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27 emner vises.
Kosar Vaezzadeh, Mahdi Sepidarkish, Abolfazl Mollalo, Nayereh As'adi, Safoura Rouholamin, Mahroo Rezaeinejad, Maryam Farid Mojtahedi, Seyed Mohammad Mehdi Hosseini, Maryam Taheri, Sanaz Mahjour, Mohsen Mohammadi, Hiam Chemaitelly, Ali Rostami
Clinical Microbiology and Infection, 19.08.2022
Tilføjet 20.08.2022
Neisseria gonorrhoeae infection (gonorrhea) is associated with several pregnancy complications, including preterm labor, spontaneous abortion, stillbirth, miscarriage, growth retardation, and intrauterine death.
Læs mere Tjek på PubMedChengchao Ding, Shuangshuang Ni, Xiangyu Zhang, Jiajia Xie, Yong Sun, Jun He, Qingmin Mei, Lina Huang, Hongliang He, Zhirong Liu, Yong Gao
Journal of Medical Virology, 20.08.2022
Tilføjet 20.08.2022
Temi Lampejo
Journal of Medical Virology, 20.08.2022
Tilføjet 20.08.2022
Paula Michelena, Beatriz Olea, Ignacio Torres, Fernando González‐Candelas, David Navarro
Journal of Medical Virology, 20.08.2022
Tilføjet 20.08.2022
Jianfei Song, Zhenyu Li, Guijin Yao, Songping Wei, Ling Li, Hui Wu
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Jianfei Song, Zhenyu Li, Guijin Yao, Songping Wei, Ling Li, Hui Wu
Neonatal necrotizing enterocolitis (NEC) occurs worldwide and is a major source of neonatal morbidity and mortality. Researchers have developed many methods for predicting NEC diagnosis and prognosis. However, most people use statistical methods to select features, which may ignore the correlation between features. In addition, because they consider a small dimension of characteristics, they neglect some laboratory parameters such as white blood cell count, lymphocyte percentage, and mean platelet volume, which could be potentially influential factors affecting the diagnosis and prognosis of NEC. To address these issues, we include more perinatal, clinical, and laboratory information, including anemia—red blood cell transfusion and feeding strategies, and propose a ridge regression and Q-learning strategy based bee swarm optimization (RQBSO) metaheuristic algorithm for predicting NEC diagnosis and prognosis. Finally, a linear support vector machine (linear SVM), which specializes in classifying high-dimensional features, is used as a classifier. In the NEC diagnostic prediction experiment, the area under the receiver operating characteristic curve (AUROC) of dataset 1 (feeding intolerance + NEC) reaches 94.23%. In the NEC prognostic prediction experiment, the AUROC of dataset 2 (medical NEC + surgical NEC) reaches 91.88%. Additionally, the classification accuracy of the RQBSO algorithm on the NEC dataset is higher than the other feature selection algorithms. Thus, the proposed approach has the potential to identify predictors that contribute to the diagnosis of NEC and stratification of disease severity in a clinical setting.
Læs mere Tjek på PubMedRodziah Romli, Rahana Abd Rahman, Kah Teik Chew, Syahnaz Mohd Hashim, Emma Mirza Wati Mohamad, Azmawati Mohammed Nawi
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Rodziah Romli, Rahana Abd Rahman, Kah Teik Chew, Syahnaz Mohd Hashim, Emma Mirza Wati Mohamad, Azmawati Mohammed Nawi
Cervical cancer (CC) screening can detect the cancer early but is underutilized, especially among the developing countries and low- to middle-income countries. Electronic health (e-health) has the potential for disseminating health education and is widely used in the developed countries. This systematic literature review investigates the effectiveness of e-health intervention for improving knowledge of CC and the intention or uptake for CC screening. We followed the PRISMA 2020 guideline and registered with PROSPERO (registration ID CRD42021276036). We searched the Web of Science, Scopus and EBSCO Medline Complete databases for eligible studies. Studies that conveyed informational material through e-health intervention were selected. The results were analyzed using narrative synthesis, and the pooled estimates were calculated using meta-analysis. A total of six studies involving 1886 women were included in this review. The use of e-health aids alone led to increased knowledge. The meta-analysis demonstrated that the mixed-education method of e-health movies and video education with didactic sessions increased CC screening uptake. A random-effects model revealed that CC screening uptake following e-health interventions were almost double of that of their comparison (odds ratio = 2.29, 95% confidence interval: 1.28–4.10, p < 0.05). Various areas of study demonstrated e-health intervention effectiveness (minority communities, urban areas, rural areas). Health education through e-health intervention has huge potential for promoting CC screening in the community. Nevertheless, the use of appropriate frameworks, user engagement and culturally tailored e-health need to be prioritized.
Læs mere Tjek på PubMedIan M. Lamb, Kelly T. Rios, Anurag Shukla, Avantika I. Ahiya, Joanne Morrisey, Joshua C. Mell, Scott E. Lindner, Michael W. Mather, Akhil B. Vaidya
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Ian M. Lamb, Kelly T. Rios, Anurag Shukla, Avantika I. Ahiya, Joanne Morrisey, Joshua C. Mell, Scott E. Lindner, Michael W. Mather, Akhil B. Vaidya
Despite ongoing efforts to control malaria infection, progress in lowering the number of deaths and infections appears to have stalled. The continued high incidence of malaria infection and mortality is in part due to emergence of parasites resistant to frontline antimalarials. This highlights the need for continued identification of novel protein drug targets. Mitochondrial functions in Plasmodium falciparum, the deadliest species of human malaria parasite, are targets of validated antimalarials including atovaquone and proguanil (Malarone). Thus, there has been great interest in identifying other essential mitochondrial proteins as candidates for novel drug targets. Garnering an increased understanding of the proteomic landscape inside the P. falciparum mitochondrion will also allow us to learn about the basic biology housed within this unique organelle. We employed a proximity biotinylation technique and mass spectrometry to identify novel P. falciparum proteins putatively targeted to the mitochondrion. We fused the leader sequence of a mitochondrially targeted chaperone, Hsp60, to the promiscuous biotin ligase TurboID. Through these experiments, we generated a list of 122 “putative mitochondrial” proteins. To verify whether these proteins were indeed mitochondrial, we chose five candidate proteins of interest for localization studies using ectopic expression and tagging of each full-length protein. This allowed us to localize four candidate proteins of unknown function to the mitochondrion, three of which have previously been assessed to be essential. We suggest that phenotypic characterization of these and other proteins from this list of 122 could be fruitful in understanding the basic mitochondrial biology of these parasites and aid antimalarial drug discovery efforts.
Læs mere Tjek på PubMedYinpei Guo, Bo Li, Tonghua Duan, Nan Yao, Han Wang, Yixue Yang, Shoumeng Yan, Mengzi Sun, Ling Wang, Yan Yao, Yuchen Sun, Jiwei Jia, Siyu Liu
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Yinpei Guo, Bo Li, Tonghua Duan, Nan Yao, Han Wang, Yixue Yang, Shoumeng Yan, Mengzi Sun, Ling Wang, Yan Yao, Yuchen Sun, Jiwei Jia, Siyu Liu
This study explored the roles of epidemic-spread-related behaviors, vaccination status and weather factors during the COVID-19 epidemic in 50 U.S. states since March 2020. Data from March 1, 2020 to February 5, 2022 were incorporated into panel model. The states were clustered by the k-means method. In addition to discussing the whole time period, we also took multiple events nodes into account and analyzed the data in different time periods respectively by panel linear regression method. In addition, influence of cluster grouping and different incubation periods were been discussed. Non-segmented analysis showed the rate of people staying at home and the vaccination dose per capita were significantly negatively correlated with the daily incidence rate, while the number of long-distance trips was positively correlated. Weather indicators also had a negative effect to a certain extent. Most segmental results support the above view. The vaccination dose per capita was unsurprisingly proved to be the most significant factor especially for epidemic dominated by Omicron strains. 7-day was a more robust incubation period with the best model fit while weather had different effects on the epidemic spread in different time period. The implementation of prevention behaviors and the promotion of vaccination may have a successful control effect on COVID-19, including variants’ epidemic such as Omicron. The spread of COVID-19 also might be associated with weather, albeit to a lesser extent.
Læs mere Tjek på PubMedMichal Mahat-Shamir, Maya Kagan
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Michal Mahat-Shamir, Maya Kagan
According to Terror Management Theory (TMT), there are three common buffers that minimize the anxiety of mortality salience: affirmation of a) one’s cultural worldview, b) the self and one’s personal values, and c) one’s significance in the context of close personal relationships. The current study aimed at examining the contents of memes, which were distributed on social media during the COVID-19 outbreak, to explore the means by which humor buffers against death anxiety. A deductive and inductive thematic analysis captured three means by which humor buffers against death anxiety, a) humor as a means for connecting to cultural worldviews; b) humor as a means for inclusion in group; c) humor as a means to gain a sense of control. These findings are discussed through the theoretical lens of TMT.
Læs mere Tjek på PubMedSuad Ajab, Sumaya Zoughbor, Lena Labania, Marie Olanda, Linda Östlundh, Zakeya Al Rasbi
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Suad Ajab, Sumaya Zoughbor, Lena Labania, Marie Olanda, Linda Östlundh, Zakeya Al Rasbi
In the human gut, there are many microbes, including bacteria, viruses and parasites. The imbalance in the numbers of each type of these microbes can translate into gastrointestinal disorders. Lately, different microbiota patterns have been associated with the levels of efficacy of immunotherapy in multiple cancer conditions. Studies have shown that patients with a more diverse gut microbiome respond better to immunotherapy than those with a homogeneous microbiome. This systematic review aims to identify and assess the available evidence on the efficacy of immunotherapy in treating colorectal cancer (CRC) patients and the effect of their microbiota on their treatment outcomes. The researchers will study the literature regarding CRC and immunotherapy outcomes to survey the different approaches employed to assess the treatment outcomes. A systematic search will be performed in five biomedical databases (PubMed, Scopus, Web of Science, Embase, and the Cochrane Library) in June-July, 2022. Also, open-access registers of clinical trials will be trawled. The search will be conducted without geographical or publication date restrictions; however, only papers published in the English language will be sought. Details regarding patients’ diets, lifestyles, and characteristics will be assessed. We will define the primary outcome to compare CRC patients’ immunotherapy responses with their gut microbiota composition. The systematic review methodology does not require ethics approval due to the nature of the study design. The systematic review results will be published in an open-access peer-reviewed journal.
PROSPERO ID: CRD42021277691.
Læs mere Tjek på PubMedHina Ashraf, Hashmat Gul, Bushra Jamil, Asfia Saeed, Mehwish Pasha, Muhammad Kaleem, Abdul Samad Khan
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Hina Ashraf, Hashmat Gul, Bushra Jamil, Asfia Saeed, Mehwish Pasha, Muhammad Kaleem, Abdul Samad Khan
Purpose This study aims to investigate new tissue conditioner (TC) formulations involving chitosan nanoparticles (CSNPs) and essential oils (EO) for their antifungal potential, release kinetics, and hardness. Materials and methods CSNPs were synthesized, and the separate solutions of CSNP were prepared with two types of EO, i.e., Oregano oil and Lemongrass. The EO was loaded separately in two concentrations (200 μL and 250 μL). The blank and EO-loaded CSNPs were screened against Candida albicans (C. albicans), and their minimum inhibitory concentration was established. GC Reline™ (GC corporation, USA) TC was considered a control group, whereby the four experimental groups were prepared by mixing CSNPs/EO solutions with TC powder. The antifungal effectiveness (C. albicans) and release kinetics behavior (1–6 h, 24 h, 48 h, and 72 h) was investigated. The Shore A hardness of control and experimental groups was evaluated in dry and wet modes (deionized water and artificial saliva). For statistical analysis, SPSS version 22 was used to do a one-way ANOVA post-hoc Tukey’s test. Results Compared to the control group, TCs containing blank CSNPs and CSNPs loaded with EO showed 3 and 5 log reductions in C. albicans growth, respectively. A significantly high antifungal effect was observed with TC containing lemongrass essential oil (200 μL). The continuous release of EO was detected for the first 6 hours, whereas completely stopped after 48 hours. Mean hardness values were highest for dry samples and lowest for samples stored in artificial saliva. The statistically significant difference within and between the study groups was observed in mean and cumulative essential oils release and hardness values of TCs over observed time intervals irrespective of storage media. Conclusion TCs containing essential-oil-loaded CSNPs seem a promising alternative treatment of denture-induced stomatitis, however, a further biological analysis should be taken.
Læs mere Tjek på PubMedEfrat Naaman, Nitai Bar, Elie Zaher, Liran Shapira, Eytan Zeev Blumenthal
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Efrat Naaman, Nitai Bar, Elie Zaher, Liran Shapira, Eytan Zeev Blumenthal
Purpose To characterize quantitative differences among ophthalmologic emergency room (OER) encounters at Rambam Health Care Campus during a 6-week complete lockdown at the peak of the first COVID-19 wave as compared to a corresponding uneventful period a year earlier. Methods A retrospective chart analysis of all OER encounters during the lockdown and non-lockdown period was conducted. Patients were stratified into primary ophthalmological conditions (OER visits) and cases in which ophthalmologic consultations were requested by a non-ophthalmologist (OER consultations). The following parameters were compared: total number of cases, age, gender, chief complaint/diagnosis categorized into major entities, and discharge vs. hospitalization. For continuous variables a t-test was used and for categorical variables a chi-squared or Fisher’s exact test was used. A 2-sided p value
Læs mere Tjek på PubMedSenai Mihreteab Siele, Nuru Abdu, Mismay Ghebrehiwet, M. Raouf Hamed, Eyasu H. Tesfamariam
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Senai Mihreteab Siele, Nuru Abdu, Mismay Ghebrehiwet, M. Raouf Hamed, Eyasu H. Tesfamariam
Rational use of medicine (RUM) for all medical conditions is crucial in attaining quality of healthcare and medical care for patients and the community as a whole. However, the actual medicine use pattern is not consistent with that of the World Health Organization (WHO) guideline and is often irrational in many healthcare setting, particularly in developing countries. Thus, the aim of the study was to evaluate rational medicine use based on WHO/International Network of Rational Use of Drugs (INRUD) core drug use indicators in Eritrean National and Regional Referral hospitals. A descriptive and cross-sectional approach was used to conduct the study. A sample of 4800 (600 from each hospital) outpatient prescriptions from all disciplines were systematically reviewed to assess the prescribing indicators. A total of 1600 (200 from each hospital) randomly selected patients were observed for patient indicators and all pharmacy personnel were interviewed to obtain the required information for facility-specific indicators. Data were collected using retrospective and prospective structured observational checklist between September and January, 2018. Descriptive statistics, Welch’s robust test of means and Duncan’s post hoc test were performed using IBM SPSS (version 22). The average number of medicines per prescription was 1.78 (SD = 0.79). Prescriptions that contained antibiotic and injectable were 54.50% and 6.60%, respectively. Besides, the percentage of medicines prescribed by generic name and from an essential medicine list (EML) was 98.86% and 94.73%, respectively. The overall average consultation and dispensing time were 5.46 minutes (SD = 3.86) and 36.49 seconds (SD = 46.83), respectively. Moreover, 87.32% of the prescribed medicines were actually dispensed. Only 68.24% of prescriptions were adequately labelled and 78.85% patients knew about the dosage of the medicine(s) in their prescriptions. More than half (66.7%) of the key medicines were available in stock. All the hospitals used the national medicine list but none of them had their own medicine list or guideline. In conclusion, majority of WHO stated core drug use indicators were not fulfilled by the eight hospitals. The results of this study suggest that a mix of policies needs to be implemented to make medicines more accessible and used in a more rational way.
Læs mere Tjek på PubMedNazdar Ezzaddin Alkhateeb, Baderkhan Saeed Ahmed, Namir Ghanim Al-Tawil, Ali A. Al-Dabbagh
PLoS One Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
by Nazdar Ezzaddin Alkhateeb, Baderkhan Saeed Ahmed, Namir Ghanim Al-Tawil, Ali A. Al-Dabbagh
Background With the emergence of the COVID-19 pandemic and lockdown approach that was adopted all over the world, conducting assessments while maintaining integrity became a big challenge. This article aims at sharing the experience of conducting an online assessment with the academic community and to assess its effectiveness from both examiners’ and students’ perspectives. Methods An online assessment was carried out for the final year medical students of Hawler Medical University/Iraq during the lockdown period of the COVID-19 pandemic, June 2020. Then, an online questionnaire was sent to a sample of 61 examiners and 108 students who have been involved in evaluating the mentioned assessment process. Mann-Whitney and Kruskal-Wallis tests were used to compare the mean ranks of the overall satisfaction scores between categories of the students and examiners. Categorical data were summarized and presented as frequencies and percentages. Results The response rates among examiners and students were 69.4% and 88.5% respectively. The majority of the examiners were generally satisfied with the online examination process compared to only around a third of the students. However, both examiners and students agreed that online examination was not suitable for assessing the physical examination skills. Conclusion The online assessment can be considered a good alternative and acceptable method for medical students’ assessment in unpredicted emergencies, yet it was not applicable in testing physical examination skills.
Læs mere Tjek på PubMedBMC Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
Abstract
Background
Orientia tsutsugamushi (O. tsutsugamushi), an obligate intracellular bacterium, is transmitted to humans through infected larval trombiculid mite bites, causing scrub typhus. Mixed genotypes of O. tsutsugamushi in canonical conserved genes were reported in 8–25% of blood samples from patients. Yet, there are few clinical descriptions of these mixed O. tsutsugamushi-infected patients.
Case presentation
We report a patient with scrub typhus complicated with pulmonary involvement and hepatic dysfunction, who carried mixed genotypes of the conserved genes but had a single immune-dominant 56-kDa type-specific antigen (tsa56) genotype. The patient was successfully recovered by doxycycline treatment.
Conclusions
In this reported case, both patient’s eschar and blood samples have repeatedly shown the same results, i.e., no variants were discovered in tsa56 gene that bears multiple hypervariable regions. Whereas the selected highly conserved genes were identified with up to 32 variants in a 2700 base-pair concatenated sequence. The prevalence, disease severity and mechanism of these single-tsa56-genotype mixed infections remain to be investigated on a large scale with more cases.
Læs mere Tjek på PubMed
BMC Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
Abstract
Background
Human Monocytic Ehrlichiosis is caused by infection with the bacteria Ehrlichia chaffeensis through the bite of an infected lone star tick (Amblyomma americanum). Patients infected with Human Monocytic Ehrlichiosis often present with symptoms including fever, headache, myalgia, and occasionally a macular rash. The presence of other endemic tick-borne diseases with similar symptoms, such as Rocky Mountain Spotted Fever, complicate the diagnosis of Human Monocytic Ehrlichiosis.
Case presentation
A patient developed a fever, diffuse myalgia, headache, and a non-productive cough 5 days after a fishing trip in late May in central North Carolina. Over the course of the illness the patient’s symptoms worsened, with arthralgia, bilateral lower extremity erythema and edema, and a developing bilateral rash on the palms. With testing that revealed elevated liver enzymes, a potential for recent tick exposure (e.g., fishing trip), presentation during tick season, and the development of a rash, Rocky Mountain Spotted Fever and Human Monocytic Ehrlichiosis were considered. The patient was prescribed a seven-day course of oral doxycycline and cefalexin, which would provide coverage from Rickettsia, Ehrlichia and gram-positive bacteria typically responsible for cellulitis. Many of the patient’s symptoms resolved or improved, although the right shoulder remained painful to active movement. The patient was prescribed another seven-day course of doxycycline due to his perceived incomplete response to the first course. Approximately 5 weeks after symptom onset (D0 + 36), the patient followed up with a provider for convalescent testing and counseling. Convalescent Ehrlichia and Rickettsia serological tests were ordered. The acute Ehrlichia serology and acute Rickettsia serology were originally non-reactive with both titers measured at < 1:64. Convalescent serology, ordered 28 days after the acute sample collection, showed a greater than four-fold increase in the Ehrlichia IgG titer (1:256), satisfying clinical and laboratory case definitions for ehrlichiosis. In follow-up, 3 weeks later (D0 + 57), the patient reported that most of his pain had subsided, though he still occasionally got shooting nerve pain when exercising.
Conclusion
This case of Human Monocytic Ehrlichiosis in North Carolina exemplifies the need for a knowledge of spatial epidemiological patterns and clinical manifestations in the diagnosis of tick-borne diseases.
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Tara C. Marcink, Thomas Kicmal, Emily Armbruster, Zhening Zhang, Gillian Zipursky, Kate L. Golub, Mohab Idris, Jonathan Khao, Jennifer Drew-Bear, Gael McGill, Tom Gallagher, Matteo Porotto, Amédée des Georges, Anne Moscona
Science Advances, 19.08.2022
Tilføjet 19.08.2022
Mena, G., Aburto, J. M.
BMJ Open, 19.08.2022
Tilføjet 19.08.2022
Objectives
To quantify the impact of the COVID-19 pandemic on life expectancy in Chile categorised by rural and urban areas, and to correlate life expectancy changes with socioeconomic factors at the municipal level.
Design
Retrospective cross-sectional demographic analysis using aggregated national all-cause death data stratified by year, sex and municipality during the period 2010–2020.
Setting and population
Chilean population by age, sex and municipality from 2002 to 2020.
Main outcome measures
Stratified mortality rates using a Bayesian methodology. These were based on vital and demographic statistics from the national institute of statistics and department of vital statistics of ministry of health. With this, we assessed the unequal impact of the pandemic in 2020 on life expectancy across Chilean municipalities for males and females and analysed previous mortality trends since 2010.
Results
Life expectancy declined for both males and females in 2020 compared with 2019. Urban areas were the most affected, with males losing 1.89 years and females 1.33 years. The strength of the decline in life expectancy correlated positively with indicators of social deprivation and poverty. Also, inequality in life expectancy between municipalities increased, largely due to excess mortality among the working-age population in socially disadvantaged municipalities.
Conclusions
Not only do people in poorer areas live shorter lives, they also have been substantially more affected by the COVID-19 pandemic, leading to increased population health inequalities. Quantifying the impact of the COVID-19 pandemic on life expectancy provides a more comprehensive picture of the toll.
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Li, C., Parpia, C., Sriharan, A., Keefe, D. T.
BMJ Open, 19.08.2022
Tilføjet 19.08.2022
Objective
Healthcare provider (HCP) burnout is on the rise with electronic medical record (EMR) use being cited as a factor, particularly with the rise of the COVID-19 pandemic. Burnout in HCPs is associated with negative patient outcomes, and, therefore, it is crucial to understand and address each factor that affects HCP burnout. This study aims to (a) assess the relationship between EMR use and burnout and (b) explore interventions to reduce EMR-related burnout.
Methods
We searched MEDLINE (Ovid), CINAHL and SCOPUS on 29 July 2021. We selected all studies in English from any publication year and country that discussed burnout in HCPs (physicians, nurse practitioners and registered nurses) related to EMR use. Studies must have reported a quantitative relationship to be included. Studies that implemented an intervention to address this burnout were also included. All titles and abstracts were screened by two reviewers, and all full-text articles were reviewed by two reviewers. Any conflicts were addressed with a third reviewer and resolved through discussion. Quality of evidence of all included articles was assessed using the Quality Rating Scheme for Studies and Other Evidence.
Findings
The search identified 563 citations with 416 citations remaining after duplicate removal. A review of abstracts led to 59 studies available for full-text assessment, resulting in 25 studies included in the scoping review. Commonly identified associations between EMR-related burnout in HCPs included: message and alert load, time spent on EMRs, organisational support, EMR functionality and usability and general use of EMRs. Two articles employed team-based interventions to improve burnout symptoms without significant improvement in burnout scores.
Conclusions and relevance
Current literature supports an association between EMR use and provider burnout. Very limited evidence exists for burnout-reducing interventions that address factors such as time spent on EMRs, organisational support or EMR design.
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Infection, 18.08.2022
Tilføjet 19.08.2022
Abstract
Purpose
The purpose of this study was to assess the clinical outcomes of adults with invasive meningococcal disease (IMD) and to compare the outcomes of patients with IMD caused by a penicillin susceptible isolate (minimum inhibitory concentration (MIC) ≤ 0.06 mg/L) with patients with IMD caused by an isolate with reduced penicillin susceptibility (MIC > 0.06 mg/L). We also assessed the outcomes of patients with IMD caused by an isolate with reduced penicillin susceptibility who were treated exclusively with intravenous (IV) benzylpenicillin.
Methods
Retrospective study of all culture positive IMD in adult patients (age ≥ 15 years) in the Auckland region from 2004 to 2017.
Results
One hundred and thirty-nine patients were included; 94 had penicillin susceptible isolates (88 cured, 6 died), and 45 had an isolate with reduced penicillin susceptibility (41 cured, 1 possible relapse, 3 died). The median benzylpenicillin/ceftriaxone treatment duration was 3 days for both groups. There was no difference in the patient outcomes of both groups. Eighteen patients with IMD caused by an isolate with reduced penicillin susceptibility received benzylpenicillin alone and were cured.
Conclusions
This study provides further support to existing data that has shown that short duration IV beta-lactam treatment is effective for IMD in adults. Only a small number of patients with meningitis caused by an isolate with reduced penicillin susceptibility received benzylpenicillin alone, limiting its evaluation. For Neisseria meningitidis meningitis, we recommend ceftriaxone as empiric treatment and as definitive treatment when this is caused by an isolate with reduced penicillin susceptibility.
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Kathy Jackson, Sara Bonanzinga, Ros Edwards, Kumar Visvanathan, Xin Li, Samuel Hall, Alison Kuchta, Jesse A. Canchola, Alex J. Thompson
Journal of Medical Virology, 19.08.2022
Tilføjet 19.08.2022
Journal of Infectious Diseases, 18.08.2022
Tilføjet 19.08.2022
AbstractThe Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised concerns regarding vaccine effectiveness. We investigated humoral and cellular immune responses against SARS-CoV-2 in healthcare workers before and after a third (booster) dose of the BNT162b2 mRNA vaccine. It significantly enhanced both humoral and cellular immunity in previously uninfected individuals. However, cellular immunity was not enhanced in previously infected persons, suggesting that three antigenic stimuli by vaccination or natural infection reached a plateau of cellular immunity. Even with reinforced immunity to SARS-CoV-2, we confirmed several post-booster breakthrough cases caused by the Omicron variant.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 18.08.2022
Tilføjet 19.08.2022
AbstractBackgroundToxoplasma gondii infection is usually benign in Europe due to the strong predominance of type II strains. Few studies have been conducted to examine the immunological course of infection in humans and have yielded conflicting results, maybe influenced by heterogeneous parasite strains.MethodsWe measured 23 immune mediators in 39, 40, and 29 sera of French non-infected, acutely infected, and chronically infected immunocompetent pregnant women, respectively.ResultsFour different cytokine patterns were identified regarding their dynamics through infection phases. For eleven of the cytokines, IFN-β, IFN-γ, IL-4, IL5, IL-6, IL-10, IL-12, IL-15, CXCL9, CCL2 and CSF2, the serum levels were significantly elevated during acute infection. The inflammatory mediators IL-1β, IL-17A, IL-18, TNF-α and CSF3 remained unchanged during acute infection, while they were significantly lower in chronically infected compared to non-infected patients. As for the anti-inflammatory cytokines TGF-β and CCL5, their levels remained significantly elevated during chronic infection. We also observed a significant negative correlation of several cytokine concentrations with IgG levels, indicating a rapid decline of serum concentrations during the acute phase.DiscussionThese results indicate an anti-inflammatory pattern in chronically infected patients in a type II dominated setting and demonstrate the highly dynamic immune situation during acute infection.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundObesity dysregulates immunity to influenza infection. Therefore, there is a critical need to investigate how obesity impairs immunity and to establish therapeutic approaches that mitigate the impact of increased adiposity. One mechanism by which obesity may alter immune response is through changes in cellular metabolism.MethodsWe studied inflammation and cellular metabolism of PBMCs isolated from individuals with obesity relative to lean controls. We also investigated if impairments to PBMC metabolism were reversible upon short-term weight loss following bariatric surgery.ResultsObesity was associated with systemic inflammation and poor inflammation resolution. Unstimulated PBMCs from subjects with obesity had lower oxidative metabolism and ATP production compared to PBMCs from lean controls. PBMC secretome analyses showed that ex vivo stimulation with A/Cal/7/2009 H1N1 influenza led to a notable increase in IL-6 with obesity. Short-term weight loss via bariatric surgery improved biomarkers of systemic metabolism but did not improve markers of inflammation resolution, PBMC metabolism, or the PBMC secretome.ConclusionsThese results show obesity drives a signature of impaired PBMC metabolism, which may be due to persistent inflammation. PBMC metabolism was not reversed after short-term weight loss despite improvements in measures of systemic metabolism.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundSARS-CoV-2 infection may be associated with worse clinical outcomes in people with HIV (PWH). We report anti-SARS-CoV-2 antibody responses in COVID-19 hospitalized patients in Durban, South Africa during the second SARS-CoV-2 infection wave dominated by the Beta (B.1.351) variant.MethodsThirty-four participants with confirmed SARS-CoV-2 infection were followed up with weekly blood sampling to examine antibody levels and neutralization potency against SARS-CoV-2 variants. Participants included 18 PWH, of whom 11 were HIV viremic.ResultsSARS-CoV-2 specific antibody concentrations were generally lower in viremic PWH relative to virologically suppressed PWH and HIV-negative participants and neutralization of the Beta variant was 4.9-fold lower in viremic PWH. Most HIV-negative participants and ART-suppressed PWH also neutralized the Delta (B.1.617.2) variant, whereas the majority of viremic PWH did not. CD4 counts <500 cells/μL were associated with lower frequencies of IgG and IgA seroconversion. In addition, there was a high correlation between a surrogate virus neutralization test and live virus neutralization against ancestral SARS-CoV-2 virus in both PWH and HIV-negative individuals, but correlation decreased for the Beta variant neutralization in PWH.ConclusionsHIV viremia was associated with reduced Beta variant neutralization. This highlights the importance of HIV suppression in maintaining an effective SARS-CoV-2 neutralization response.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundA major goal of COVID-19 vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of mRNA and ChAdOx1 COVID-19 vaccines against severe outcomes in four Canadian provinces between December 2020 and September 2021.MethodsWe conducted this multiprovincial retrospective test-negative study among community-dwelling adults aged ≥18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random effects models.ResultsWe included 2,508,296 tested subjects, with 31,776 COVID-19 hospitalizations and 5,842 deaths. Vaccine effectiveness was 83% after a first dose, and 98% after a second dose, against both hospitalization and death (separately). Against severe outcomes (hospitalization or death), effectiveness was 87% (95%CI: 71%–94%) ≥84 days after a first dose of mRNA vaccine, increasing to 98% (95%CI: 96%–99%) ≥112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95%CI: 75%–94%) ≥56 days after a first dose, increasing to 97% (95%CI: 91%–99%) ≥56 days after a second dose. Lower one-dose effectiveness was observed for adults aged ≥80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules, and against Alpha, Gamma, and Delta variants.ConclusionsTwo doses of mRNA or ChAdOx1 vaccines provide excellent protection against severe outcomes of hospitalization and death.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundEngland’s third trimester maternal pertussis vaccination, introduced in October 2012, was extended to the second trimester in 2016. Maternal vaccination provides high protection against infant disease but routine second trimester vaccination has not previously been assessed.MethodsNational laboratory-confirmed pertussis case-surveillance determined vaccination history, maternal vaccination history and hospitalisation. Pertussis hospital admissions between 2012-2019 were extracted from the Hospital Episode Statistics dataset. Vaccine effectiveness (VE) was calculated for pertussis cases born between October 2012 and September 2018 using the screening method and matching with a nationally representative dataset.ResultsHigher coverage was observed after earlier maternal vaccination with approximately 40% of pregnant women vaccinated ≥13 weeks before delivery. Cases and hospitalisations stabilised at low levels in younger infants but remained elevated in older infants, children and adults. No deaths arose in infants with vaccinated mothers after 2016.Of 1162 laboratory-confirmed pertussis cases in the study, 599 (52%) were aged <93 days: 463 (77%) with unvaccinated mothers and 136 (23%) with vaccinated.Vaccine effectiveness was equivalent in infants with mothers vaccinated at different gestational periods excepting infants with mothers vaccinated between 7-days pre- and 41-days post-delivery. Children whose mothers were unvaccinated but with vaccination in a previous pregnancy had a VE against disease of 44% (19% to 75%). There was no increased disease risk after primary vaccination in children with mothers vaccinated at least 7 days before delivery.ConclusionsNational policy recommending vaccination from second trimester increased earlier maternal vaccine uptake with sustained high effectiveness and impact against early infant disease.
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