Nyt fra tidsskrifterne
Ingen søgeord valgt.
32 emner vises.
Azizi, Z., Shiba, Y., Alipour, P., Maleki, F., Raparelli, V., Norris, C., Forghani, R., Pilote, L., El Emam, K., The GOING-FWD investigators, The GOING FWD Investigators, Kautzky-Willer, Kublickiene, Herrero
BMJ Open, 18.05.2022
Tilføjet 18.05.2022
Objective
To examine sex and gender roles in COVID-19 test positivity and hospitalisation in sex-stratified predictive models using machine learning.
Design
Cross-sectional study.
Setting
UK Biobank prospective cohort.
Participants
Participants tested between 16 March 2020 and 18 May 2020 were analysed.
Main outcome measures
The endpoints of the study were COVID-19 test positivity and hospitalisation. Forty-two individuals’ demographics, psychosocial factors and comorbidities were used as likely determinants of outcomes. Gradient boosting machine was used for building prediction models.
Results
Of 4510 individuals tested (51.2% female, mean age=68.5±8.9 years), 29.4% tested positive. Males were more likely to be positive than females (31.6% vs 27.3%, p=0.001). In females, living in more deprived areas, lower income, increased low-density lipoprotein (LDL) to high-density lipoprotein (HDL) ratio, working night shifts and living with a greater number of family members were associated with a higher likelihood of COVID-19 positive test. While in males, greater body mass index and LDL to HDL ratio were the factors associated with a positive test. Older age and adverse cardiometabolic characteristics were the most prominent variables associated with hospitalisation of test-positive patients in both overall and sex-stratified models.
Conclusion
High-risk jobs, crowded living arrangements and living in deprived areas were associated with increased COVID-19 infection in females, while high-risk cardiometabolic characteristics were more influential in males. Gender-related factors have a greater impact on females; hence, they should be considered in identifying priority groups for COVID-19 infection vaccination campaigns.
Læs mere Tjek på PubMed
Fugazzaro, S., Denti, M., Mainini, C., Accogli, M. A., Bedogni, G., Ghizzoni, D., Bertolini, A., Esseroukh, O., Gualdi, C., Schiavi, M., Braglia, L., Costi, S.
BMJ Open, 18.05.2022
Tilføjet 18.05.2022
Objectives
COVID-19 can result in persistent symptoms leaving potential rehabilitation needs unmet. This study aims to describe persistent symptoms and health status of individuals hospitalised for COVID-19 according to the International Classification of Functioning, Disability and Health domains of impairments, limitations in activity, and participation restrictions.
Design
Cross-sectional study consisting in a telephone interview 3 months after hospital discharge.
Setting
This study was conducted during the first peak of the COVID-19 pandemic by the Local Health Authority of Reggio Emilia (Italy).
Participants
Adult individuals discharged from hospital between April and June 2020 after COVID-19. Exclusion criteria: hospitalisation for reasons other than COVID-19, inability to participate in the study, concomitant acute or chronic conditions causing disability.
Primary and secondary outcome measures
We assessed: dyspnoea (Medical Research Council), fatigue (Fatigue Severity Scale), mood disturbances (Hospital Anxiety and Depression Scale), limitations in activity (Barthel Index) and participation restrictions (Reintegration to Normal Living Index). We also collected data on sociodemographic characteristics, health status prior to COVID-19, COVID-related clinical manifestations and hospital care pathway up to discharge, rehabilitation interventions, accidental falls and emergency room access.
Results
149 participants (men, 62%; average age 62 (±11) years) were enrolled, 35 of which (23%) were admitted to the intensive care unit (ICU) while hospitalised. Three months after hospital discharge, nearly half of the participants still suffered from dyspnoea (44%) or fatigue (39%). Almost all individuals (91.2%) recovered a good level of independence in activity of daily living, but 76% still suffered participation restrictions. Female sex was significantly associated with worse outcomes for all symptoms.
Conclusions
Individuals who had moderate or severe COVID-19 may perceive persistent symptoms which may result in reduced social participation. Sex differences should be monitored, as women may recover more slowly than men.
Trial registration number
NCT04438239.
Læs mere Tjek på PubMed
Theodosiou, A. A., Laver, J. R., Dale, A. P., Cleary, D. W., Jones, C. E., Read, R. C.
BMJ Open, 18.05.2022
Tilføjet 18.05.2022
Introduction
Infant upper respiratory microbiota are derived partly from the maternal respiratory tract, and certain microbiota are associated with altered risk of infections and respiratory disease. Neisseria lactamica is a common pharyngeal commensal in young children and is associated with reduced carriage and invasive disease by Neisseria meningitidis. Nasal inoculation with N. lactamica safely and reproducibly reduces N. meningitidis colonisation in healthy adults. We propose nasal inoculation of pregnant women with N. lactamica, to establish if neonatal pharyngeal colonisation occurs after birth, and to characterise microbiome evolution in mother–infant pairs over 1 month post partum.
Methods and analysis
20 healthy pregnant women will receive nasal inoculation with N. lactamica (wild type strain Y92-1009) at 36–38 weeks gestation. Upper respiratory samples, as well as optional breastmilk, umbilical cord blood and infant venous blood samples, will be collected from mother–infant pairs over 1 month post partum. We will assess safety, N. lactamica colonisation (by targeted PCR) and longitudinal microevolution (by whole genome sequencing), and microbiome evolution (by 16S rRNA gene sequencing).
Ethics and dissemination
This study has been approved by the London Central Research Ethics Committee (21/PR/0373). Findings will be published in peer-reviewed open-access journals as soon as possible.
Trial registration number
NCT04784845.
Læs mere Tjek på PubMed
Li, S., Wu, Z., Liu, S., Sun, Y., Liu, G. G.
BMJ Open, 18.05.2022
Tilføjet 18.05.2022
Introduction
Alcohol consumption is the seventh leading risk factor for disability-adjusted life years in the world, according to the Global Burden of Disease Study 2017. As the largest developing country, China has a substantial population of alcohol consumers who suffer from related health risks. Despite having made significant advancements in eradicating absolute poverty, many people still live in relative poverty, which suggests that the adverse health effects caused by alcohol consumption among vulnerable populations in China warrant more attention. This paper aims to provide an overview of alcohol consumption among ethnic populations in China and test the feasibility and efficacy of a brief advice intervention with a small financial incentive in reducing harmful drinking behaviours.
Methods
This study is a three-arm, single-blinded, pragmatic, individually randomised controlled trial with follow-ups at 1,2 and 3 months after randomisation. A total of 440 daily drinkers living in Xichang will be recruited and divided into three groups: brief intervention group, financial incentive group and control group. All participants will receive a urine ethyl glucuronide (EtG) test, which detects alcohol consumption in the past 80 hours. Additionally, participants in the brief intervention group will receive three free counselling sessions alongside multimedia messages on the topic of alcohol consumption after each session. The participants in the financial incentive group will receive the same interventions as well as cash incentives according to the results of the EtG test. The primary outcomes are the self-reported drinking quantity, binge drinking frequency, drinking intensity and the proportion of participants who pass the EtG test.
Ethics and dissemination
This protocol was approved by the Peking University Health Science Center Institutional Review Board (IRB00001052-20049). Findings will be published in peer-reviewed journals and presented at local, national and international conferences to publicise and explain the research to key audiences.
Trial registration number
NCT04999371.
Læs mere Tjek på PubMed
Mehmood, M., Setayesh, H., Siddiqi, D. A., Siddique, M., Iftikhar, S., Soundardjee, R., Dharma, V. K., Bhurgri, A. K., Stuckey, E. M., Sultan, M. A., Chandir, S.
BMJ Open, 18.05.2022
Tilføjet 18.05.2022
Objectives
To estimate the prevalence of zero dose children (who have not received any dose of pentavalent (diphtheria, tetanus, pertussis, Haemophilus influenzae type B and hepatitis B) vaccine by their first birthday) among those who interacted with the immunisation system in Sindh, Pakistan along with their sociodemographic characteristics and risk factors.
Design and participants
We conducted a descriptive analysis of child-level longitudinal immunisation records of 1 467 975 0–23 months children from the Sindh’s Zindagi Mehfooz (Safe Life) Electronic Immunisation Registry (ZM-EIR), for the birth cohorts of 2017 and 2018.
Setting
Sindh province, Pakistan which has a population of 47.9 million people and an annual birth cohort of 1.7 million.
Primary and secondary outcome measures
The primary outcome measure was zero dose status among enrolled children. Logistic regression was performed to identify the risk factors associated with the zero dose status.
Results
Out of 1 467 975 children enrolled in the ZM-EIR in Sindh, 10.6% (154 881/1 467 975) were zero dose. There were sharp inequities across the 27 districts. Zero dose children had a lower proportion of hospital births (28.5% vs 34.0%; difference 5.5 percentage points (pp) (95% CI 5.26 to 5.74); p<0.001) and higher prevalence from slums (49.5% vs 42.3%; difference 7.2 pp (95% CI 6.93 to 7.46); p<0.001), compared with non-zero dose children. Children residing in urban compared with rural areas were at a higher risk (relative risk (RR): 1.20; p<0.001; 95% CI 1.18 to 1.22), while children with educated compared with uneducated mothers were at a lower risk of being zero dose (RR: 0.47–0.96; p<0.001; 95% CI 0.45 to 0.98).
Conclusions
Despite interacting with the immunisation system, 1 out of 10 children enrolled in the ZM-EIR in Sindh were zero dose. It is crucial to monitor the prevalence of zero dose children and investigate their characteristics and risk factors to effectively reach and follow-up with them.
Læs mere Tjek på PubMed
Jan Choutka, Viraj Jansari, Mady Hornig, Akiko Iwasaki
Nature, 18.05.2022
Tilføjet 18.05.2022
Nature Medicine, Published online: 18 May 2022; doi:10.1038/s41591-022-01810-6Certain acute infections (including SARS-CoV-2) are associated with an unexplained chronic disability in a minority of patients; this Review summarizes what is known about these understudied and complex illnesses.
Læs mere Tjek på PubMedMartin Ackah, Louise Ameyaw, Mohammed Gazali Salifu, Delali Pearl Afi Asubonteng, Cynthia Osei Yeboah, Eugene Narkotey Annor, Eunice Abena Kwartemaa Ankapong, Hosea Boakye
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Martin Ackah, Louise Ameyaw, Mohammed Gazali Salifu, Delali Pearl Afi Asubonteng, Cynthia Osei Yeboah, Eugene Narkotey Annor, Eunice Abena Kwartemaa Ankapong, Hosea Boakye
Introduction Coronavirus Disease (COVID-19) vaccine acceptance, and hesitancy amongst Health Care Workers (HCWs) on the African continent have been examined through observational studies. However, there are currently no comprehensive reviews among these cadre of population in Africa. Hence, we aimed to review the acceptance rate and possible reasons for COVID-19 vaccine non-acceptance/hesitancy amongst HCWs in Africa. Methods We searched Medline/PubMed, Google Scholar, and Africa Journal Online from January, 2020 to September, 2021. The Newcastle-Ottawa Quality Assessment tool adapted for cross-sectional studies was used to assess the quality of the retrieved studies. DerSimonian and Laird random-effects model was used to pool the COVID-19 vaccine acceptance rate. Sub-group and sensitivity analyses were performed. Reasons for COVID-19 vaccine hesitancy were also systematically analyzed. Results Twenty-one (21) studies were found to be eligible for review out of the 513 initial records. The estimated pooled COVID-19 vaccine acceptance rate was 46% [95% CI: 37%-54%]. The pooled estimated COVID-19 vaccine acceptance rate was 37% [95% CI: 27%-47%] in North Africa, 28% [95% CI: 20%-36%] in Central Africa, 48% [CI: 38%-58%] in West Africa, 49% [95% CI: 30%-69%] in East Africa, and 90% [CI: 85%-96%] in Southern Africa. The estimated pooled vaccine acceptance was 48% [95% CI:38%-57%] for healthcare workers, and 34% [95% CI:29%-39%] for the healthcare students. Major drivers and reasons were the side effects of the vaccine, vaccine’s safety, efficacy and effectiveness, short duration of the clinical trials, COVID-19 infections, limited information, and social trust. Conclusion The data revealed generally low acceptance of the vaccine amongst HCWs across Africa. The side effects of the vaccine, vaccine’s safety, efficacy and effectiveness, short duration of the clinical trials, COVID-19 infections, limited information, and social trust were the major reasons for COVID-19 hesitancy in Africa. The misconceptions and barriers to COVID-19 vaccine acceptance amongst HCWs must be addressed as soon as possible in the continent to boost COVID-19 vaccination rates in Africa.
Læs mere Tjek på PubMedSergei Kopanchuk, Edijs Vavers, Santa Veiksina, Kadri Ligi, Liga Zvejniece, Maija Dambrova, Ago Rinken
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Sergei Kopanchuk, Edijs Vavers, Santa Veiksina, Kadri Ligi, Liga Zvejniece, Maija Dambrova, Ago Rinken
Sigma-1 receptor (Sig1R) is an endoplasmic reticulum (ER)-related membrane protein, that forms heteromers with other cellular proteins. As the mechanism of action of this chaperone protein remains unclear, the aim of the present study was to detect and analyze the intracellular dynamics of Sig1R in live cells using super-resolution imaging microscopy. For that, the Sig1R-yellow fluorescent protein conjugate (Sig1R-YFP) together with fluorescent markers of cell organelles were transfected into human ovarian adenocarcinoma (SK-OV-3) cells with BacMam technology. Sig1R-YFP was found to be located mainly in the nuclear envelope and in both tubular and vesicular structures of the ER but was not detected in the plasma membrane, even after activation of Sig1R with agonists. The super-resolution radial fluctuations approach (SRRF) performed with a highly inclined and laminated optical sheet (HILO) fluorescence microscope indicated substantial overlap of Sig1R-YFP spots with KDEL-mRFP, slight overlap with pmKate2-mito and no overlap with the markers of endosomes, peroxisomes, lysosomes, or caveolae. Activation of Sig1R with (+)-pentazocine caused a time-dependent decrease in the overlap between Sig1R-YFP and KDEL-mRFP, indicating that the activation of Sig1R decreases its colocalization with the marker of vesicular ER and does not cause comprehensive translocations of Sig1R in cells.
Læs mere Tjek på PubMedCamille Rich, Webster Mavhu, Nadine Ferris France, Vongai Munatsi, Elaine Byrne, Nicola Willis, Ann Nolan
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Camille Rich, Webster Mavhu, Nadine Ferris France, Vongai Munatsi, Elaine Byrne, Nicola Willis, Ann Nolan
Background HIV-related self-stigma is a significant barrier to HIV management. However, very little research has explored this phenomenon, particularly in sub-Saharan Africa. This study explored the beliefs, experiences, and impacts of HIV self-stigma amongst adolescents and young adults (AYALHIV) in Harare, Zimbabwe to inform future interventions. It aimed to capture the lived experience of self-stigmatization among AYALHIV and its impact on their social context using Corrigan et al (2009) self-stigma framework of ‘awareness’, ‘agreement’, and ‘application’. Methods Virtual semi-structured key informant interviews were conducted between June and July 2020 with adolescents and young adults (Female = 8; Male = 8) living with HIV (18–24 years) in Harare, Zimbabwe. We conducted the interviews with a purposive sample of AYALHIV enrolled in Africaid’s ‘Zvandiri’ program which provides HIV support services. Interviews were mainly conducted in English and with three in Shona, the main indigenous language. Audio-recorded qualitative data were transcribed, translated into English (where necessary) and deductively coded using Corrigan et al.’s self-stigma framework. The outbreak of SARS-CoV-2 coincided with the commencement of data collection activities, which impacted on both the sample size and a shift from in-person to virtual interviewing methods. Results Sixteen respondents (50% male) took part in the interviews. The mean age of respondents was 22 years. All respondents reported HIV-related self-stigma either occasionally or frequently. Three main themes of self-stigmatizing experiences emerged: disclosure, relationships, and isolation. These themes were then analyzed within the self-stigma development framework by Corrigan et al. (2009) known as ‘the three As’: awareness, agreement, and application of self-stigmatizing thoughts. Respondents’ experiences of self-stigma reportedly led to poor well-being and decreased mental and physical health. Gendered experiences and coping mechanisms of self-stigma were reported. Data suggested that context is key in the way that HIV is understood and how it then impacts the way people living with HIV (PLHIV) live with, and experience, HIV. Conclusions HIV-related negative self-perceptions were described by all respondents in this study, associated with self-stigmatizing beliefs that adversely affected respondents’ quality of life. Study findings supported Corrigan et al.’s framework on how to identify self-stigma and was a useful lens through which to understand HIV-related self-stigma among young people in Harare. Study findings highlight the need for interventions targeting PLHIV and AYALHIV to be context relevant if they are to build individual resilience, while working concurrently with socio-political and systemic approaches that challenge attitudes to HIV at the wider societal levels. Finally, the gendered experiences of self-stigma point to the intersecting layers of self-stigma that are likely to be felt by particularly marginalized populations living with HIV and should be further explored.
Læs mere Tjek på PubMedAdriana Guzman-Holst, Gerardo Luna-Casas, Ana Burguete Garcia, Vicente Madrid-Marina, Maria Yolanda Cervantes-Apolinar, Anar Andani, Gloria Huerta-Garcia, Gilberto Sánchez-González
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Adriana Guzman-Holst, Gerardo Luna-Casas, Ana Burguete Garcia, Vicente Madrid-Marina, Maria Yolanda Cervantes-Apolinar, Anar Andani, Gloria Huerta-Garcia, Gilberto Sánchez-González
Background Hepatitis A virus (HAV) infection is a leading cause of viral hepatitis in children, yet the HAV vaccine is not included in the national immunization program (NIP) in Mexico. This study addresses an identified evidence gap of the burden of hepatitis A disease, complications, and associated costs in Mexico by analyzing surveillance and healthcare data. Data review included disease morbidity (incidence and hospitalization), mortality, and healthcare resource utilization costs. Methods In this observational, retrospective database study, we conducted a systematic screening, extraction, and analysis of outcome data from the national surveillance system in Mexico from January 2000 to December 2019. Results During the analysis period (2000–2019), the average incidence rate/year of HAV cases was 14.7 (5.4–21.5) per 100,000 inhabitants. Children 1–9 years of age (YoA) had the highest average incidence rate/year with 47.8 (14.7–74.5). The average hospitalization rate/year due to HAV infection was 5.8% (2.9–9.6%). Although the highest burden of HAV continued to be in children (1–9 YoA), an increase in incidence and hospitalizations (with complications) in older age groups (≥ 10–64 YoA) was observed. The annual average fatality rate was estimated to be 0.44% (0.26–0.83%) of which 28.8% of deaths were concentrated in adults ≥ 65 YoA. The total direct costs of medical attention due to HAV and related complications were estimated at $382 million Mexican pesos. Conclusion The overall results suggest an uptrend in HAV infections in adolescents/adults compared to children in Mexico. Therefore, as the overall incidence risk of HAV infection decreases, the mean age of infection increases. This consequently increases the risk of severity and complications in older age groups, thus increasing the demand for healthcare resources. Our findings provide evidence for including the inactivated HAV vaccine in the Mexican NIP.
Læs mere Tjek på PubMedValeria Guglielmi, Luca Colangeli, Valeria Scipione, Simona Ballacci, Martina Di Stefano, Lauren Hauser, Michela Colella Bisogno, Monica D’Adamo, Emanuela Medda, Paolo Sbraccia
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Valeria Guglielmi, Luca Colangeli, Valeria Scipione, Simona Ballacci, Martina Di Stefano, Lauren Hauser, Michela Colella Bisogno, Monica D’Adamo, Emanuela Medda, Paolo Sbraccia
Introduction During COVID-19 pandemic, Internal Medicine Units (IMUs) accounted for about 70% of patients hospitalized. Although a large body of data has been published regarding the so-called first wave of the pandemic, little is known about the characteristics and predictors of worse outcomes of patients managed in IMUs during the second wave. Methods We prospectively assessed demographics, comorbidities, treatment and outcomes, including ventilation support (VS) and death, in patients admitted to our IMU for SARS-CoV-2 between October 13th, 2020 and January 21st, 2021. Clinical evolution and biochemical testing 1, 7 and 14 days after COVID-19 diagnosis were recorded. Results We studied 120 patients (M/F 56/64, age 71±14.5 years) admitted to our IMU. Most of them had at least one comorbidity (80%). Patients who died were older, more frequently underweight, affected by malignant neoplasms and on statin therapy compared to patients eventually discharged. Both worse outcome groups (VS and death) presented higher neutrophils, ferritin, IL-6 and lower total proteins levels than controls. Age was significantly associated with mortality but not with VS need. The multivariate analysis showed age and gender independent association of mortality with underweight, malignancy and antibiotics use at the admission. With regard to biochemical parameters, both unfavourable outcomes were positively associated with high WBC count, neutrophils, blood urea nitrogen and low serum total proteins. Conclusions Our study identified inflammation, underweight, malignancy and a marked catabolic state as the main predictors for worse outcomes in COVID-19 patients admitted to IMU during the so-called second wave of the pandemic.
Læs mere Tjek på PubMedKelly R. Ylitalo, Wendy Cox, Raejone Lucas, Jordan Smith, Kelley Pettee Gabriel, Matthew Rafalski, John Gill, Brock Niceler
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Kelly R. Ylitalo, Wendy Cox, Raejone Lucas, Jordan Smith, Kelley Pettee Gabriel, Matthew Rafalski, John Gill, Brock Niceler
Physical activity is essential to maintain physical and mental well-being. During the COVID-19 pandemic, in-person physical activity opportunities were limited. This paper describes a telephone-based physical activity support strategy among racially/ethnically diverse patients during the COVID-19 pandemic. Adult patients at a large, Federally Qualified Health Center with an on-site exercise facility referral were eligible to transition to telephone support with personal fitness advisors during the pandemic stay-at-home orders. Baseline surveys assessed physical activity and environmental characteristics; follow-up phone calls used motivational interviewing and physical activity goal setting strategies. From March 23-July 23, 2020, 72 patients participated in 270 phone calls, or 3.8 (±2.1) calls per participant. Participants were, on average, aged 51.3 (±11.6) years, 87.5% female, 31.9% Hispanic/Latino, and 47.2% non-Hispanic Black. Patients meeting physical activity guidelines pre-pandemic reported more planned exercise (100.0% vs. 55.3%; p<0.001), exercise days at home (5.0 vs. 1.7; p<0.001), and accomplishment of personal physical activity goals (57.0% vs. 39.7%; p = 0.11) than patients not meeting guidelines pre-pandemic. Patients with a home treadmill participated in twice the rate of calls compared to those without (RR = 2.22; 95%CI:1.35,3.64), but no other home environmental characteristics predicted participation rate. Pre-pandemic physical activity behavior appeared to predict pandemic physical activity and telephone-based physical activity support was effective for maintaining physical activity for some participants. Long term applications of this work will support continuity of clinic-community partnerships for health behavior change and provide a model for patient physical activity support by community health centers without on-site exercise facilities.
Læs mere Tjek på PubMedTesfaye Abera Bokoro, Habtamu Kiros Gebresilassie, Melkamu A. Zeru
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Tesfaye Abera Bokoro, Habtamu Kiros Gebresilassie, Melkamu A. Zeru
Childhood diarrhea and Acute Respiratory Infection (ARI) are two diseases with similar risk factors in tropical developing regions. The objective of this study was to employ a joint binary response model and identify risk factors for childhood diarrhea and ARI in children under the age of five. A joint binary response model that takes into account the interdependence of the two diseases was used. Explanatory variables such as residence, vaccination, mother’s education, and antenatal care visits during pregnancy were found to be statistically significant risk factors for diarrhea in the joint model, whereas residence, the number of children ever born, vaccination, mother’s education, and wealth index were found to be statistically significant risk factors for childhood Acute Respiratory Infection. We discovered a common odds ratio value (4.30) greater than one, indicating a positive relationship between the two childhood diseases. As a result, using a joint model to assess the risk factors for diarrhea and acute respiratory infection (ARI) was reasonable. Furthermore, the standard errors of the parameter estimates in the joint response model were found to be smaller than the corresponding standard errors in the separate models. The risk factors such as residence, vaccination, and mother’s education all had a significant effect on the two correlated dichotomous response variables, diarrhea and ARI.
Læs mere Tjek på PubMedAna C. Ricardo, Jinsong Chen, Stephanie M. Toth-Manikowski, Natalie Meza, Min Joo, Shruti Gupta, Deepa G. Lazarous, David E. Leaf, James P. Lash, on behalf of the STOP-COVID Investigators
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Ana C. Ricardo, Jinsong Chen, Stephanie M. Toth-Manikowski, Natalie Meza, Min Joo, Shruti Gupta, Deepa G. Lazarous, David E. Leaf, James P. Lash, on behalf of the STOP-COVID Investigators
Background Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown. Objective To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). Methods Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups. Results A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51–71) years (non-Hispanic White, 66 [57–74] years; Hispanic, 56 [46–67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7–24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12–1.84). Conclusions Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.
Læs mere Tjek på PubMedJosephina Hartung, Madelaine Böhme
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Josephina Hartung, Madelaine Böhme
Tragulids, chevrotains or mouse deer, were common faunal elements during the Miocene. During that time, Dorcatherium was the most abundant genus, with D. naui being the first described species. Besides their abundance, until recently only very limited cranial material was available for investigation. Here we present a redescription of the first complete skull of D. naui from the middle to late Miocene locality of Eppelsheim, Germany, based on micro-computed tomography. Furthermore, we present a description and comparison of two additional, new skulls of D. naui from the late Miocene hominid locality Hammerschmiede, Germany. Within Dorcatherium, so far, only three other complete skulls are known, all belonging to D. crassum. A comparison between the three skulls of D. naui and the already known skulls of D. crassum shows that these two species differ in morphological features of the skull, such as laterally facing orbitae, separation of supraorbital foramen from supraorbital groove by a bony bridge, well-developed parietal plateau, prominent nuchal tubercle, less-developed nuchal crests, and the presence of an occipital crest. Moreover, two different osteological morphotypes are present in the skulls of D. naui that can be interpreted as a previously unknown sexual dimorphism. Very similar features are observed in D. crassum, which can be likewise related to the same dimorphism. However, males of D. naui differ from males of D. crassum by the presence of frontoparietal bulges, which were probably used for sexual display and during male-male combats in males of D. naui. For the first time, sexual dimorphism in Dorcatherium is described based on skull characteristics, which are, so far, unknown from any other fossil or extant tragulid.
Læs mere Tjek på PubMedJeonghyun Kang, Hyesung Kim, HyeJin Park, Bora Lee, Kang Young Lee
PLoS One Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
by Jeonghyun Kang, Hyesung Kim, HyeJin Park, Bora Lee, Kang Young Lee
Background Nationwide research about the clinical and economic burden caused by anastomotic leakage (AL) has not been published yet in Korea. This study assessed the AL rate and quantified the economic burden using the nationwide database. Methods This real world evidence study used health claims data provided by the Korean Health Insurance Review and Assessment Service (HIRA, which showed that 156,545 patients underwent anterior resection (AR), low anterior resection (LAR), or ultra-low anterior resection (uLAR) for colorectal cancer (CRC) between January 1, 2007 and January 31, 2020. The incidence of AL was identified using a composite operational definition, a composite of imaging study, antibacterial drug use, reoperation, or image-guided percutaneous drainage. Total hospital costs and length of stay (LOS) were evaluated in patients with AL versus those without AL during index hospitalization and within 30 days after the surgery. Results Among 120,245 patients who met the eligibility criteria, 7,194 (5.98%) patients had AL within 30 days after surgery. Male gender, comorbidities (diabetes, metastatic disease, ischemic heart disease, ischemic stroke), protective ostomy, and multiple linear stapler use, blood transfusion, and urinary tract injury were associated with the higher odds of AL. Older age, rectosigmoid junction cancer, AR, LAR, and laparoscopic approach were related with the reduced odds of AL. Patients with AL incurred higher costs for index hospitalization compared to those without AL (8,991 vs. 7,153 USD; p<0.0001). Patients with AL also required longer LOS (16.78 vs. 14.22 days; p<0.0001) and readmissions (20.83 vs. 13.93 days; p<0.0001). Conclusion Among patients requiring resection for CRC, the occurrence of AL was associated with significantly increased costs and LOS. Preventing AL could not only produce superior clinical outcomes, but also reduce the economic burden for patients and payers.
Læs mere Tjek på PubMedBenjamin D. Fowler, Nurgun Kose, Joseph X. Reidy, Laura S. Handal, Eric P. Skaar, James E. Crowe aDepartment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Centergrid.412807.8, Nashville, Tennessee, USA bVanderbilt Vaccine Center, Vanderbilt University Medical Centergrid.412807.8, Nashville, Tennessee, USA cVanderbilt Institute for Infection, Immunology, and Inflammation, Vanderbilt University Medical Centergrid.412807.8, Nashville, Tennessee, USA dDepartment of Pediatrics, Vanderbilt University Medical Centergrid.412807.8, Nashville, Tennessee, USA, Andreas J. Bäumler
Infection and Immunity, 18.05.2022
Tilføjet 18.05.2022
Laarni Kendra T. Aguila, Dorothy L. Patton, German G. Gornalusse, Lucia N. Vojtech, Robert D. Murnane, Gwendolyn E. Wood aDepartment of Medicine, Division of Allergy and Infectious Diseases, University of Washingtongrid.34477.33, Seattle, Washington, USA bDepartment of Obstetrics and Gynecology, University of Washingtongrid.34477.33, Seattle, Washington, USA cWashington National Primate Research Center, Department of Comparative Medicine, University of Washingtongrid.34477.33, Seattle, Washington, USA, Craig R. Roy
Infection and Immunity, 18.05.2022
Tilføjet 18.05.2022
Sack D, Ateudjieu J, Debes A.
Journal of Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
Amano M, Maeda K, Tsuchiya K, et al.
Journal of Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
SARS-CoV-2BNT162b2vaccineneutralizing activityVOCs (variants of concern)Omicron variants (BA 1 and BA.2)
Læs mere Tjek på PubMedRek J, Blanken S, Okoth J, et al.
Journal of Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractAchieving malaria elimination requires a better understanding of the transmissibility of human infections in different transmission settings. This study aimed to characterize the human infectious reservoir in a high endemicity setting in eastern Uganda, using gametocyte quantification and mosquito feeding assays. In asymptomatic infections, gametocyte densities were positively associated with the proportion of infected mosquitoes (β=1.60, 95%CI 1.32-1.92, p < 0.0001). Combining transmissibility and abundance in the population, symptomatic and asymptomatic infections were estimated to contribute to 5.3% and 94.7% of the infectious reservoir, respectively. School-aged children (5-15 years-old) contributed to 50.4% of transmission events and were important drivers of malaria transmission.
Læs mere Tjek på PubMedDaly G, Ghini V, Adessi A, et al.
FEMS Microbiology Reviews, 14.05.2022
Tilføjet 18.05.2022
AbstractInteractions amongst marine microalgae and heterotrophic bacteria drive processes underlying major biogeochemical cycles and are important for many artificial systems. These dynamic and complex interactions span the range from cooperative to competitive and it is the diverse and intricate networks of metabolites and chemical mediators that are predicted to principally dictate the nature of the relationship at any point in time. Recent advances in technologies to identify, analyze, and quantify metabolites have allowed for a comprehensive view of the molecules available for exchange and/or reflective of organismal interactions, setting the stage for development of mechanistic understanding of these systems. Here, we (i) review the current knowledge landscape of microalgal-bacterial interactions by focusing on metabolomic studies of selected, simplified model systems; (ii) describe the state of the field of metabolomics, with specific focus on techniques and approaches developed for microalga-bacterial interaction studies; (iii) outline the main approaches for development of mathematical models of these interacting systems, which collectively have the power to enhance interpretation of experimental data and generate novel testable hypotheses. We share the viewpoint that a comprehensive and integrated series of -omics approaches that include theoretical formulations are necessary to develop predictive and mechanistic understanding of these biological entities.
Læs mere Tjek på PubMedMARTINUZZI E, BENZAQUEN J, GUERIN O, et al.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractBackgroundMucosal antibodies can prevent virus entry and replication in mucosal epithelial cells and hence virus shedding. Parenteral booster injection of a vaccine against a mucosal pathogen promotes stronger mucosal immune responses following prior mucosal infection compared to injections of a parenteral vaccine in a mucosally naive subject. We investigated whether this was also the case for the BNT162b2 COVID-19 mRNA vaccine.MethodsTwenty recovered COVID-19 subjects (RCS) and 23 SARS-CoV-2 naive subjects were vaccinated with respectively one and two doses of the BNT162b2 COVID-19 vaccine. Nasal Epithelial Lining Fluid (NELF) and plasma were collected before and after vaccination and assessed for Immunoglobulin (Ig)G and IgA antibody levels to Spike and for their ability to neutralize binding of Spike to ACE-2 receptor. Blood was analyzed one week after vaccination for the number of Spike-specific Antibody Secreting Cells (ASCs) with a mucosal tropism.ResultsAll RCS had both nasal and blood SARS-CoV-2 specific antibodies at least 90 days after initial diagnosis. In RCS, a single dose of vaccine amplified pre-existing Spike-specific IgG and IgA antibody responses in both NELF and blood against both vaccine homologous and variant strains, including delta. These responses were associated with Spike-specific IgG and IgA ASCs with a mucosal tropism in blood. Nasal IgA and IgG antibody responses were lower in magnitude in SARS-CoV-2 naive subjects after two vaccine doses compared to RCS after one dose.ConclusionMucosal immune response to the SARS-CoV-2 Spike protein is higher in RCS after a single vaccine dose compared to SARS-CoV-2 naive subjects after two doses.
Læs mere Tjek på PubMedSkinner A, Petrella L, Spandoni S, et al.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
Kuitunen I, Jääskeläinen J, Korppi M, et al.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractBackgroundThe optimal treatment duration of community-acquired pneumonia (CAP) in children has been controversial in high-income countries. We conducted a meta-analysis to compare short antibiotic treatment (3–5 days) to longer treatment (7–10 days) among children aged ≥6 months.MethodsOn January 31, 2022, we searched PubMed, Scopus, and Web of Science databases for studies published in English from 2003 to 2022. We included randomized controlled trials focusing on antibiotic treatment duration in children with CAP treated as outpatients. We calculated risk differences (RD) with 95% confidence intervals (CI) and used the fixed effect model (low heterogeneity). Our main outcome was treatment failure, defined as need for re-treatment or hospitalization within 1 month. Our secondary outcome was presence of antibiotic-related harms.Results541 studies were screened and 4 studies with 1541 children were included in the review. Three studies had low risk of bias and one study had some concerns. All 4 studies assessed treatment failures, and the RD was 0.1% (CI -3.0% to 2.0%) with high quality of evidence. Two studies (1194 children) assessed adverse events related to antibiotic treatment, and RD was 0.0% (-5.0% to 5.0%) with moderate quality of evidence. The diagnostic criteria varied between the included studies.ConclusionsA short antibiotic treatment duration of 3–5 days was equally effective and safe compared to the longer (current) recommendation of 7–10 days in children aged over 6 months with CAP. We suggest that short antibiotic courses can be implemented in treatment of pediatric CAP.
Læs mere Tjek på PubMedOdumade OA, van Haren SD, Angelidou A.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractRespiratory viral infections account for a large percentage of global morbidity and mortality. Respiratory Syncytial Virus (RSV) is a seasonal virus affecting immunologically vulnerable populations, such as preterm newborns and young infants; however, its epidemiology has changed drastically during the COVID-19 pandemic. In this perspective, we discuss the implications of COVID-19 on RSV seasonality patterns and mitigation efforts, as well as the urgent need for vaccination as a preventative tool.
Læs mere Tjek på PubMedShoham S, Bloch E, Casadevall A, et al.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractBackgroundThe efficacy of SARS-CoV-2 convalescent plasma (CCP) for preventing infection in exposed, uninfected individuals is unknown. CCP might prevent infection when administered before symptoms or laboratory evidence of infection.MethodsThis double-blinded, phase 2 randomized, controlled trial (RCT) compared the efficacy and safety of prophylactic high titer (≥1:320 by Euroimmun ELISA) CCP with standard plasma. Asymptomatic participants aged ≥18 years with close contact exposure to a person with confirmed COVID-19 in the previous 120 hours and negative SARS-CoV-2 test within 24 hours before transfusion were eligible. The primary outcome was new SARS-CoV-2 infection.Results180 participants were enrolled; 87 were assigned to CCP and 93 to control plasma, and 170 transfused at 19 sites across the United States from June 2020 to March 2021. Two were excluded for screening SARS-CoV-2 RT-PCR positivity. Of the remaining 168 participants, 12/81 (14·8%) CCP and 13/87 (14·9%) control recipients developed SARS-CoV-2 infection; 6 (7·4%) CCP and 7 (8%) control recipients developed COVID-19 (infection with symptoms). There were no COVID-19-related hospitalizations in CCP and 2 in control recipients. Efficacy by restricted mean infection free time (RMIFT) by 28 days for all SARS-CoV-2 infections (25·3 vs. 25·2 days; p = 0·49) and COVID-19 (26·3 vs. 25·9 days; p = 0·35) was similar for both groups.ConclusionsAdministration of high-titer CCP as post-exposure prophylaxis, while appearing safe, did not prevent SARS-CoV-2 infection.
Læs mere Tjek på PubMedWeitzman ER, Kossowsky J, Blakemore LM, et al.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractObjectiveThe opioid epidemic worsened during the COVID-19 pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development and insight is needed into its acceptability.MethodsUsing a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public, were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically.ResultsAmong N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision-making. Reactions to vignettes revealed complex attitudes towards fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain.ConclusionPositive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.
Læs mere Tjek på PubMedWeitzman ER, Sherman AC, Levy O.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractAuthorization of SARS-CoV-2 vaccines for children has ushered in a new phase of the immunization campaign to address the pandemic but has been received with mixed responses from parents, children, and opinion leaders. Herein we consider perceptions and attitudes towards pediatric SARS-CoV-2 vaccines from FDA public commentary reflecting >63,000 comments.
Læs mere Tjek på PubMedCox H, Workman L, Bateman L, et al.
Clinical Infectious Diseases, 17.05.2022
Tilføjet 18.05.2022
AbstractBackgroundMicrobiological diagnosis of childhood tuberculosis may be difficult. Oral swabs are a potential non-invasive alternative to sputum for diagnosis.MethodsA prospective diagnostic accuracy study of oral swabs (buccal and tongue) for pulmonary tuberculosis (PTB) diagnosis in children (aged ≤15 years) in two South African hospital sites. Children with cough of any duration and either: a positive tuberculin skin test, TB contact, loss of weight or chest X-ray suggestive of PTB were enrolled. Two induced sputum specimens were tested with Xpert MTB/RIF (or Ultra) and liquid culture. Oral swabs were taken preceding sputum, frozen and later tested with Xpert MTB/RIF Ultra. Children were classified as microbiologically confirmed TB, Unconfirmed TB (received TB treatment) or unlikely TB according to NIH consensus definitions based on sputum microbiological results.ResultsAmong 291 participants (median age 32 [IQR 14-73] months), 57 (20%) were living with HIV and 87 (30%) were malnourished. 90 (31%) had confirmed PTB (six (7%) with rifampicin-resistant TB), 157 (54%) unconfirmed PTB and 44 (15%) unlikely TB. One oral swab was obtained from 126 (43%) participants (96 tongue, 30 buccal) and two swabs from 165 (57%) (110 tongue, 55 buccal). Sensitivity was low; 22% (95% CI 15-32) for all swabs combined (confirmed PTB as reference), but specificity was high (100%, 95% CI 91-100). The highest sensitivity was 33% (15-58) among participants living with HIV. Overall yield was 6.9% with one oral swab, and 7.2% with two.ConclusionsUltra on oral swabs provides poor yield for microbiologic PTB confirmation in children.
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.05.2022
Tilføjet 18.05.2022
Abstract
Background
Vaccination is a key intervention to prevent COVID-19. Many vaccines are administered globally, yet there is not much evidence regarding their safety and adverse effects. Iran also faces this challenge, especially as data regarding the Sputnik V vaccine is sparse. Therefore, the aim of this study is to determine the adverse effects of the most commonly used vaccines in Iran.
Methods
Using a retrospective cohort study design, 6600 subjects aged 18 years or older who had received two doses of any of the three COVID-19 vaccines (Sinopharm, AstraZeneca, and Sputnik V) were selected using a random sampling method between March and August 2021. Subjects were asked about any adverse effects of the vaccines by trained interviewers via telephone interview. Vaccine-related adverse effects in individuals during the first 72 h and subsequently following both doses of the vaccines were determined. The demographic variables, type of administered vaccine, adverse effects, and history of the previous infection with COVID-19 were collected. Descriptive statistics (mean, standard deviation) and analytical statistics (Chi-squared and Wilcoxon tests) were performed at a 95% significance level using STATA software version 15 (STATA Corp, College Station, TX, USA).
Results
From 6600 participants, 4775 responded (response rate = 72.3%). Of the participants, 1460 (30.6%) received the AstraZeneca vaccine, 1564 (32.8%) received the Sinopharm vaccine and 1751 (36.7%) received the Sputnik V vaccine. 2653 participants (55.56%) reported adverse effects after the first dose and 1704 (35.7%) after the second dose. Sputnik V caused the most adverse effects with 1449 (82.7%) vaccine recipients reporting symptoms after the first or second dose, compared with 1030 (70.5%) for AstraZeneca and only 585 (37.4%) for the Sinopharm vaccine. The most common adverse effects after the first dose were fatigue (28.37%), chill/fever (26.86%), and skeletal pain (22.38%). These three adverse effects were the same for the second dose, although their prevalence was lower.
Conclusions
In this study, we demonstrate that the Sputnik V vaccine has the highest rate of adverse effects, followed by the AstraZeneca and Sinopharm vaccines. COVID-19 vaccines used in Iran are safe and there were no reports of serious adverse effects.
Læs mere Tjek på PubMed
Lilian Yan Liang, Terry Cheuk‐Fung Yip, Jimmy Che‐To Lai, Amy Shuk‐Man Lam, Yee‐Kit Tse, Vicki Wing‐Ki Hui, Henry Lik‐Yuen Chan, Vincent Wai‐Sun Wong, Grace Lai‐Hung Wong
Journal of Medical Virology, 18.05.2022
Tilføjet 18.05.2022