Nyt fra tidsskrifterne
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
Ingen søgeord valgt.
19 emner vises.
Andreas W. Oehm, Andrea Springer, Daniela Jordan, Christina Strube, Gabriela Knubben-Schweizer, Katharina Charlotte Jensen, Yury Zablotski
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Andreas W. Oehm, Andrea Springer, Daniela Jordan, Christina Strube, Gabriela Knubben-Schweizer, Katharina Charlotte Jensen, Yury Zablotski
Fasciola hepatica and Ostertagia ostertagi are internal parasites of cattle compromising physiology, productivity, and well-being. Parasites are complex in their effect on hosts, sometimes making it difficult to identify clear directions of associations between infection and production parameters. Therefore, unsupervised approaches not assuming a structure reduce the risk of introducing bias to the analysis. They may provide insights which cannot be obtained with conventional, supervised methodology. An unsupervised, exploratory cluster analysis approach using the k–mode algorithm and partitioning around medoids detected two distinct clusters in a cross-sectional data set of milk yield, milk fat content, milk protein content as well as F. hepatica or O. ostertagi bulk tank milk antibody status from 606 dairy farms in three structurally different dairying regions in Germany. Parasite–positive farms grouped together with their respective production parameters to form separate clusters. A random forests algorithm characterised clusters with regard to external variables. Across all study regions, co–infections with F. hepatica or O. ostertagi, respectively, farming type, and pasture access appeared to be the most important factors discriminating clusters (i.e. farms). Furthermore, farm level lameness prevalence, herd size, BCS, stage of lactation, and somatic cell count were relevant criteria distinguishing clusters. This study is among the first to apply a cluster analysis approach in this context and potentially the first to implement a k–medoids algorithm and partitioning around medoids in the veterinary field. The results demonstrated that biologically relevant patterns of parasite status and milk parameters exist between farms positive for F. hepatica or O. ostertagi, respectively, and negative farms. Moreover, the machine learning approach confirmed results of previous work and shed further light on the complex setting of associations a between parasitic diseases, milk yield and milk constituents, and management practices.
Læs mere Tjek på PubMedTina Nazari, Fatemeh Sadeghi, Alireza Izadi, Setayesh Sameni, Shahram Mahmoudi
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Tina Nazari, Fatemeh Sadeghi, Alireza Izadi, Setayesh Sameni, Shahram Mahmoudi
Objectives This systematic review aims to summarize the mycological and clinical features of COVID-19-associated fungal infections (CAFIs) in Iran. Methods PubMed, Web of Science, Scopus, Cochrane Library, SID, Magiran, IranDoc, and Google Scholar were searched for Persian and English articles published from January 1, 2020, to November 5, 2021, using a systematic search strategy. Studies on Iranian patients suffering from CAFIs were included in the review. Results Twenty-two studies comprising 169 patients were retrieved. Reported CAFIs included candidiasis (85, 50.30%), mucormycosis (35, 20.71%), aspergillosis (29, 17.16%), fusariosis (6, 3.55%), three cases caused by rare pathogens (Rhodotorula mucilaginosa, Diaporthe foeniculina, and Sarocladium kiliense) and 11 (6.51%) uncharacterized mold infections. The most common underlying diseases were diabetes (67/168, 39.88%), cardiovascular diseases (55/168, 32.74%), and hypertension (43/168, 25.59%). The use of antibiotics (111/124, 89.52%), corticosteroids (93/132, 70.44%), and mechanical ventilation (66, 51.16%) were the most common predisposing factors. Totally, 72 (50.35%) of 143 patients with CAFIs died (data were not available for 26 patients). Conclusion Fungal infections are evident to be a complication of COVID-19 in Iran; thus, clinicians should consider them as a differential diagnosis, especially in patients with comorbidities and previous antibiotic or corticosteroid use.
Læs mere Tjek på PubMedTomokazu Konishi
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Tomokazu Konishi
Monovalent vaccines using mRNA or adenoviruses have provided substantial protection against the COVID-19 pandemic in many countries. However, viral mutations have hampered the efficacy of this approach. The Omicron variant, which appeared in Dec 2021, has caused a pandemic that has exerted pressure on the healthcare system worldwide. The COVID-19 vaccines are not very effective against this variant, resulting in an increased rate of infection and mortality. Owing to the rapidly increasing number of patients, few countries, such as Australia, New Zealand, and Taiwan, which aimed at zero-COVID cases, have discontinued their attempts to contain the spread of infection by imposing strict lockdowns, for example. Therefore, the administration of booster vaccinations has been initiated; however, there are concerns about their effectiveness, sustainability, and possible dangers. There is also the question of how a variant with such isolated mutations originated and whether this is likely to continue in the future. Here, we compare the mutations in the Omicron variant with others by direct PCA to consider questions pertaining to their evolution and characterisation. The Omicron variant, like the other variants, has mutated in humans. The accumulated mutations overwhelmed the acquired immunity and caused a pandemic. Similar mutations are likely to occur in the future. Additionally, the variants infecting animals were investigated; they rapidly mutated in animals and varied from the human strains. These animal-adapted strains are probably not highly infectious or pathogenic to humans. Hence, the possibility of using these strains as vaccines will be discussed.
Læs mere Tjek på PubMedRobert H. Shoemaker, Reynold A. Panettieri Jr., Steven K. Libutti, Howard S. Hochster, Norman R. Watts, Paul T. Wingfield, Philipp Starkl, Lisabeth Pimenov, Riem Gawish, Anastasiya Hladik, Sylvia Knapp, Daniel Boring, Jonathan M. White, Quentin Lawrence, Jeremy Boone, Jason D. Marshall, Rebecca L. Matthews, Brian D. Cholewa, Jeffrey W. Richig, Ben T. Chen, David L. McCormick, Romana Gugensberger, Sonja Höller, Josef M. Penninger, Gerald Wirnsberger
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Robert H. Shoemaker, Reynold A. Panettieri Jr., Steven K. Libutti, Howard S. Hochster, Norman R. Watts, Paul T. Wingfield, Philipp Starkl, Lisabeth Pimenov, Riem Gawish, Anastasiya Hladik, Sylvia Knapp, Daniel Boring, Jonathan M. White, Quentin Lawrence, Jeremy Boone, Jason D. Marshall, Rebecca L. Matthews, Brian D. Cholewa, Jeffrey W. Richig, Ben T. Chen, David L. McCormick, Romana Gugensberger, Sonja Höller, Josef M. Penninger, Gerald Wirnsberger
As ACE2 is the critical SARS-CoV-2 receptor, we hypothesized that aerosol administration of clinical grade soluble human recombinant ACE2 (APN01) will neutralize SARS-CoV-2 in the airways, limit spread of infection in the lung, and mitigate lung damage caused by deregulated signaling in the renin-angiotensin (RAS) and Kinin pathways. Here, after demonstrating in vitro neutralization of SARS-CoV-2 by APN01, and after obtaining preliminary evidence of its tolerability and preventive efficacy in a mouse model, we pursued development of an aerosol formulation. As a prerequisite to a clinical trial, we evaluated both virus binding activity and enzymatic activity for cleavage of Ang II following aerosolization. We report successful aerosolization for APN01, retaining viral binding as well as catalytic RAS activity. Dose range-finding and IND-enabling repeat-dose aerosol toxicology testing were conducted in dogs. Twice daily aerosol administration for two weeks at the maximum feasible concentration revealed no notable toxicities. Based on these results, a Phase I clinical trial in healthy volunteers has now been initiated (NCT05065645), with subsequent Phase II testing planned for individuals with SARS-CoV-2 infection.
Læs mere Tjek på PubMedEnrique Canessa, Livio Tenze
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Enrique Canessa, Livio Tenze
We apply the new GenomeBits method to uncover underlying genomic features of omicron and delta coronavirus variants. This is a statistical algorithm whose salient feature is to map the nucleotide bases into a finite alternating (±) sum series of distributed terms of binary (0,1) indicators. We show how by this method, distinctive signals can be uncovered out of the intrinsic data organization of amino acid progressions along their base positions. Results reveal a sort of ‘ordered’ (or constant) to ‘disordered’ (or peaked) transition around the coronavirus S-spike protein region. Together with our previous results for past variants of coronavirus: Alpha, Beta, Gamma, Epsilon and Eta, we conclude that the mapping into GenomeBits strands of omicron and delta variants can help to characterize mutant pathogens.
Læs mere Tjek på PubMedXiaoying Li, Tao Xiao, Pengzhi Hu, Kun Yan, Jiongxing Wu, Xinya Tu, Yishu Tang, Hong Xia
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Xiaoying Li, Tao Xiao, Pengzhi Hu, Kun Yan, Jiongxing Wu, Xinya Tu, Yishu Tang, Hong Xia
Background Psittacosis pneumonia is a community-acquired pneumonia caused by Chlamydia psittaci. It is usually under-diagnosed due to its atypical clinical presentation and lack of routine laboratory tests. Methods To better understand the clinical features, 52 patients diagnosed with psittacosis pneumonia by metagenomic next-generation sequencing (mNGS) were enrolled in this study. The clinical, radiological and pathological characteristics were retrospectively analyzed. Results The onset of psittacosis pneumonia in this study occurred all year round, with a peak from December to January. Most of the patients were 51–80 years old. About 65.38% of patients had a history of exposure to poultry or parrots. Abnormalities of multiple clinical signals were detected in these patients. Elevated levels of neutrophil ratio, C-reactive protein, erythrocyte sedimentation rate, and procalcitonin were detected in most patients. Radiological evidence revealed air-space consolidation or ground-glass opacities in lungs of all patients, which is the typical feature of psittacosis pneumonia. In addition, hyperemia, swelling of bronchial mucosa, and bronchial patency were detected by bronchoscopy in all patients, and bronchial sub-mucosal edema, inflammatory cells infiltration and alveolar epithelial hyperplasia were identified in the bronchial mucosa and alveolar tissue. Beta-lactam antibiotics were administered for empirical treatment before mNGS in 17 patients but showed no improvement. The treatment was switched to doxycycline or moxifloxacin immediately since psittacosis pneumonia were suspected and confirmed by mNGS detection (within 48 hours). After receiving adjustment of treatment, 94.23% (49/52) of patients were cured successfully. Conclusions In conclusion, mNGS may be a promising approach for clinical diagnosis of psittacosis. For patients with a history of exposure to birds, hyperpyrexia, nonproductive cough, multiple elevated inflammatory markers, and air-space consolidation in lung, psittacosis pneumonia should be considered, especially when beta-lactam antibiotics showed limited efficacy.
Læs mere Tjek på PubMedTitus A. P. de Hond, Wout J. Hamelink, Mark C. H. de Groot, Imo E. Hoefer, Jan Jelrik Oosterheert, Saskia Haitjema, Karin A. H. Kaasjager
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Titus A. P. de Hond, Wout J. Hamelink, Mark C. H. de Groot, Imo E. Hoefer, Jan Jelrik Oosterheert, Saskia Haitjema, Karin A. H. Kaasjager
Objectives To evaluate the prognostic value of the coefficient of variance of axial light loss of monocytes (cv-ALL of monocytes) for adverse clinical outcomes in patients suspected of infection in the emergency department (ED). Methods We performed an observational, retrospective monocenter study including all medical patients ≥18 years admitted to the ED between September 2016 and June 2019 with suspected infection. Adverse clinical outcomes included 30-day mortality and ICU/MCU admission
Læs mere Tjek på PubMedMohak Gupta, Giridara G. Parameswaran, Manraj S. Sra, Rishika Mohanta, Devarsh Patel, Amulya Gupta, Bhavik Bansal, Vardhmaan Jain, Archisman Mazumder, Mehak Arora, Nishant Aggarwal, Tarun Bhatnagar, Jawaid Akhtar, Pankaj Pandey, Vasanthapuram Ravi, Giridhara R. Babu
PLoS One Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
by Mohak Gupta, Giridara G. Parameswaran, Manraj S. Sra, Rishika Mohanta, Devarsh Patel, Amulya Gupta, Bhavik Bansal, Vardhmaan Jain, Archisman Mazumder, Mehak Arora, Nishant Aggarwal, Tarun Bhatnagar, Jawaid Akhtar, Pankaj Pandey, Vasanthapuram Ravi, Giridhara R. Babu
Background India has experienced the second largest outbreak of COVID-19 globally, yet there is a paucity of studies analysing contact tracing data in the region which can optimise public health interventions (PHI’s). Methods We analysed contact tracing data from Karnataka, India between 9 March and 21 July 2020. We estimated metrics of transmission including the reproduction number (R), overdispersion (k), secondary attack rate (SAR), and serial interval. R and k were jointly estimated using a Bayesian Markov Chain Monte Carlo approach. We studied determinants of risk of further transmission and risk of being symptomatic using Poisson regression models. Findings Up to 21 July 2020, we found 111 index cases that crossed the super-spreading threshold of ≥8 secondary cases. Among 956 confirmed traced cases, 8.7% of index cases had 14.4% of contacts but caused 80% of all secondary cases. Among 16715 contacts, overall SAR was 3.6% [95% CI, 3.4–3.9] and symptomatic cases were more infectious than asymptomatic cases (SAR 7.7% vs 2.0%; aRR 3.63 [3.04–4.34]). As compared to infectors aged 19–44 years, children were less infectious (aRR 0.21 [0.07–0.66] for 0–5 years and 0.47 [0.32–0.68] for 6–18 years). Infectors who were confirmed ≥4 days after symptom onset were associated with higher infectiousness (aRR 3.01 [2.11–4.31]). As compared to asymptomatic cases, symptomatic cases were 8.16 [3.29–20.24] times more likely to cause symptomatic infection in their secondary cases. Serial interval had a mean of 5.4 [4.4–6.4] days, and case fatality rate was 2.5% [2.4–2.7] which increased with age. Conclusion We found significant heterogeneity in the individual-level transmissibility of SARS-CoV-2 which could not be explained by the degree of heterogeneity in the underlying number of contacts. To strengthen contact tracing in over-dispersed outbreaks, testing and tracing delays should be minimised and retrospective contact tracing should be implemented. Targeted measures to reduce potential superspreading events should be implemented. Interventions aimed at children might have a relatively small impact on reducing transmission owing to their low symptomaticity and infectivity. We propose that symptomatic cases could cause a snowballing effect on clinical severity and infectiousness across transmission generations; further studies are needed to confirm this finding.
Læs mere Tjek på PubMedJennifer Chua, Ethan Nguyenkhoa, Sherry Mou, Steven A. Tobery, Arthur M. Friedlander, David DeShazer aBacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA bHeadquarters, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA, Guy H. Palmer
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
Lindsey K. Schmidt, Caitlyn E. Orne, Teresa L. Shaffer, Shane M. Wilson, Nittaya Khakhum, Alfredo G. Torres, Paul J. Brett, Mary N. Burtnick aDepartment of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA bDepartment of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA cDepartment of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, Manuela Raffatellu
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
R. C. A. de Groot, H. Zhu, T. Hoogenboezem, A. C. J. M. de Bruijn, E. Eenjes, A. E. J. ’t Jong, A. I. Belo, S. C. Estevão, J. J. Bajramovic, R. J. Rottier, M. Kool, A. M. C. van Rossum, W. W. J. Unger aLaboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MCgrid.5645.2 University Medical Center Rotterdam–Sophia Children’s Hospital, Rotterdam, The Netherlands bDepartment of Pediatric Surgery and Department of Cell Biology, Erasmus MCgrid.5645.2 University Medical Center Rotterdam–Sophia Children’s Hospital, Rotterdam, The Netherlands cAlternatives Unit, Biomedical Primate Research Centregrid.11184.3d, Rijswijk, The Netherlands dDepartment of Pulmonary Medicine, Erasmus MCgrid.5645.2 University Medical Center Rotterdam, Rotterdam, The Netherlands eDepartment of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MCgrid.5645.2 University Medical Center Rotterdam–Sophia Children’s Hospital, Rotterdam, The Netherlands, Liise-anne Pirofski
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
Bessie Liu, Rezia Era D. Braza, Katherine L. Cotten, Robert K. Davidson, Kimberly M. Davis aW. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Denise Monack
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
Amrita Saha, Souravi Roy, Anindita Ukil aInfectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, India bDepartment of Biochemistry, University of Calcutta, Kolkata, India, Anthony R. Richardson
Infection and Immunity, 11.07.2022
Tilføjet 11.07.2022
Aubin Souche, Camille Kolenda, Jordan Teoli, Raymond Schuch, Tristan Ferry, Frédéric Laurent, Jérôme Josse aCIRI–Centre International de Recherche en Infectiologie, Inserm, U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France bLaboratoire de Bactériologie, Institut des Agents Infectieux, Hospices Civils de Lyongrid.413852.9, Lyon, France cContraFect Corporation, Yonkers, New York, USA dUniversité Claude Bernard Lyon 1, Lyon, France eCentre de Référence des Infections Ostéo-articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyongrid.413852.9, Lyon, France fService des Maladies Infectieuses, Hospices Civils de Lyongrid.413852.9, Lyon, France
Antimicrobial Agents And Chemotherapy, 11.07.2022
Tilføjet 11.07.2022
Xiangri Kong, Bingmei Wang, Xiaoyu Chen, Li Wang, Xingye Wang, Juan Hou, Lin Wei, Liyan Sui, Chi Zhang, Jiyu Guan, Yanhe Luan, Wei Wang, Wu Song, Yicheng Zhao aChangchun University of Chinese Medicinegrid.440665.5, Changchun, People’s Republic of China bKey Laboratory of Zoonosis, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun, People’s Republic of China cCenter for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital Jilin University, Changchun, People’s Republic of China dAffiliated Hospital to Changchun University of Chinese Medicinegrid.440665.5, Changchun, People’s Republic of China
Antimicrobial Agents And Chemotherapy, 11.07.2022
Tilføjet 11.07.2022
Infection, 11.07.2022
Tilføjet 11.07.2022
Abstract
Background
Monkeypox is a zoonotic orthopoxvirus infection endemic in central and western Africa. In May 2022, human monkeypox infections including human-to-human transmission were reported in a multi-country outbreak in Europe and North America.
Case presentations
Here we present the first two cases of monkeypox infection in humans diagnosed in Germany. We present clinical and virological findings, including the detection of monkeypox virus DNA in blood and semen. The clinical presentation and medical history of our patients suggest close physical contact during sexual interactions as the route of infection.
Conclusion
Monkeypox requires rapid diagnosis and prompt public health response. The disease should be considered in the current situation especially the differential diagnosis of vesicular or pustular rash, particularly in patients with frequent sexual contacts. Most importantly, it is essential to raise awareness among all health professionals for the rapid and correct recognition and diagnosis of this disease, which is probably still underreported in Europe (Adler et al. in Lancet Infect Dis https://doi.org/10.1016/s1473-3099(22)00228-6, 2022).
Læs mere Tjek på PubMed
BMC Infectious Diseases, 11.07.2022
Tilføjet 11.07.2022
Abstract
Background
Tuberculosis (TB) is a leading cause of morbidity and mortality in children but epidemiological data are scarce, particularly for hard-to-reach populations. We aimed to identify the risk factors for unsuccessful outcome and TB mortality in migrant children at a supportive residential TB programme on the Thailand–Myanmar border.
Methods
We conducted retrospective analysis of routine programmatic data for children (aged ≤ 15 years old) with TB diagnosed either clinically or bacteriologically between 2013 and 2018. Treatment outcomes were described and risk factors for unsuccessful outcome and death were identified using multivariable logistic regression.
Results
Childhood TB accounted for a high proportion of all TB diagnoses at this TB programme (398/2304; 17.3%). Bacteriological testing was done on a quarter (24.9%) of the cohort and most children were diagnosed on clinical grounds (94.0%). Among those enrolled on treatment (n = 367), 90.5% completed treatment successfully. Unsuccessful treatment outcomes occurred in 42/398 (10.6%) children, comprising 26 (6.5%) lost to follow-up, one (0.3%) treatment failure and 15 (3.8%) deaths. In multivariable analysis, extra-pulmonary TB [adjusted OR (aOR) 3.56 (95% CI 1.12–10.98)], bacteriologically confirmed TB [aOR 6.07 (1.68–21.92)] and unknown HIV status [aOR 42.29 (10.00–178.78)] were independent risk factors for unsuccessful outcome. HIV-positive status [aOR 5.95 (1.67–21.22)] and bacteriological confirmation [aOR 9.31 (1.97–44.03)] were risk factors for death in the secondary analysis.
Conclusions
Children bear a substantial burden of TB disease within this migrant population. Treatment success rate exceeded the WHO End TB target of 90%, suggesting that similar vulnerable populations could benefit from the enhanced social support offered by this TB programme, but better child-friendly diagnostics are needed to improve the quality of diagnoses.
Læs mere Tjek på PubMed
Bogard, Sherri N.; Lee, James T.; Patel, Manish; Kempker, Russell R
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 11.07.2022
Background:
Although the price increase of pyrimethamine in 2015 received heavy media coverage, there is little data regarding specific implications to hospitals and the total costs of treating inpatients with toxoplasmosis encephalitis (TE).
Methods:
Utilizing average drug wholesale costs, we estimated the inpatient drug costs of TE drugs three years pre- and post- pyrimethamine price increase in August 2015. The drug regimens and total doses were determined through retrospective chart review of patients living with HIV who received treatment for toxoplasmosis encephalitis while inpatient during this period.
Results:
The three-year pre-increase TE drug costs for 66 admissions were estimated at $50,310 compared to a total drug cost of $1,026,006 for 61 admissions post-increase. Pyrimethamine made up 98% of the drug costs post-increase, compared to 57% pre-increase. Pyrimethamine-based regimens were the most frequently used throughout the study period.
Conclusions:
The price increase of pyrimethamine in 2015 led to a substantial and unnecessary financial burden to hospitals. This required healthcare systems to shift valuable resources in order to continue to provide medications to a vulnerable patient population. There has been more focus on providing high value care in recent years. Our study highlights the need for further examination of pharmaceutical companies’ arbitrary determination of medication costs and how they contribute to patient care.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChyten-Brennan, Jules; Patel, Viraj V.; Anastos, Kathryn; Hanna, David B.
Journal of Acquired Immune Deficiency Syndromes, 13.05.2022
Tilføjet 11.07.2022
Background:
Transgender women (trans-women) are frequently conflated with cisgender sexual minority men (cis-SMM) in HIV research. We examined the impact of socioeconomic and health conditions, and gender-affirming hormones in comparing HIV-related outcomes between cis-SMM and trans-women.
Setting:
Large tertiary care health system in the Bronx, NY, USA.
Methods:
Retrospective cohort study of people with HIV receiving care in 2008-2017. We compared retention in care, antiretroviral therapy (ART) prescription, and viral suppression between cis-SMM and trans-women, using modified Poisson regression, adjusting for demographic and clinical factors. Trans-women were further stratified by receipt of estrogen prescription.
Results:
We included 166 trans-women (1.4%), 1,936 cis-SMM (17%), 4,715 other cisgender men (41%), and 4,745 cisgender women (41%). Trans-women were more likely to have public insurance (78% vs 65%) and mental health (49% vs 39%) or substance use (43% vs 33%) diagnoses than cis-SMM. Compared with cis-SMM, trans-women prescribed estrogen (67% of trans-women) were more likely to be retained (adjusted risk ratio [aRR] 1.15, 95% confidence interval [CI] 1.08-1.23), prescribed ART (aRR 1.06, CI 1.01-1.11), and virally suppressed (aRR 1.08, CI 1.01-1.16). Trans-women not prescribed estrogen were less likely to be retained (aRR 0.92, CI 0.83-1.02), prescribed ART (aRR 0.90, CI 0.82-0.98), or virally suppressed (aRR 0.85, CI 0.76-0.95).
Conclusions:
In the context of HIV, socioeconomic factors, comorbidities, and gender-affirming care distinguish trans-women from cis-SMM. Compared with cis-SMM, trans-women who were prescribed estrogen had better HIV care continuum outcomes; trans-women not prescribed estrogen had worse outcomes. These differences should be accounted for in HIV-related research.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMed