seasons when the H3N2 virus predominates, many countries have markedly higher mortality rates than in other seasons, especially in older people, owing to their reduced immune functions.
Læs mere Tjek på PubMedVivek Shinde, Iksung Cho, Joyce S Plested, Sapeckshita Agrawal, Jamie Fiske, Rongman Cai, Haixia Zhou, Xuan Pham, Mingzhu Zhu, Shane Cloney-Clark, Nan Wang, Bin Zhou, Maggie Lewis, Patty Price-Abbott, Nita Patel, Michael J Massare, Gale Smith, Cheryl Keech, Louis Fries, Gregory M Glenn
Lancet Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
qNIV was well tolerated and produced qualitatively and quantitatively enhanced humoral and cellular immune response in older adults compared with IIV4. qNIV might enhance the effectiveness of seasonal influenza vaccination, and future studies to show clinical efficacy are planned.
Læs mere Tjek på PubMedThe Lancet
Lancet, 25.09.2021
Tilføjet 24.09.2021
There were some grounds for hope that the COVID-19 pandemic would be under control by now. Huge scientific advances have been made in our understanding of COVID-19, as well as its countermeasures. Countries have had 18 months to understand which policies work, and to develop strategies accordingly. Yet the pandemic is at a dangerous and shifting stage. Almost 10 000 deaths are reported globally every day. National responses to COVID-19 range from the complete lifting of restrictions in Denmark, to new state-wide lockdowns in Australia, and a growing political and public health crisis in the USA.
Læs mere Tjek på PubMedEun-Ju Lee, Alfred I Lee
Lancet, 7.08.2021
Tilføjet 24.09.2021
An important but rare complication of COVID-19 vaccination is vaccine-induced immune thrombotic thrombocytopenia (VITT) associated with the adenovirus vector vaccines, Ad26.COV2.S (Johnson & Johnson) and ChAdOx1 (Oxford–AstraZeneca).1–5 VITT occurs more commonly in women younger than 50 years who present within 5–24 days of vaccination with thrombosis in unusual sites—the majority with cerebral venous sinus thrombosis.1,6 Thrombocytopenia, elevated D-dimer, decreased fibrinogen, and positive antibodies against platelet factor 4 (PF4) are commonly observed.
Læs mere Tjek på PubMedShabbar Jaffar, Kaushik Ramaiya, Catherine Karekezi, Nelson Sewankambo, RESPOND-AFRICA Group
Lancet, 8.09.2021
Tilføjet 24.09.2021
The prevalences of diabetes and hypertension have risen sharply in sub-Saharan Africa, but only a minority of people living with these conditions receive regular care and among those who do, glycaemia and blood pressure are generally poorly controlled.1,2 Diabetes and hypertension can be effectively controlled,1,3 but complications from these two conditions are estimated to be responsible for up to 2 million premature deaths in sub-Saharan Africa each year.4 Diabetes and hypertension programmes in Africa could learn lessons from HIV programmes that are also relevant for other non-communicable diseases in low-income and middle-income settings.
Læs mere Tjek på PubMedNeema Kaseje, David Walcott
Lancet, 2.09.2021
Tilføjet 24.09.2021
As of Aug 24, 2021, globally there were more than 212 million confirmed COVID-19 cases and more than 4 million deaths from COVID-19.1 Current infections are driven by SARS-CoV-2 variants circulating in largely unvaccinated populations.2–4 As of Aug 24, 2021, the global distribution of more than 5 billion COVID-19 vaccine doses reveals gross disparities in vaccine access: the EU and North America received 727 million and 547 million doses, respectively; Asia received 3 billion doses; South America received 336 million doses, while Africa received 93 million doses, translating into a vaccine coverage rate below 1%.
Læs mere Tjek på PubMedRob Hyde
Lancet, 25.09.2021
Tilføjet 24.09.2021
Health system funding, social care, staffing, and COVID-19 are key issues in the German election, on Sept 26, 2021. Rob Hyde reports on the manifesto pledges of the main parties.
Læs mere Tjek på PubMedAarathi Prasad
Lancet, 25.09.2021
Tilføjet 24.09.2021
Waheed Arian is an accident and emergency doctor at Shrewsbury and Telford Hospital NHS Trust in the UK and an NHS Innovation Clinical Entrepreneur Fellow and Mentor. But his journey to becoming a doctor was challenging. Born in Kabul in 1983, the first 5 years of his life were spent in hiding from rockets, bombs, and shelling, until his family migrated to Pakistan for their safety. For the next 3 months their home would be the Babu refugee camp near the city of Peshawar. At the camp, Arian became malnourished and contracted malaria and tuberculosis.
Læs mere Tjek på PubMedRichard J Perry, Arina Tamborska, Bhagteshwar Singh, Brian Craven, Richard Marigold, Peter Arthur-Farraj, Jing Ming Yeo, Liqun Zhang, Ghaniah Hassan-Smith, Matthew Jones, Christopher Hutchcroft, Esther Hobson, Dana Warcel, Daniel White, Phillip Ferdinand, Alastair Webb, Tom Solomon, Marie Scully, David J Werring, Christine Roffe, CVT After Immunisation Against COVID-19 (CAIAC) collaborators
Lancet, 7.08.2021
Tilføjet 24.09.2021
Cerebral venous thrombosis is more severe in the context of VITT. Non-heparin anticoagulants and immunoglobulin treatment might improve outcomes of VITT-associated cerebral venous thrombosis. Since existing criteria excluded some patients with otherwise typical VITT-associated cerebral venous thrombosis, we propose new diagnostic criteria that are more appropriate.
Læs mere Tjek på PubMedDiederik van de Beek, Matthijs C Brouwer, Uwe Koedel, Emma C Wall
Lancet, 23.07.2021
Tilføjet 24.09.2021
Progress has been made in the prevention and treatment of community-acquired bacterial meningitis during the past three decades but the burden of the disease remains high globally. Conjugate vaccines against the three most common causative pathogens (Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae) have reduced the incidence of disease, but with the replacement by non-vaccine pneumococcal serotypes and the emergence of bacterial strains with reduced susceptibility to antimicrobial treatment, meningitis continues to pose a major health challenge worldwide.
Læs mere Tjek på PubMedMarisa P McGinley, Jeffrey A Cohen
Lancet, 25.06.2021
Tilføjet 24.09.2021
The sphingosine 1-phosphate (S1P) signalling pathways have important and diverse functions. S1P receptors (S1PRs) have been proposed as a therapeutic target for various diseases due to their involvement in regulation of lymphocyte trafficking, brain and cardiac function, vascular permeability, and vascular and bronchial tone. S1PR modulators were first developed to prevent rejection by the immune system following renal transplantation, but the only currently approved indication is multiple sclerosis.
Læs mere Tjek på PubMedYuhuan Yin, Fugui Shi, Yiyin Zhang, Xiaoli Zhang, Jianying Ye, Juxia Zhang
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Yuhuan Yin, Fugui Shi, Yiyin Zhang, Xiaoli Zhang, Jianying Ye, Juxia Zhang
Objective To evaluate the reporting quality of randomized controlled trials (RCTs) regarding patients with COVID-19 and analyse the influence factors.
Methods PubMed, Embase, Web of Science and the Cochrane Library databases were searched to collect RCTs regarding patients with COVID-19. The retrieval time was from the inception to December 1, 2020. The CONSORT 2010 statement was used to evaluate the overall reporting quality of these RCTs.
Results 53 RCTs were included. The study showed that the average reporting rate for 37 items in CONSORT checklist was 53.85% with mean overall adherence score of 13.02±3.546 (ranged: 7 to 22). The multivariate linear regression analysis showed the overall adherence score to the CONSORT guideline was associated with journal impact factor (P = 0.006), and endorsement of CONSORT statement (P = 0.014).
Conclusion Although many RCTs of COVID-19 have been published in different journals, the overall reporting quality of these articles was suboptimal, it can not provide valid evidence for clinical decision-making and systematic reviews. Therefore, more journals should endorse the CONSORT statement, authors should strictly follow the relevant provisions of the CONSORT guideline when reporting articles. Future RCTs should particularly focus on improvement of detailed reporting in allocation concealment, blinding and estimation of sample size.
Læs mere Tjek på PubMedDalia Omran, Mohamed Al Soda, Eshak Bahbah, Gamal Esmat, Hend Shousha, Ahmed Elgebaly, Muhammad Abdel Ghaffar, Mohamed Alsheikh, Enass El Sayed, Shimaa Afify, Samah Abdel Hafez, Khaled Elkelany, Ayman Eltayar, Omnia Ali, Lamiaa Kamal, Ahmed Heiba
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Dalia Omran, Mohamed Al Soda, Eshak Bahbah, Gamal Esmat, Hend Shousha, Ahmed Elgebaly, Muhammad Abdel Ghaffar, Mohamed Alsheikh, Enass El Sayed, Shimaa Afify, Samah Abdel Hafez, Khaled Elkelany, Ayman Eltayar, Omnia Ali, Lamiaa Kamal, Ahmed Heiba
Objectives We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt.
Methods The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test.
Results This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031).
Conclusion In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.
Læs mere Tjek på PubMedBernt Hjertner, Claudia Lützelschwab, Elise Schieck, Benjamin Nzau, Sonal Henson, Marie Sjölund, Caroline Fossum, Ulf Magnusson
PLoS One Infectious Diseases, 23.09.2021
Tilføjet 24.09.2021
by Bernt Hjertner, Claudia Lützelschwab, Elise Schieck, Benjamin Nzau, Sonal Henson, Marie Sjölund, Caroline Fossum, Ulf Magnusson
Indiscriminate use of antibiotics to treat infections that are of viral origin contributes to unnecessary use which potentially may induce resistance in commensal bacteria. To counteract this a number of host gene transcriptional studies have been conducted to identify genes that are differently expressed during bacterial and viral infections in humans, and thus could be used as a tool to base decisions on the use of antibiotics. In this paper, we aimed to evaluate the potential of a selection of genes that have been considered biomarkers in humans, to differentially diagnose bacterial from viral infections in the pig. First porcine PBMC were induced with six toll-like receptor (TLR) agonists (FliC, LPS, ODN 2216, Pam3CSK4, poly I:C, R848) to mimic host gene expression induced by bacterial or viral pathogens, or exposed to heat-killed Actinobacillus pleuropneumoniae or a split influenza virus. Genes that were differentially expressed between bacterial and viral inducers were further evaluated on clinical material comprising eleven healthy pigs, and six pigs infected with A. pleuropneumoniae. This comprised three virally upregulated genes (IFI44L, MxA, RSAD2) and four bacterially upregulated genes (IL-1β, IL-8, FAM89A, S100PBP). All six infected pigs could be differentially diagnosed to healthy pigs using a host gene transcription assay based on the geometric average of the bacterially induced genes IL-8 and S100PBP over that of the virally induced gene MxA.
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