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47 ud af 47 tidsskrifter valgt, ingen søgeord valgt, emner højest 7 dage gamle, sorteret efter nyeste først.
273 emner vises.
Jon M. Steichen, Ivy Phung, Eugenia Salcedo, Gabriel Ozorowski, Jordan R. Willis, Sabyasachi Baboo, Alessia Liguori, Christopher A. Cottrell, Jonathan L. Torres, Patrick J. Madden, Krystal M. Ma, Henry J. Sutton, Jeong Hyun Lee, Oleksandr Kalyuzhniy, Joel D. Allen, Oscar L. Rodriguez, Yumiko Adachi, Tina-Marie Mullen, Erik Georgeson, Michael Kubitz, Alison Burns, Shawn Barman, Rohini Mopuri, Amanda Metz, Tasha K. Altheide, Jolene K. Diedrich, Swati Saha, Kaitlyn Shields, Steven E. Schultze, Melissa L. Smith, Torben Schiffner, Dennis R. Burton, Corey T. Watson, Steven E. Bosinger, Max Crispin, John R. Yates, James C. Paulson, Andrew B. Ward, Devin Sok, Shane Crotty, William R. Schief
Science, 17.05.2024
Tilføjet 17.05.2024
Zhenfei Xie, Ying-Cing Lin, Jon M. Steichen, Gabriel Ozorowski, Sven Kratochvil, Rashmi Ray, Jonathan L. Torres, Alessia Liguori, Oleksandr Kalyuzhniy, Xuesong Wang, John E. Warner, Stephanie R. Weldon, Gordon A. Dale, Kathrin H. Kirsch, Usha Nair, Sabyasachi Baboo, Erik Georgeson, Yumiko Adachi, Michael Kubitz, Abigail M. Jackson, Sara T. Richey, Reid M. Volk, Jeong Hyun Lee, Jolene K. Diedrich, Thavaleak Prum, Samantha Falcone, Sunny Himansu, Andrea Carfi, John R. Yates, James C. Paulson, Devin Sok, Andrew B. Ward, William R. Schief, Facundo D. Batista
Science, 17.05.2024
Tilføjet 17.05.2024
Rogier W. Sanders and John P. Moore
Science, 17.05.2024
Tilføjet 17.05.2024
GBD 2021 Demographics Collaborators
Lancet, 17.05.2024
Tilføjet 17.05.2024
Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages.
Læs mere Tjek på PubMedGBD 2021 Causes of Death Collaborators
Lancet, 17.05.2024
Tilføjet 17.05.2024
Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic.
Læs mere Tjek på PubMedGBD 2021 Diseases and Injuries Collaborators
Lancet, 17.05.2024
Tilføjet 17.05.2024
Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important.
Læs mere Tjek på PubMedÁlvaro de Oliveira Franco, Victor Uberti dos Santos, Otávio von Ameln Lovison, Alexandre Prehn Zavascki, Afonso Luís Barth, Jonas Alex Morales Saute, Marino Muxfeldt Bianchin
Lancet, 17.05.2024
Tilføjet 17.05.2024
A 57-year-old woman with a 3-day history of abdominal pain, vomiting, diffuse myalgia, and a temperature peaking at 39°C presented to her local hospital. The patient had a medical history of hypertension and type 2 diabetes and was prescribed losartan and metformin.
Læs mere Tjek på PubMedChockalingam Shivashri, Wesley Hannah, Mohan Deepa, Yonas Ghebremichael-Weldeselassie, Ranjit Mohan Anjana, Ram Uma, Viswanathan Mohan, Ponnusamy Saravanan
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Chockalingam Shivashri, Wesley Hannah, Mohan Deepa, Yonas Ghebremichael-Weldeselassie, Ranjit Mohan Anjana, Ram Uma, Viswanathan Mohan, Ponnusamy Saravanan
Læs mere Tjek på PubMedThe PLOS ONE Editors
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
Berihun Bantie, Gebrie Kassaw Yirga, Moges Wubneh Abate, Abreham Tsedalu Amare, Adane Birhanu Nigat, Agmasie Tigabu, Gashaw Kerebeh, Tigabu Desie Emiru, Nigusie Selomon Tibebu, Chalie Marew Tiruneh, Natnael Moges Misganaw, Dessie Temesgen, Molla Azmeraw Bizuayehu, Ahmed Nuru Muhamed, Endalk Getasew Hiruy, Amare Kassaw
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Berihun Bantie, Gebrie Kassaw Yirga, Moges Wubneh Abate, Abreham Tsedalu Amare, Adane Birhanu Nigat, Agmasie Tigabu, Gashaw Kerebeh, Tigabu Desie Emiru, Nigusie Selomon Tibebu, Chalie Marew Tiruneh, Natnael Moges Misganaw, Dessie Temesgen, Molla Azmeraw Bizuayehu, Ahmed Nuru Muhamed, Endalk Getasew Hiruy, Amare Kassaw
Læs mere Tjek på PubMedSaltanat T. Urazayeva, Saulesh S. Kurmangaliyeva, Asset A. Kaliyev, Kymbat Sh. Tussupkaliyeva, Arman Issimov, Aisha B. Urazayeva, Zhuldyz K. Tashimova, Nadiar M. Mussin, Toleukhan Begalin, Aimeken A. Amanshiyeva, Gulaiym Zh. Nurmaganbetova, Shara M. Nurmukhamedova, Saule Balmagambetova
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Saltanat T. Urazayeva, Saulesh S. Kurmangaliyeva, Asset A. Kaliyev, Kymbat Sh. Tussupkaliyeva, Arman Issimov, Aisha B. Urazayeva, Zhuldyz K. Tashimova, Nadiar M. Mussin, Toleukhan Begalin, Aimeken A. Amanshiyeva, Gulaiym Zh. Nurmaganbetova, Shara M. Nurmukhamedova, Saule Balmagambetova The scale of emergency caused by COVID-19, the ease of survey, and the crowdsourcing deployment guaranteed by the latest technology have allowed unprecedented access to data describing behavioral changes induced by the pandemic. The study aimed to present the survey results identifying attitudes toward vaccination against COVID-19 among the population of West Kazakhstan, the level of confidence in the national QazVac vaccine, and the role of different sources of information on COVID-19 in decision-making concerning vaccination. A computer-assisted survey was conducted using WhatsApp messenger. Overall, 2,009 participants responded, with a response rate of 92%. Most (83.1%) were immunized against COVID-19; among them, 20.1% obeyed the request of their employers that had been practiced within non-pharmaceutical interventions to contain the disease. The youngest respondents, individuals with a college education, students, and employed people, as well as those with chronic diseases, showed positive attitudes toward vaccination (all p
Læs mere Tjek på PubMedDiego F. Quito-Avila, Edison Reyes-Proaño, Gerardo Armijos-Capa, Ricardo I. Alcalá Briseño, Robert Alvarez, Francisco F. Flores
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Diego F. Quito-Avila, Edison Reyes-Proaño, Gerardo Armijos-Capa, Ricardo I. Alcalá Briseño, Robert Alvarez, Francisco F. Flores This study presents the complete genome sequence of a novel nege-like virus identified in whiteflies (Bemisia tabaci MEAM1), provisionally designated as whitefly negevirus 1 (WfNgV1). The virus possesses a single-stranded RNA genome comprising 11,848 nucleotides, organized into four open reading frames (ORFs). These ORFs encode the putative RNA-dependent-RNA-polymerase (RdRp, ORF 1), a glycoprotein (ORF 2), a structural protein with homology to those in the SP24 family, (ORF 3), and a protein of unknown function (ORF 4). Phylogenetic analysis focusing on RdRp and SP24 amino acid sequences revealed a close relationship between WfNgV1 and Bemisia tabaci negevirus 1, a negevirus sequence recently discovered in whiteflies from Israel. Both viruses form a clade sharing a most recent common ancestor with the proposed nelorpivirus and centivirus taxa. The putative glycoprotein from ORF 2 and SP24 (ORF 3) of WfNgV1 exhibit the characteristic topologies previously reported for negevirus counterparts. This marks the first reported negevirus-like sequence from whiteflies in the Americas.
Læs mere Tjek på PubMedLucas Vinicius Morais, Samuel Nascimento dos Santos, Tabatah Hellen Gomes, Camila Malta Romano, Patricia Colombo-Souza, Jonatas Bussador Amaral, Marina Tiemi Shio, Lucas Melo Neves, André Luis Lacerda Bachi, Carolina Nunes França, Luiz Henrique da Silva Nali
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Lucas Vinicius Morais, Samuel Nascimento dos Santos, Tabatah Hellen Gomes, Camila Malta Romano, Patricia Colombo-Souza, Jonatas Bussador Amaral, Marina Tiemi Shio, Lucas Melo Neves, André Luis Lacerda Bachi, Carolina Nunes França, Luiz Henrique da Silva Nali Background Human Endogenous Retroviruses (HERVs) are fossil viruses that composes 8% of the human genome and plays several important roles in human physiology, including muscle repair/myogenesis. It is believed that inflammation may also regulate HERV expression, and therefore may contribute in the muscle repair, especially after training exercise. Hence, this study aimed to assess the level of HERVs expression and inflammation profile in practitioners’ resistance exercises after an acute strength training session. Methods Healthy volunteers were separated in regular practitioners of resistance exercise training group (REG, n = 27) and non-trained individuals (Control Group, n = 20). All individuals performed a strength exercise section. Blood samples were collected before the exercise (T0) and 45 minutes after the training session (T1). HERV-K (HML1-10) and W were relatively quantified, cytokine concentration and circulating microparticles were assessed. Results REG presented higher level of HERV-W expression (~2.5 fold change) than CG at T1 (p
Læs mere Tjek på PubMedFassiatou Tairou, Ibrahima Gaye, Samantha Herrera, Saira Nawaz, Libasse Sarr, Birane Cissé, Babacar Faye, Roger C. K. Tine
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Fassiatou Tairou, Ibrahima Gaye, Samantha Herrera, Saira Nawaz, Libasse Sarr, Birane Cissé, Babacar Faye, Roger C. K. Tine Introduction In Senegal, the widespread use of vector control measures has resulted in a significant reduction in the malaria burden and led the country to consider the possibility of elimination. Given this shift and changing context, it is important to characterize the malaria burden across all age groups to guide decision-making on programmatic interventions to interrupt transmission and ultimately eradicate the disease. In Senegal, there is a lack of information on malaria prevalence among certain populations, particularly among adolescents and adults. This study sought to assess the magnitude of malaria infections in all age groups, as well as malaria associated factors in an area of persistent transmission in Senegal. Methods A cross-sectional household survey was conducted in four health posts (Khossanto, Mamakhona, Diakhaling and Sambrambougou), of the health district of Saraya, in November 2021, among individuals over 6 months of age. Households were selected using multistage sampling. Consented participants were screened for malaria parasites by microscopic examination of blood smears, and hemoglobin levels were measured using the Hemocue HB 301TM analyzer. Socio-demographic information of the participants, household heads, household assets, and information on ownership and use of preventive measures were collected using a structured questionnaire. Weighted generalized mixed effects logistic regression model was used to identify factors associated with microscopically confirmed malaria infection. Results A total of 1759 participants were enrolled in the study. Overall, about 21% of participants were classified as having Plasmodium infection; children aged 5–10 years old (26.6%), adolescents aged 10–19 years old (24.7%), and children under five years of age (20.5%) had higher rates of infection compared to adults (13.5%). Plasmodium falciparum accounted for 99.2% of the malaria infections, and most infections (69%) were asymptomatic. Around one-third of study participants had anemia (hemoglobin level
Læs mere Tjek på PubMedHuong Duong, Elizabeth Minogue, Shannon Fullbrook, Thomas Barry, Kate Reddington
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Huong Duong, Elizabeth Minogue, Shannon Fullbrook, Thomas Barry, Kate Reddington The Burkholderia cepacia complex (Bcc) is the number one bacterial complex associated with contaminated Finished Pharmaceutical Products (FPPs). This has resulted in multiple healthcare related infection morbidity and mortality events in conjunction with significant FPP recalls globally. Current microbiological quality control of FPPs before release for distribution depends on lengthy, laborious, non-specific, traditional culture-dependent methods which lack sensitivity. Here, we present the development of a culture-independent Bcc Nucleic Acid Diagnostic (NAD) method for detecting Bcc contaminants associated with Over-The-Counter aqueous FPPs. The culture-independent Bcc NAD method was validated to be specific for detecting Bcc at different contamination levels from spiked aqueous FPPs. The accuracy in Bcc quantitative measurements was achieved by the high degree of Bcc recovery from aqueous FPPs. The low variation observed between several repeated Bcc quantitative measurements further demonstrated the precision of Bcc quantification in FPPs. The robustness of the culture-independent Bcc NAD method was determined when its accuracy and precision were not significantly affected during testing of numerous aqueous FPP types with different ingredient matrices, antimicrobial preservative components and routes of administration. The culture-independent Bcc NAD method showed an ability to detect Bcc in spiked aqueous FPPs at a concentration of 20 Bcc CFU/mL. The rapid (≤ 4 hours from sample in to result out), robust, culture-independent Bcc NAD method presented provides rigorous test specificity, accuracy, precision, and sensitivity. This method, validated with equivalence to ISO standard ISO/TS 12869:2019, can be a valuable diagnostic tool in supporting microbiological quality control procedures to aid the pharmaceutical industry in preventing Bcc contamination of aqueous FPPs for consumer safety.
Læs mere Tjek på PubMedEnyew Getaneh Mekonen, Belayneh Shetie Workneh, Tadesse Tarik Tamir, Alebachew Ferede Zegeye
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Enyew Getaneh Mekonen, Belayneh Shetie Workneh, Tadesse Tarik Tamir, Alebachew Ferede Zegeye Introduction Despite the decrease in the global under-five mortality rate, the highest rates of mortality are reported in sub-Saharan Africa. More than one-third of all deaths among under-five children are either from lower respiratory tract infections, diarrhea, or malaria. Poor treatment-seeking behavior for fever among mothers of under-five children is a big concern in sub-Saharan Africa. However, the pooled prevalence of prompt treatment of fever and its associated factors among under-five children in the region using nationally representative data is not known. Therefore, the findings of this study will inform policymakers and program managers who work on child health to design interventions to improve the timely and appropriate treatment of fever among under-five children. Methods Data from the recent demographic and health surveys of 36 countries in sub-Saharan Africa conducted between 2006 and 2022 were used. A total weighted sample of 71,503 living children aged under five years with a fever was included in the study. Data extracted from DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value
Læs mere Tjek på PubMedYoung Ho Lee, Gwan Gyu Song
PLoS One Infectious Diseases, 17.05.2024
Tilføjet 17.05.2024
by Young Ho Lee, Gwan Gyu Song Objective The objective of this study was to evaluate the relationship between the platelet-to-lymphocyte ratio (PLR) and systemic lupus erythematosus (SLE). Additionally, the study aimed to establish an association between PLR and SLE disease activity, specifically lupus nephritis (LN). Methods We conducted a comprehensive search across Medline, Embase, and Cochrane databases to identify relevant articles. Subsequently, we performed meta-analyses to compare PLR between SLE patients and controls, as well as active and inactive SLE cases, along with LN and non-LN groups. Furthermore, a meta-analysis was conducted on correlation coefficients between PLR and various parameters in SLE patients, including the SLE Disease Activity Index (SLEDAI), C3, C4, anti-dsDNA, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results In total, fifteen studies comprising 1,522 SLE patients and 1,424 controls were eligible for inclusion. The meta-analysis demonstrated a significant elevation of PLR in the SLE group compared to the control group (Standardized Mean Difference [SMD] = 0.604, 95% Confidence Interval [CI] = 0.299–0.909, p < 0.001). Upon stratification by ethnicity, an elevated PLR was observed in the SLE group among both Asian and Arab populations. Subgroup analysis based on sample size revealed consistently higher PLR in both small (n < 200) and large sample (n ≥ 200) SLE groups. Moreover, when considering disease activity, there was a noteworthy trend of increased PLR in the active disease group compared to the inactive group (SMD = 0.553, 95% CI = 0.000–1.106, p = 0.050). However, the meta-analysis did not demonstrate a significant distinction in PLR between the LN and non-LN groups. Notably, a positive association was established between PLR and SLEDAI (correlation coefficient = 0.325, 95% CI = 0.176–0.459, p < 0.001). Furthermore, PLR exhibited positive correlations with ESR, CRP, proteinuria, C3, and anti-dsDNA antibody levels. Conclusions The outcomes of this meta-analysis underscored the elevated PLR in SLE patients, suggesting its potential as a biomarker for gauging systemic inflammation in SLE. Additionally, PLR exhibited correlations with SLEDAI, as well as with key indicators such as ESR, CRP, proteinuria, C3, and anti-dsDNA antibody levels.
Læs mere Tjek på PubMedAyan ChatterjeeKaran Gautam KavalDanielle A. Garsin1Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center, Houston, Texas, USA, Nancy E. Freitag
Infection and Immunity, 16.05.2024
Tilføjet 16.05.2024
Patrycja Woldan-Gradalska, Wojciech Gradalski, Ronny K Gunnarsson, Pär-Daniel Sundvall, Karin Rystedt
International Journal of Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Eight-year old Maria recently came to your clinic accompanied by her mother. She\'s been dealing with a sore throat and a history of fever for the past two days. Upon examination, swollen anterior cervical lymph nodes and inflamed tonsils with exudate are noticeable. Despite the absence of a cough and her generally good condition, Maria is avoiding food due to the pain in her throat. Her mother is seeking an understanding of the cause and wants to know if antibiotics could offer relief. Would a throat swab aimed to identify Streptococcus pyogenes (Group A Streptococcus) be useful in determining whether Maria\'s illness is due to S.
Læs mere Tjek på PubMedBMC Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Abstract Background In November 2019, the world faced a pandemic called SARS-CoV-2, which became a major threat to humans and continues to be. To overcome this, many plants were explored to find a cure. Methods Therefore, this research was planned to screen out the active constituents from Artemisia annua that can work against the viral main protease Mpro as this non-structural protein is responsible for the cleavage of replicating enzymes of the virus. Twenty-five biocompounds belonging to different classes namely alpha-pinene, beta-pinene, carvone, myrtenol, quinic acid, caffeic acid, quercetin, rutin, apigenin, chrysoplenetin, arteannunin b, artemisinin, scopoletin, scoparone, artemisinic acid, deoxyartemisnin, artemetin, casticin, sitogluside, beta-sitosterol, dihydroartemisinin, scopolin, artemether, artemotil, artesunate were selected. Virtual screening of these ligands was carried out against drug target Mpro by CB dock. Results Quercetin, rutin, casticin, chrysoplenetin, apigenin, artemetin, artesunate, sopolin and sito-gluside were found as hit compounds. Further, ADMET screening was conducted which represented Chrysoplenetin as a lead compound. Azithromycin was used as a standard drug. The interactions were studied by PyMol and visualized in LigPlot. Furthermore, the RMSD graph shows fluctuations at various points at the start of simulation in Top1 (Azithromycin) complex system due to structural changes in the helix-coil-helix and beta-turn-beta changes at specific points resulting in increased RMSD with a time frame of 50 ns. But this change remains stable after the extension of simulation time intervals till 100 ns. On other side, the Top2 complex system remains highly stable throughout the time scale. No such structural dynamics were observed bu the ligand attached to the active site residues binds strongly. Conclusion This study facilitates researchers to develop and discover more effective and specific therapeutic agents against SARS-CoV-2 and other viral infections. Finally, chrysoplenetin was identified as a more potent drug candidate to act against the viral main protease, which in the future can be helpful.
Læs mere Tjek på PubMedPamplin, Jeremy C.; Gray, Brooke; Quinn, Matthew T.; Little, Jeanette R.; Colombo, Christopher J.; Subramanian, Sanjay; Farmer, Joseph C.; Ries, Michael; Scott, Benjamin; for the Governance Stakeholder Working Group and National Emergency Tele-Critical Care Network Team Participants
Critical Care Explorations, 16.05.2024
Tilføjet 16.05.2024
The COVID-19 pandemic caused tremendous disruption to the U.S. healthcare system and nearly crippled some hospitals during large patient surges. Limited ICU beds across the country further exacerbated these challenges. Telemedicine, specifically tele-critical care (TCC), can expand a hospital’s clinical capabilities through remote expertise and increase capacity by offloading some monitoring to remote teams. Unfortunately, the rapid deployment of telemedicine, especially TCC, is constrained by multiple barriers. In the summer of 2020, to support the National Emergency Tele-Critical Care Network (NETCCN) deployment, more than 50 national leaders in applying telemedicine technologies to critical care assembled to provide their opinions about barriers to NETCCN implementation and strategies to overcome them. Through consensus, these experts developed white papers that formed the basis of this article. Herein, the authors share their experience and propose multiple solutions to barriers presented by laws, local policies and cultures, and individual perspectives according to a minimum, better, best paradigm for TCC delivery in the setting of a national disaster. Cross-state licensure and local privileging of virtual experts were identified as the most significant barriers to rapid deployment of services, whereas refining the model of TCC to achieve the best outcomes and defining the best financial model is the most significant for long-term success. Ultimately, we conclude that a rapidly deployable national telemedicine response system is achievable.
Læs mere Tjek på PubMedNairon, Emerson B.; Joseph, Jeslin; Kamal, Abdulkadir; Busch, David R.; Olson, DaiWai M.
Critical Care Explorations, 16.05.2024
Tilføjet 16.05.2024
IMPORTANCE: Patients admitted with cerebral hemorrhage or cerebral edema often undergo external ventricular drain (EVD) placement to monitor and manage intracranial pressure (ICP). A strain gauge transducer accompanies the EVD to convert a pressure signal to an electrical waveform and assign a numeric value to the ICP. OBJECTIVES: This study explored ICP accuracy in the presence of blood and other viscous fluid contaminates in the transducer. DESIGN: Preclinical comparative design study. SETTING: Laboratory setting using two Natus EVDs, two strain gauge transducers, and a sealed pressure chamber. PARTICIPANTS: No human subjects or animal models were used. INTERVENTIONS: A control transducer primed with saline was compared with an investigational transducer primed with blood or with saline/glycerol mixtures in mass:mass ratios of 25%, 50%, 75%, and 100% glycerol. Volume in a sealed chamber was manipulated to reflect changes in ICP to explore the impact of contaminates on pressure measurement. MEASUREMENTS AND MAIN RESULTS: From 90 paired observations, ICP readings were statistically significantly different between the control (saline) and experimental (glycerol or blood) transducers. The time to a stable pressure reading was significantly different for saline vs. 25% glycerol (< 0.0005), 50% glycerol (< 0.005), 75% glycerol (< 0.0001), 100% glycerol (< 0.0005), and blood (< 0.0005). A difference in resting stable pressure was observed for saline vs. blood primed transducers (0.041). CONCLUSIONS AND RELEVANCE: There are statistically significant and clinically relevant differences in time to a stable pressure reading when contaminates are introduced into a closed drainage system. Changing a transducer based on the presence of blood contaminate should be considered to improve accuracy but must be weighed against the risk of introducing infection.
Læs mere Tjek på PubMedLi, Jie; Lyu, Shan; Luo, Jian; Liu, Ping; Albuainain, Fai A.; Alamoudi, Omar A.; Rochette, Violaine; Ehrmann, Stephan
Critical Care Medicine, 16.05.2024
Tilføjet 16.05.2024
Objectives: To assess the effects of antibiotics delivered via the respiratory tract in preventing ventilator-associated pneumonia (VAP). Data Sources: We searched PubMed, Scopus, the Cochrane Library, and ClinicalTrials.gov for studies published in English up to October 25, 2023. Study Selection: Adult patients with mechanical ventilation of over 48 h and receiving inhaled or instilled antibiotics (with control group) to prevent VAP were included. Data Extraction: Two independent groups screened studies, extracted the data, and assessed the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty/quality of the evidence. Results of a random-effects model were reported for overall and predefined subgroup meta-analyses. The analysis was primarily conducted on randomized controlled trials, and observational studies were used for sensitivity analyses. Data Synthesis: Seven RCTs with 1445 patients were included, of which six involving 1283 patients used nebulizers to deliver antibiotics. No obvious risk of bias was found among the included RCTs for the primary outcome. Compared with control group, prophylactic antibiotics delivery via the respiratory tract significantly reduced the risk of VAP (risk ratio [RR], 0.69 [95% CI, 0.53–0.89]), particularly in subgroups where aminoglycosides (RR, 0.67 [0.47–0.97]) or nebulization (RR, 0.64 [0.49–0.83]) were used as opposed to other antibiotics (ceftazidime and colistin) or intratracheal instillation. No significant differences were observed in mortality, mechanical ventilation duration, ICU and hospital length of stay, duration of systemic antibiotics, need for tracheostomy, and adverse events between the two groups. Results were confirmed in sensitivity analyses. Conclusions: In adult patients with mechanical ventilation for over 48 h, prophylactic antibiotics delivered via the respiratory tract reduced the risk of VAP, particularly for those treated with nebulized aminoglycosides.
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Abstract Background Limited data exists on effects of intrapartum azithromycin on prevalence of carriage and antibiotic resistance of Enterobacterales.Methods We conducted a randomized trial in Gambia and Burkina Faso where women received intrapartum azithromycin (2g) or placebo. We determined impact of treatment on prevalence of carriage and antibiotic resistance of Escherichia coli and Klebsiella pneumoniae by analysing rectal swabs (RS), nasopharyngeal swabs (NPS), breast milk and recto-vaginal swabs (RVS). Bacteria were isolated microbiologically; antibiotic susceptibility was confirmed with an E-test. Prevalence ratios (PR) with 95% confidence intervals (CI’s) were used for comparison between arms.Results In infants, E. coli carriage in RS was lower in the intervention than placebo arm at days 6 (63.0% vs. 75.2%, PR, 0.84; CI, 0.75-0.95) and 28 (52.7% vs. 70.4%, 0.75; 0.64-0.87) post-intervention. Prevalence of azithromycin-resistant E. coli was higher in the azithromycin arm at days 6 (13.4% vs. 3.6%, 3.75; 1.83-7.69) and 28 (16.4% vs. 9.6%, 1.71; 1.05-2.79). For K. pneumoniae, carriage in RS was higher in the intervention than placebo arm at days 6 (49.6% vs. 37.2%, 1.33; 1.08-1.64) and 28 (53.6% vs. 32.9%, 1.63; 1.31-2.03). Prevalence of azithromycin-resistant K. pneumoniae was higher in the azithromycin arm at day 28 (7.3% vs. 2.1%, 3.49; 1.30-9.37). No differences were observed for other sample types.Conclusion Intrapartum azithromycin decreased E. coli carriage but increased both K. pneumoniae carriage and azithromycin resistance in both bacteria. These data need to be considered together with efficacy results to balance the potential short- and long-term impact of the intervention.Clinical Trials registration www.clinicaltrials.gov: NCT03199547
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Abstract Background Few data are available on the real-world efficacy of receiving tenofovir-lamivudine-dolutegravir (DTG) as HIV treatment, particularly among young people in West Africa. Here, we evaluated pharmaco-virological outcomes and resistance profiles among Togolese children and adolescents.Methods A cross-sectional study was conducted in Lomé, Togo, enrolling antiretroviral-treated people with HIV aged from 18 months to 24 years. Plasma HIV-1 viral load and antiretroviral concentrations were measured. Next-Generation Sequencing (NGS) of protease, Reverse Transcriptase (RT) and integrase was performed on all samples with viral load >200 c/mL. Drug resistance mutations (DRMs) were identified and interpreted using the ANRS-MIE algorithm.Results 264 participants were enrolled (median age=17 years), 226 received a DTG-based regimen for a median of 20.5 months. Among them, virological suppression at the 200 c/mL threshold in 80.0% of the participants. Plasma DTG concentrations were adequate (i.e., >640 ng/mL), suboptimal and below the limit of quantification in 74.1%, 6.7% and 19.2% of participants receiving DTG, respectively. Overall, viruses resistant to any of Nucleoside RT Inhibitors, Non-NRTIs, and protease inhibitors were found in 52%, 66% and 1.6% of participants, respectively. A major integrase inhibitor DRM was observed in 9.4% (n=3/32, R263K, E138A-G140A-Q148R, and N155H) of participants with a viral load >200 c/mL.Conclusions These first findings in such a large series of adolescents in a low-income country, showed a good virological response of 80% and the presence of an integrase DRM in 9.4% of the virological failures, supporting the need to monitor DTG drug resistance to reduce the risk of resistance acquisition.
Læs mere Tjek på PubMedClinical Infectious Diseases, 16.05.2024
Tilføjet 16.05.2024
Abstract Background People with HIV (PHIV) admitted to hospital have high mortality, with tuberculosis (TB) being the major cause of death. Systematic use of new TB diagnostics could improve TB diagnosis and might improve outcomes.Methods We conducted a cluster randomised trial among adult PHIV admitted to Zomba Central Hospital, Malawi. Admission-days were randomly assigned to: enhanced TB diagnostics using urine lipoarabinomannan (LAM) antigen tests (SILVAMP-LAM, Fujifilm, Japan and Determine-LAM, Alere/Abbot, USA), digital chest X-ray with computer aided diagnosis (dCXR-CAD, CAD4TBv6, Delft, Netherlands), plus usual care (“enhanced TB diagnostics”); or usual care alone (“usual care”). The primary outcome was TB treatment initiation during admission. Secondary outcomes were 56-day mortality, TB diagnosis within 24-hours, and undiagnosed TB at discharge, ascertained by culture of one admission sputum sample.Findings Between 2 September 2020 and 15 February 2022, we recruited 419 people. Four people were excluded post-recruitment, leaving 415 adults recruited during 207 randomly assigned admission-days in modified intention-to-treat analysis. At admission, 90.8% (377/415) were taking antiretroviral therapy (ART) with median (IQR) CD4 cell count 240 cells/mm3. In the enhanced diagnostic arm, median CAD4TBv6 score was 60 (IQR: 51-71), 4.4% (9/207) had SILVAMP-LAM-positive and 14.4% (29/201) had Determine-LAM positive urine with three samples positive by both urine tests. TB treatment was initiated in 46/208 (22%) in enhanced TB diagnostics arm and 24/207 (12%) in usual care arm (risk ratio [RR] 1.92, 95% CI 1.20-3.08). There was no difference in mortality by 56 days (enhanced TB diagnosis: 54/208, 26%; usual care: 52/207, 25%; hazard ratio 1.05, 95% CI 0.72–1.53); TB treatment initiation within 24 hours (enhanced TB diagnosis: 8/207, 3.9%; usual care: 5/208, 2.4%; RR 1.61, 95% CI 0.53–4.71); or undiagnosed microbiological-confirmed TB at discharge (enhanced TB diagnosis, 0/207 (0.0%), usual care arm 2/208 (1.0%) (p = 0.50).Interpretation Urine SILVAMP-LAM/Determine-LAM plus dCXR-CAD diagnostics identified more hospitalised PHIV with TB than usual care. The increase in TB treatment appeared mainly due to greater use of Determine-LAM, rather than SILVAMP-LAM or dCXR-CAD. Poor concordance between Determine-LAM and SILVAMP-LAM urine tests requires further investigation. Inpatient mortality for adults with HIV remains unacceptability high.
Læs mere Tjek på PubMedDongxin LiuFei HuangYaru LiLingfeng MaoWencong HeSihao WuHui XiaPing HeHuiwen ZhengYang ZhouBing ZhaoXichao OuYuanyuan SongZexuan SongLi MeiLi LiuGuoliang ZhangQiang WeiYanlin Zhaoa National Pathogen Resource Center, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinab National Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinac Department of Nutrition, Beijing Friendship Hospital, Capital Medical Universityd Joint Research Center for Molecular Diagnosis of Severe Infection in Children, Binjiang Institute of Zhejiang University, Hangzhou, People’s Republic of Chinae Laboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children’s Health, Beijing, People’s Republic of Chinaf National Clinical Research Center for Infectious Diseases, Guangdong Clinical Research Center for Tuberculosis, Shenzhen Third People’s Hospital, Shenzhen, People’s Republic of China
Emerg Microbes Infect, 16.05.2024
Tilføjet 16.05.2024
Jinlu ZhuJianping WangWeiming KangXiyan ZhangAnusak KerdsinHuochun YaoHan ZhengZongfu Wua MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, People’s Republic of Chinab Key Lab of Animal Bacteriology, Ministry of Agriculture, Nanjing, People’s Republic of Chinac WOAH Reference Lab for Swine Streptococcosis, Nanjing, People’s Republic of Chinad Guangdong Provincial Key Laboratory of Research on the Technology of Pig-breeding and Pig-disease Prevention, Guangzhou, People’s Republic of Chinae National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinaf Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, People’s Republic of Chinag Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
Emerg Microbes Infect, 16.05.2024
Tilføjet 16.05.2024
Jieshi YuZhenyu WenWanke HuMingwang ChenYuanlong ZhangShasha LiuGang WangZhao WangDan WangShao-lun ZhaiWen-kang WeiTianyu LiMing Liaoa State Key Laboratory of Swine and Poultry Breeding Industry, Agro-biological Gene Research Center, Guangdong Academy of Agricultural Sciences, Guangzhou, People’s Republic of Chinab National and Regional Joint Engineering Laboratory for Medicament of Zoonosis Prevention and Control, Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou, People’s Republic of Chinac College of Coastal Agricultural Sciences, Guangdong Ocean University, Zhanjiang, People’s Republic of Chinad Zhongshan Animal Disease Control Center, Zhongshan, People’s Republic of Chinae Guangdong Animal Disease Control Center, Guangzhou, People’s Republic of Chinaf College of Veterinary Medicine, South China Agricultural University, Guangzhou, People’s Republic of Chinag Key Laboratory of Livestock Disease Prevention of Guangdong Province, Institute of Animal Health, Guangdong Academy of Agricultural Sciences, Guangzhou, People’s Republic of Chinah School of Laboratory Animal & Shandong Laboratory Animal Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, People’s Republic of Chinai Maxwell H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USAj College of Animal Science and Technology, Guangxi University, Nanning, People’s Republic of Chinak College of Animal Science and Technology, Zhongkai University of Agriculture and Engineering, Guangzhou, People’s Republic of China
Emerg Microbes Infect, 16.05.2024
Tilføjet 16.05.2024
New England Journal of Medicine, 16.05.2024
Tilføjet 16.05.2024
New England Journal of Medicine, Volume 390, Issue 19, Page 1835-1836, May 16/23, 2024.
Læs mere Tjek på PubMedJing Jing WangFlinders University, Adelaide, SA, Australia, Linda SchönbornGreifswald University Hospital, Greifswald, Germany, Theodore E. WarkentinMcMaster University, Hamilton, ON, Canada twarken@mcmaster.ca, Tim ChatawayFlinders University, Adelaide, SA, Australia, Leonie GrosseLudwig Maximilians University, Munich, Germany, Paolo SimioniPadua University Hospital, Padua, Italy, Stephan MollUniversity of North Carolina School of Medicine, Chapel Hill, NC, Andreas GreinacherGreifswald University Hospital, Greifswald, Germany, Tom P. GordonSA Pathology, Adelaide, SA, Australia
New England Journal of Medicine, 16.05.2024
Tilføjet 16.05.2024
New England Journal of Medicine, Volume 390, Issue 19, Page 1827-1829, May 16/23, 2024.
Læs mere Tjek på PubMedMalaria Journal, 16.05.2024
Tilføjet 16.05.2024
Abstract Background Vector control using insecticides is a key prevention strategy against malaria. Unfortunately, insecticide resistance in mosquitoes threatens all progress in malaria control. In the perspective of managing this resistance, new insecticide formulations are being tested to improve the effectiveness of vector control tools. Methods The efficacy and residual activity of Pirikool® 300 CS was evaluated in comparison with Actellic® 300 CS in experimental huts at the Tiassalé experimental station on three substrates including cement, wood and mud. The mortality, blood-feeding inhibition, exiting behaviour and deterrency of free-flying wild mosquitoes was evaluated. Cone bioassay tests with susceptible and resistant mosquito strains were conducted in the huts to determine residual efficacy. Results A total of 20,505 mosquitoes of which 10,979 (53%) wild female Anopheles gambiae were collected for 112 nights. Residual efficacy obtained from monthly cone bioassay was higher than 80% with the susceptible, laboratory-maintained An. gambiae Kisumu strain, from the first to the tenth study period on all three types of treated substrate for both Actellic® 300CS and Pirikool® 300CS. This residual efficacy on the wild Tiassalé strain was over 80% until the 4th month of study on Pirikool® 300CS S treated substrates. Overall 24-h mortalities of wild free-flying An. gambiae sensu lato which entered in the experimental huts over the 8-months trial on Pirikool® 300CS treatment was 50.5%, 75.9% and 52.7%, respectively, on cement wall, wood wall and mud wall. The positive reference product Actellic® 300CS treatment induced mortalities of 42.0%, 51.8% and 41.8% on cement wall, wood wall and mud wall. Conclusion Pirikool® 300CS has performed really well against resistant strains of An. gambiae using indoor residual spraying method in experimental huts. It could be an alternative product for indoor residual spraying in response to the vectors\' resistance to insecticides.
Læs mere Tjek på PubMedMalaria Journal, 16.05.2024
Tilføjet 16.05.2024
Abstract Background In Uganda, village health workers (VHWs) manage childhood illness under the integrated community case management (iCCM) strategy. Care is provided for malaria, pneumonia, and diarrhoea in a community setting. Currently, there is limited evidence on the cost-effectiveness of iCCM in comparison to health facility-based management for childhood illnesses. This study examined the cost-effectiveness of the management of childhood illness using the VHW-led iCCM against health facility-based services in rural south-western Uganda. Methods Data on the costs and effectiveness of VHW-led iCCM versus health facility-based services for the management of childhood illness was collected in one sub-county in rural southwestern Uganda. Costing was performed using the ingredients approach. Effectiveness was measured as the number of under-five children appropriately treated. The Incremental Cost-Effectiveness Ratio (ICER) was calculated from the provider perspective. Results Based on the decision model for this study, the cost for 100 children treated was US$628.27 under the VHW led iCCM and US$87.19 for the health facility based services, while the effectiveness was 77 and 71 children treated for VHW led iCCM and health facility-based services, respectively. An ICER of US$6.67 per under five-year child treated appropriately for malaria, pneumonia and diarrhoea was derived for the provider perspective. Conclusion The health facility based services are less costly when compared to the VHW led iCCM per child treated appropriately. The VHW led iCCM was however more effective with regard to the number of children treated appropriately for malaria, pneumonia and diarrhoea. Considering the public health expenditure per capita for Uganda as the willingness to pay threshold, VHW led iCCM is a cost-effective strategy. VHW led iCCM should, therefore, be enhanced and sustained as an option to complement the health facility-based services for treatment of childhood illness in rural contexts.
Læs mere Tjek på PubMedMalaria Journal, 16.05.2024
Tilføjet 16.05.2024
Abstract Background In 2020, during the COVID-19 pandemic, Médecins Sans Frontières (MSF) initiated three cycles of dihydroartemisin-piperaquine (DHA-PQ) mass drug administration (MDA) for children aged three months to 15 years within Bossangoa sub-prefecture, Central African Republic. Coverage, clinical impact, and community members perspectives were evaluated to inform the use of MDAs in humanitarian emergencies. Methods A household survey was undertaken after the MDA focusing on participation, recent illness among eligible children, and household satisfaction. Using routine surveillance data, the reduction during the MDA period compared to the same period of preceding two years in consultations, malaria diagnoses, malaria rapid diagnostic test (RDT) positivity in three MSF community healthcare facilities (HFs), and the reduction in severe malaria admissions at the regional hospital were estimated. Twenty-seven focus groups discussions (FGDs) with community members were conducted. Results Overall coverage based on the MDA card or verbal report was 94.3% (95% confidence interval (CI): 86.3–97.8%). Among participants of the household survey, 2.6% (95% CI 1.6–40.3%) of round 3 MDA participants experienced illness in the preceding four weeks compared to 30.6% (95% CI 22.1–40.8%) of MDA non-participants. One community HF experienced a 54.5% (95% CI 50.8–57.9) reduction in consultations, a 73.7% (95% CI 70.5–76.5) reduction in malaria diagnoses, and 42.9% (95% CI 36.0–49.0) reduction in the proportion of positive RDTs among children under five. A second community HF experienced an increase in consultations (+ 15.1% (− 23.3 to 7.5)) and stable malaria diagnoses (4.2% (3.9–11.6)). A third community HF experienced an increase in consultations (+ 41.1% (95% CI 51.2–31.8) and malaria diagnoses (+ 37.3% (95% CI 47.4–27.9)). There were a 25.2% (95% CI 2.0–42.8) reduction in hospital admissions with severe malaria among children under five from the MDA area. FGDs revealed community members perceived less illness among children because of the MDA, as well as fewer hospitalizations. Other indirect benefits such as reduced household expenditure on healthcare were also described. Conclusion The MDA achieved high coverage and community acceptance. While some positive health impact was observed, it was resource intensive, particularly in this rural context. The priority for malaria control in humanitarian contexts should remain diagnosis and treatment. MDA may be additional tool where the context supports its implementation.
Læs mere Tjek på PubMedAlberto Rizzo, Davide Dalu, Davide Moschese, Andrea Giacomelli
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Seyit Ali Büyüktuna, Serra İlayda Yerlitaş, Gözde Ertük Zararsız, Kübra Doğan, Demet Kablan, Gökhan Bağcı, Selda Özer, Cihad Baysal, Yasemin Çakır, Ahu Cephe, Necla Koçhan, Gökmen Zararsız, Halef Okan Doğan
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Junhao Luo, Yongjun Gao, Wenhui Guo, Song Zhao, Li Li, Zhuohan Zhang, Rongbao Gao
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Haleema Qayyum Abbasi, Aman Goyal, Abdul Moiz Khan
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
César Fernández‐de‐las‐Peñas, Juan Torres‐Macho, Maria Ruiz‐Ruigómez, Estibaliz Arrieta‐Ortubay, Carolina Rodríguez‐Rebollo, Míriam Akasbi‐Moltalvo, Virginia Pardo‐Guimerá, Pablo Ryan‐Murua, Carlos Lumbreras‐Bermejo, Oscar J. Pellicer‐Valero, Rocco Giordano, Lars Arendt‐Nielsen, Anabel Franco‐Moreno
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Qingyuan Li, Wenxian Wen, Yijin Wang, Tao Gong, Xinwei Wang, Qi Tan, Bin Fan, He Xie, Yujia Li, Shilin Li, Chunhui Yang, Zhonghui Zhou, Xiaoqiong Duan, Wenyu Lin, Limin Chen
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Chen‐Hua Liu, Yu‐Ping Chang, Ji‐Yuh Lee, Chi‐Yi Chen, Wei‐Yu Kao, Chih‐Lin Lin, Sheng‐Shun Yang, Yu‐Lueng Shih, Cheng‐Yuan Peng, Fu‐Jen Lee, Ming‐Chang Tsai, Shang‐Chin Huang, Tung‐Hung Su, Tai‐Chung Tseng, Chun‐Jen Liu, Pei‐Jer Chen, Jia‐Horng Kao
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Haowen Qiao, Xiangxue Deng, Lingxi Qiu, Yafei Qu, Yuanpu Chiu, Feixiang Chen, Shangzhou Xia, Cheyene Muenzel, Tenghuan Ge, Zixin Zhang, Pengfei Song, Alexandre Bonnin, Zhen Zhao, Weiming Yuan
Journal of Medical Virology, 16.05.2024
Tilføjet 16.05.2024
Simms, Victoria; Kranzer, Katharina; Chikwari, Chido Dziva; Dauya, Ethel; BandasonMSc, Tsitsi; Dzavakwa, Nyasha; Ferrand, Rashida A
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: Perinatally acquired HIV may lead to worse health outcomes compared to later acquisition. We compared the demographic and clinical characteristics of youth diagnosed with HIV in childhood and adulthood, as a proxy for acquisition route (perinatal vs horizontal). Setting: Youth aged 18-24 years in 3 provinces in Zimbabwe Methods: In a representative population-based survey, participants were asked their HIV status, date of HIV diagnosis if positive, and whether they were diagnosed in childhood. A dried blood spot was taken to measure viral load. Multilevel mixed-effects generalized linear modelling was used to estimate the association between HIV acquisition time and viral non-suppression (≥1000 copies/ml). Results: 17,682 participants (60.8% female) were enrolled, 17553 (99.3%) gave a DBS sample, 1200 (6.8%) tested HIV antibody positive (7 indeterminate results) and 26 reported being HIV positive without confirmation. Of the 1226 participants living with HIV, 435 (35.5%) self-reported they were HIV-positive, of whom 196 (45.1%) were diagnosed in childhood (median age 7 years). A higher proportion of adult-diagnosed than child-diagnosed participants were female (91.2% vs 76.5%), had ever had sex (93.3% vs 61.5%), been married/cohabiting (59.4% vs 19.4%) and been pregnant (78.9% of women vs 40.0%). A lower proportion had viral suppression (39.3% vs 52.5%). Adjusting for sex, age, marital status and education, those diagnosed as children had higher odds of viral non-suppression (adjusted odds ratio=1.83, 95%CI 1.17-2.85, p=0.008). Conclusion: Youth who acquired HIV perinatally have differentiated care needs and greater risk of viral non-suppression compared to those who acquired HIV later. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedNicolau, Ioana A.; Moineddin, Rahim; Brooks, Jennifer D.; Antoniou, Tony; Gillis, Jennifer L.; Kendall, Claire E.; Cooper, Curtis; Cotterchio, Michelle; Salters, Kate; Smieja, Marek; Kroch, Abigail E.; Price, Colleen; Mohamed, Anthony; Burchell, Ann N.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: People with human immunodeficiency virus (HIV) are at higher risk of infection-related cancers than the general population which could be due, in part, to immune dysfunction. Our objective was to examine associations between four CD4 count measures as indicators of immune function and infection-related and -unrelated cancer risk. Setting: We conducted a cohort study of adults with HIV who were diagnosed with cancer in Ontario, Canada. Incident cancers were identified from January 1, 1997 to December 31, 2020. Methods: We estimated adjusted hazard ratios (aHR) for the associations between CD4 measures (baseline CD4, nadir CD4, time-updated CD4, time-updated CD4:CD8) and cancer incidence rates using competing risk analyses, adjusted for socio-demographic factors, history of hepatitis B or C infection, baseline viral load, smoking, and alcohol use. Results: Among 4,771 people with HIV, contributing 59,111 person-years of observation, a total of 549 cancers were observed. Low baseline CD4 (
Læs mere Tjek på PubMedPence, Brian W.; Darnell, Doyanne; Ranna-Stewart, Minu; Psaros, Christine; Gaynes, Bradley N.; Grimes, LaKendra; Henderson, Savannah; Parman, Mariel; Filipowicz, Teresa R.; Gaddis, Kathy; Dorsey, Shannon; Mugavero, Michael J.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: Depression, anxiety, post-traumatic stress (PTS), and alcohol/substance use disorders are prevalent among people with HIV (PWH), commonly co-occur, and predict worse HIV care outcomes. Transdiagnostic counseling approaches simultaneously address multiple co-occurring mental health disorders. Methods: We conducted a pilot individually randomized trial of the Common Elements Treatment Approach adapted for people with HIV (CETA-PWH), a transdiagnostic counseling intervention, compared to usual care at a large academic medical center in the southern US. Participants were adults with HIV, at risk for HIV care disengagement, with elevated symptoms of depression, anxiety, PTS, and/or alcohol/substance use. Mental health and HIV care engagement were assessed at four and nine months. Results: Among participants (n=60), follow-up was high at four (92%) and nine (85%) months. Intervention engagement was challenging: 93% attended ≥1 session, 43% attended ≥6 sessions in three months (“moderate dose”), and 30% completed treatment. While not powered for effectiveness, mental health outcomes and HIV appointment attendance improved in CETA-PWH relative to usual care in intent-to-treat analyses; those receiving a moderate dose and completers showed progressively greater improvement. Viral load showed small differences between arms. The dose-response pattern was not explained by differences between those who did and did not complete treatment. Conclusions: This pilot trial provides preliminary evidence for the potential of CETA-PWH to simultaneously address co-occurring mental health co-morbidities and support HIV appointment attendance among PWH. Additional strategies may be an important part of ensuring that clients can engage in the full course of treatment and realize its full benefits. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedHallarn, Jason; Scheim, Ayden I.; Bauer, Greta R.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Foley, Jacklyn D.; Bernier, Lauren B.; Ngo, Long; Batchelder, Abigail W.; O’Cleirigh, Conall; Lydston, Melissa; Yeh, Gloria
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
People with HIV (PWH) are disproportionately affected by cardiovascular disease (CVD). Psycho-behavioral therapies are capable of targeting the pathophysiology underlying HIV-CVD comorbidity. This study synthesized findings from randomized controlled trials (RCTs) of psycho-behavioral therapies for reducing CVD risk among PWH following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were: (1) utilized an RCT design, (2) evaluated a cognitive-behavioral or mindfulness-based therapy, (3) sampled adults (age ≥18 years) with HIV, (4) measured a behavioral (e.g., diet) or biological (e.g., immune functioning) CVD risk factor, and (5) published in an English-language peer-reviewed journal. Electronic searches were conducted in six databases (e.g., MEDLINE) using controlled vocabulary and free-text synonyms for HIV, psycho-behavioral therapy, and CVD risk. Data were independently extracted with consensus reached. Outcomes were immune activation, tobacco-smoking, stress, inflammation, and physical activity from 33 studies. There were stronger effects for psycho-behavioral interventions compared to controls on CD4 (Hedge’s g=0.262, 95% Confidence Interval [CI]=0.127, 0.396) and tobacco-smoking abstinence (Hedge’s g=0.537, 95% CI=0.215, 0.86). There were no differences or insufficient data for stress, inflammation, or physical activity. No eligible studies examined psycho-behavioral interventions on blood pressure, lipids, or weight in PWH. There is increasing importance to further invest in broader CVD risk reduction effort for PWH that include psycho-behavioral intervention strategies. People with HIV (PWH) are disproportionately affected by cardiovascular disease (CVD). Psycho-behavioral therapies are capable of targeting the pathophysiology underlying HIV-CVD comorbidity. This study synthesized findings from randomized controlled trials (RCTs) of psycho-behavioral therapies for reducing CVD risk among PWH following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were: (1) utilized an RCT design, (2) evaluated a cognitive-behavioral or mindfulness-based therapy, (3) sampled adults (age ≥18 years) with HIV, (4) measured a behavioral (e.g., diet) or biological (e.g., immune functioning) CVD risk factor, and (5) published in an English-language peer-reviewed journal. Electronic searches were conducted in six databases (e.g., MEDLINE) using controlled vocabulary and free-text synonyms for HIV, psycho-behavioral therapy, and CVD risk. Data were independently extracted with consensus reached. Outcomes were immune activation, tobacco-smoking, stress, inflammation, and physical activity from 33 studies. There were stronger effects for psycho-behavioral interventions compared to controls on CD4 (Hedge’s g=0.262, 95% Confidence Interval [CI]=0.127, 0.396) and tobacco-smoking abstinence (Hedge’s g=0.537, 95% CI=0.215, 0.86). There were no differences or insufficient data for stress, inflammation, or physical activity. No eligible studies examined psycho-behavioral interventions on blood pressure, lipids, or weight in PWH. There is increasing importance to further invest in broader CVD risk reduction effort for PWH that include psycho-behavioral intervention strategies. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedShorer, Ef; Dastgheyb, Rm; French, Al; Daubert, E; Morack, R; Yohannes, T; Clish, C; Gustafson, D; Sharma, A; Rogando, A; Qi, Q; Burgess, H; Rubin, Lh; Weber, Km
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background: Immune and cognitive dysfunction persists even in virally suppressed women with HIV (VS-WWH). Since inflammation and HIV proteins induce the enzyme IDO (indoleamine 2, 3-dioxygenase), converting tryptophan (T) to kynurenine (K) while producing downstream neurotoxic metabolites, we investigated IDO activation (KT ratio) in relation to cognition in VS-WWH and demographically similar women without HIV (WWoH). Methods: 99 VS-WWH on stable antiretroviral therapy and 102 WWoH (median age 52 vs 54 years; 73% vs 74% Black respectively) from the New York and Chicago sites of the Women’s Interagency HIV Study (WIHS) completed a neuropsychological test battery assessing motor function, processing speed, attention/working memory, verbal fluency, verbal learning and memory, and executive function) and had plasma measured for TK metabolites via liquid chromatography-tandem mass spectrometry and monocyte derived (sCD14, sCD163, MCP-1/CCL-2) plus general inflammatory markers (TNF-RII, hsCRP, hsIL-6) via enzyme-linked immunosorbent assays between 2017-20. Results: VS-WWH had a higher KT ratio (P
Læs mere Tjek på PubMedPaladhi, Unmesha Roy; Katz, David A.; Otieno, George; Hughes, James P.; Thirumurthy, Harsha; Lagat, Harison; Masyuko, Sarah; Sharma, Monisha; Macharia, Paul; Bosire, Rose; Mugambi, Mary; Kariithi, Edward; Farquhar, Carey
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Background Incentives have shown mixed results in increasing HIV testing rates in low-resource settings. We investigated the effectiveness of offering additional self-tests (HIVSTs) as an incentive to increase testing among partners receiving assisted partner services. Setting Western Kenya Methods We conducted a single-crossover study nested within a cluster-randomized controlled trial. Twenty-four facilities were randomized 1:1 to 1) control: provider-delivered testing, or 2) intervention: offered one HIVST or provider-delivered testing for six months (pre-implementation), then switched to offering two HIVSTs for six months (post-implementation). A difference-in-differences approach using generalized linear mixed models, accounting for facility clustering and adjusting for age, sex, and income, was used to estimate the effect of the incentive on HIV testing and first-time testing among partners in APS. Results March 2021-June 2022, 1127 index clients received APS and named 8155 partners, among whom 2333 reported a prior HIV diagnosis and were excluded from analyses, resulting in 5822 remaining partners: 3646 (62.6%) and 2176 (37.4%) in the pre- and post-implementation periods respectively. Overall, 944/2176 (43%) partners were offered a second HIVST during post-implementation, of whom 34.3% picked up two kits, of whom 71.7% reported that the second kit encouraged HIV testing. Comparing partners offered one vs. two HIVSTs showed no difference in HIV testing (relative risk[RR]:1.01, 95%Confidence Interval[CI]:0.951-1.07) or HIV testing for the first time (RR:1.23, 95%CI:0.671-2.24). Conclusions Offering a second HIVST as an incentive within APS did not significantly impact HIV testing or first-time testing, although those opting for two kits reported it incentivized them to test. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYan, Cynthia Y.; Cooley, Sarah A.; Ances, Beau M.
Journal of Acquired Immune Deficiency Syndromes, 16.05.2024
Tilføjet 16.05.2024
Objective: This study examined whether the revised VACS2.0 index (including serum albumin, body mass index (BMI), and white blood cell (WBC) count) had stronger correlations with cognitive function, brain volume, and frailty in PWH ≥ 50 years compared to the VACS1.0. Design and Methods: Neuropsychological performance (NP) Z-scores (learning, retention, executive functioning (EF), psychomotor function/processing speed (PM/PS), language, and global cognition), and neuroimaging measures (brain volumetrics) were analyzed in PWH (n = 162). A subset of the sample (n = 159) was defined as either frail (n = 18) or non-frail (n = 141) according to the Fried phenotype criteria. Brain volumes, NP scores, and frailty subgroups were analyzed with both VACS scores, albumin, BMI, and WBC count using Pearson\'s significance tests and independent T-tests. Results: Higher VACS scores significantly correlated with lower brain volumes. Higher VACS2.0 scores were associated with lower NP in the EF and PM/PS domains and were primarily driven by albumin. VACS1.0 scores did not correlate with cognition Z-scores. There was no relationship between frailty status and VACS1.0. PWH who were frail had significantly greater VACS2.0 scores than non-frail PWH. Conclusions: The addition of albumin to the VACS index improved its correlations with NP and frailty in PWH. While low albumin levels may contribute to cognitive decline or frailty, the reverse causality should also be considered. These findings suggest that the VACS2.0 index (especially albumin) is a valuable measure for clinicians to improve outcomes in PWH. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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