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46 emner vises.
Benjamin A. Krishna, Eleanor Y. Lim, Marina Metaxaki, Sarah Jackson, Lenette Mactavous, NIHR BioResource, Paul A. Lyons, Rainer Doffinger, John R. Bradley, Kenneth G. C. Smith, John Sinclair, Nicholas J. Matheson, Paul J. Lehner, Nyaradzai Sithole, Mark R. Wills
Science Advances, 21.02.2024
Tilføjet 21.02.2024
Clinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract BACKGROUND Non-toxigenic Corynebacterium diphtheriae (C. diphtheriae), often associated with wounds, can rarely cause infective endocarditis (IE). Five patients with C. diphtheriae IE were identified within 12 months at a Seattle-based hospital system. We reviewed prior C. diphtheriae positive cultures to determine if detections had increased over time and evaluated epidemiologic trends.METHODS We conducted a formal electronic health record search to identify all patients ≥ 18 years of age with C. diphtheriae detected in a clinical specimen (i.e. wound, blood, sputum) between September 1, 2020–April 1, 2023. We collected patient demographics, housing status, comorbidities, substance use history and level of medical care required at detection. We extracted laboratory data on susceptibilities of C. diphtheriae isolates, and on other pathogens detected at the time of C. diphtheriae identification.RESULTS Between September 1, 2020–April 1, 2023, 44 patients (median age 44 years) had a C. diphtheriae-positive clinical culture, with most detections occurring after March 2022. Patients were predominantly male (75%), White (66%), unstably housed (77%), and had a lifetime history of injecting drugs (75%). Most C. diphtheriae positive cultures were polymicrobial, including wound cultures from 36 (82%) patients and blood cultures from 6 (14%) patients, not mutually exclusive. Thirty-four patients (77%), including all five patients with C. diphtheriae IE, required hospital admission for C. diphtheriae or a related condition. Of the five patients with IE, three died of IE and one from COVID-19.CONCLUSION Findings suggest a high-morbidity outbreak disproportionately affecting patients who use substances and are unstably housed.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract Introduction Surgical site infections (SSIs) are a common complication in liver transplant(LT) recipients. Lack of pediatric prophylaxis guidelines results in variation in preventative antibiotic regimens.Methods We performed a retrospective observational study of LT recipients under 18 years using a merged dataset that included data from PHIS and UNOS between 2006 and 2017. The exposure was defined as the antibiotic(s) received within 24 hours of LT; with 6 categories, ranging from narrow (category 1: cefazolin), to broad). The primary outcome was presence or absence of SSI in the index admission. Mixed-effects logistic regression compared the effectiveness of each category relative to category 1 in preventing SSI.Results Of the 2586 LT, 284 (11%) met SSI criteria. SSI rate was higher (16.2%) in the younger sub-cohort compared to older (8.6%), necessitating a stratified analysis. Antibiotics from category 5 were most commonly used. In the younger sub-cohort, the adjusted risk was increased in all categories compared to the reference, most notably in category 3 (OR 2.58; 0.69-9.59) and category 6 (OR 2.76; 0.66-11.56). In the older sub-cohort, estimated ORs were also increased for each category, most notably in category 4 (2.49; 0.99-6.27). None of the ORs suggested benefit from broader-spectrum prophylaxis. Our E value assessment suggests it’s unlikely there is unmeasured confounding by indication to the degree necessary to revert ORs to protective.Conclusion There was wide variation in antibiotic prophylaxis. Adjusted analyses did not reveal a protective benefit of broader-spectrum prophylaxis in either sub-cohort, suggesting that narrower regimens may be adequate.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract Introduction Intussusception is the primary cause of acute bowel obstruction in infants. The majority of cases under 2 years of age are classed as idiopathic with viral infection implicated as one of the causes. COVID-19 public health measures led to significant decreases in communicable disease prevalence. During these times, reductions in intussusception frequency were reported - reductions greater than would be expected with our previous understanding of its infectious aetiology.Methods We conducted a retrospective, multi-state, ecological study over a twelve-year period. Monthly case numbers of ICD-10-AM K56.1 ‘Intussusception’ coded admissions were acquired from state-wide admissions datasets from New South Wales (NSW), Victoria and Queensland, representing 77.62% of the eligible Australian population. These counts within differing jurisdictional lockdowns were compared to non-lockdown periods in order to investigate a correlation between intussusception frequency and lockdown periods.Results We found a negative association between intussusception frequency and lockdown periods in both eligible states. The largest reductions were seen in the under 2 year age groups with Victoria experiencing a 62.7% reduction (Rate ratio (RR) = 0.37, p
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
To the Editor— From early in the coronavirus disease 2019 (COVID-19) pandemic, it became evident that the natural disease course undergoes different stages, from an initial mild viral phase to a more severe inflammatory phase and ultimately to a critical thromboinflammatory phase, often corresponding to acute respiratory distress syndrome in hospitalized patients. Most treatment guidelines have kept these disease stages in their algorithms, generally recommending early antiviral treatment for the mild to moderate disease, and immunomodulatory treatment for severe to critical disease [1]. However, as the virus has changed from pre-omicron to omicron variants, and the target population from immunologically naive to mostly vaccinated or recovered, these phases are less distinct [2].
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract Background Persistent mortality in adults hospitalized due to acute COVID-19 justifies pursuit of disease mechanisms and potential therapies. The aim was to evaluate which virus and host response factors were associated with mortality risk among participants in Therapeutics for Inpatients with COVID-19 (TICO/ACTIV-3) trials.Methods A secondary analysis of 2625 adults hospitalized for acute SARS-CoV-2 infection randomized to 1 of 5 antiviral products or matched placebo in 114 centers on 4 continents. Uniform, site-level collection of participant baseline clinical variables was performed. Research laboratories assayed baseline upper respiratory swabs for SARS-CoV-2 viral RNA and plasma for anti–SARS-CoV-2 antibodies, SARS-CoV-2 nucleocapsid antigen (viral Ag), and interleukin-6 (IL-6). Associations between factors and time to mortality by 90 days were assessed using univariate and multivariable Cox proportional hazards models.Results Viral Ag ≥4500 ng/L (vs
Læs mere Tjek på PubMedVijay Vinayak Chavan, Alpa Dalal, Sharath Nagaraja, Pruthu Thekkur, Homa Mansoor, Augusto Meneguim, Roma Paryani, Pramila Singh, Stobdan Kalon, Mrinalini Das, Gabriella Ferlazzo, Petros Isaakidis
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Vijay Vinayak Chavan, Alpa Dalal, Sharath Nagaraja, Pruthu Thekkur, Homa Mansoor, Augusto Meneguim, Roma Paryani, Pramila Singh, Stobdan Kalon, Mrinalini Das, Gabriella Ferlazzo, Petros Isaakidis
Læs mere Tjek på PubMedJacob Rosén, Peter Frykholm, Malin Jonsson Fagerlund, Mariangela Pellegrini, Francesca Campoccia Jalde, Erik von Oelreich, Diddi Fors
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Jacob Rosén, Peter Frykholm, Malin Jonsson Fagerlund, Mariangela Pellegrini, Francesca Campoccia Jalde, Erik von Oelreich, Diddi Fors Background The effects of awake prone positioning (APP) on respiratory mechanics in patients with COVID-19 are not well characterized. The aim of this study was to investigate changes of global and regional lung volumes during APP compared with the supine position using electrical lung impedance tomography (EIT) in patients with hypoxemic respiratory failure due to COVID-19. Materials and methods This exploratory non-randomized cross-over study was conducted at two university hospitals in Sweden between January and May 2021. Patients admitted to the intensive care unit with confirmed COVID-19, an arterial cannula in place, a PaO2/FiO2 ratio
Læs mere Tjek på PubMedHajime Maeda, Koichi Hashimoto, Hajime Iwasa, Hyo Kyozuka, Yohei Kume, Hayato Go, Akiko Sato, Yuka Ogata, Tsuyoshi Murata, Keiya Fujimori, Kosei Shinoki, Hidekazu Nishigori, Seiji Yasumura, Mitsuaki Hosoya, the Japan Environment and Children’s Study (JECS) Group
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Hajime Maeda, Koichi Hashimoto, Hajime Iwasa, Hyo Kyozuka, Yohei Kume, Hayato Go, Akiko Sato, Yuka Ogata, Tsuyoshi Murata, Keiya Fujimori, Kosei Shinoki, Hidekazu Nishigori, Seiji Yasumura, Mitsuaki Hosoya, the Japan Environment and Children’s Study (JECS) Group Background There has been a recent decrease in the prevalence of infectious diseases in children worldwide due to the usage of vaccines. However, the association between cesarean delivery and infectious diseases remains unclear. Here, we aimed to clarify the association between cesarean delivery and the development of infectious diseases. Methods This study is a cross-sectional study. We used data from the Japan Environment and Children’s Study, which is a prospective, nationwide, government-funded birth cohort study. The data of 104,065 records were included. Information about the mode of delivery, central nervous system infection (CNSI), otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastrointestinal infection (GI), and urinary tract infection (UTI) was obtained from questionnaires and medical records transcripts. Multiple logistic regression analysis was used to assess the association between cesarean delivery and CNSI, OM, URTI, LRTI, GI, and UTI risk. Results We included a total of 74,477 subjects in this study, of which 18.4% underwent cesarean deliveries. After adjusting for the perinatal, socioeconomic, and postnatal confounding factors, children born by cesarean delivery did not have an increased risk of developing CNSI (95% confidence interval [CI] 0.46–1.35), OM (95% CI 0.99–1.12), URTI (95% CI 0.97–1.06), LRTI (95% CI 0.98–1.15), GI (95% CI 0.98–1.11), or UTI (95% CI 0.95–1.45). Conclusions This nationwide cohort study did not find an association between cesarean delivery and CNSI, OM, URTI, LRTI, GI, and UTI. However, further studies are needed to evaluate the role of cesarean delivery in the development of infectious diseases.
Læs mere Tjek på PubMedTainã Lago, Thyago Marconi Cardoso, Alan Rocha, Edgar M. Carvalho, Léa Cristina Castellucci
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Tainã Lago, Thyago Marconi Cardoso, Alan Rocha, Edgar M. Carvalho, Léa Cristina Castellucci Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis, is a disease characterized by well-limited ulcerated lesions with raised borders in exposed parts of the body. miRNAs are recognized for their role in the complex and plastic interaction between host and pathogens, either as part of the host’s strategy to neutralize infection or as a molecular mechanism employed by the pathogen to modulate host inflammatory pathways to remain undetected. The mir155 targets a broad range of inflammatory mediators, following toll-like receptors (TLRs) signaling. In this work, we evaluated the effects of the expression of miR155a-5p in human macrophages infected with L. braziliensis. Our results show that miR155a-5p is inversely correlated with early apoptosis and conversely, seems to influence an increment in the oxidative burst in these cells. Altogether, we spotted a functional role of the miR155a-5p in CL pathogenesis, raising the hypothesis that an increased miR-155 expression by TLR ligands influences cellular mechanisms settled to promote both killing and control of parasite density after infection.
Læs mere Tjek på PubMedThomas Yau, McKyla McIntyre, Josh Chan, Damanveer Bhogal, Angie Andreoli, Mark Bayley, Carl Froilan D. Leochico, Ailene Kua, Meiqi Guo, Sarah Munce
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Thomas Yau, McKyla McIntyre, Josh Chan, Damanveer Bhogal, Angie Andreoli, Mark Bayley, Carl Froilan D. Leochico, Ailene Kua, Meiqi Guo, Sarah Munce Objective This scoping review aims to map the existing research on adverse events during the delivery of telerehabilitation. Introduction Telerehabilitation, a subset of telemedicine, has gained traction during the COVID-19 pandemic as a means to deliver rehabilitation services remotely. However, there exists a research gap as there has yet to be any scoping review, systematic review, or meta-analysis published to identify and summarize the current primary research on adverse events related to telerehabilitation as a whole. It is important to understand how adverse events, such as falls during physiotherapy or aspiration pneumonia during speech language pathology sessions, are associated with telerehabilitation delivery. This will help to identify key limitations for optimizing telerehabilitation delivery by allowing for the development of key risk-mitigation measures and quality indicators. It can also help improve the uptake of telerehabilitation among clinicians and patients. This review aims to fill this research gap by conducting a search of published literature on adverse events in telerehabilitation. Anticipated key findings of this scoping review include identifying the characteristics and frequencies of adverse events during telerehabilitation, the patient populations and types of telerehabilitation associated with the most adverse events, and the quality of reporting of adverse events. Methods The review follows the Joanna Briggs Institute (JBI) methodological framework and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The review protocol has been registered and published on Open Science Framework. A comprehensive search strategy was implemented across multiple databases (MEDLINE ALL, EMBASE, APA PsycINFO, CENTRAL, and CINAHL). All stages (screening, extraction, and synthesis) will be conducted in duplicate and independently, with data extraction following the TIDieR framework, along with authors, year of publication (before or after COVID), population and sample size, and specific mode/s of telerehabilitation delivery. For synthesis, data will be summarized quantitatively using numerical counts and qualitatively via content analysis. The data will be grouped by intervention type and by type of adverse event. Inclusion Criteria This scoping review will include qualitative and quantitative studies published between 2013 and 2023, written in English, and conducted in any geographic area. All modes of telerehabilitation delivery (asynchronous, synchronous, or hybrid) will be included. Systematic reviews, meta-analyses, commentaries, protocols, opinion pieces, conference abstracts, and case series with fewer than five participants will be excluded.
Læs mere Tjek på PubMedHye Su Jeong, Byung Chul Chun
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Hye Su Jeong, Byung Chul Chun Background To properly assess an association between vaccines and specific adverse events requires a comparison between the observed and background rates; however, studies in South Korea are currently limited. Therefore, in this study, we estimated the background incidence of anaphylaxis, myocarditis, pericarditis, Guillain-Barré syndrome (GBS), and mortality in South Korea. Methods A retrospective cohort study was conducted using the National Sample Cohort (NSC) data. Using NSC, the background incidence rate was estimated by dividing the number of episodes during 2009–2019 by the total population by year and then multiplying by 100,000. Using Statistics Korea data, the background mortality rate was estimated by dividing the number of deaths, during 2009–2019 by the standard population for that year and then multiplying by 100,000. Using background mortality rates, we predicted mortality rates for 2021 using autoregressive integrated moving average models. Further, the expected mortality rates were compared with observed mortality rates. Results The age-adjusted incidence rate (AIR) of anaphylaxis increased from 4.28 to 22.90 cases per 100,000 population (p = 0.003); myocarditis showed no significant increase, changing from 0.56 to 1.26 cases per 100,000 population (p = 0.276); pericarditis increased from 0.94 to 1.88 cases per 100,000 population (p = 0.005); and GBS increased from 0.78 to 1.21 cases per 100,000 population (p = 0.013). The age-adjusted mortality rate decreased from 645.24 to 475.70 deaths per 100,000 population (p
Læs mere Tjek på PubMedKinga Humińska-Lisowska, Kinga Zielińska, Jan Mieszkowski, Monika Michałowska-Sawczyn, Paweł Cięszczyk, Paweł P Łabaj, Bartosz Wasąg, Barbara Frączek, Anna Grzywacz, Andrzej Kochanowicz, Tomasz Kosciolek
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Kinga Humińska-Lisowska, Kinga Zielińska, Jan Mieszkowski, Monika Michałowska-Sawczyn, Paweł Cięszczyk, Paweł P Łabaj, Bartosz Wasąg, Barbara Frączek, Anna Grzywacz, Andrzej Kochanowicz, Tomasz Kosciolek The influence of human gut microbiota on health and disease is now commonly appreciated. Therefore, it is not surprising that microbiome research has found interest in the sports community, hoping to improve health and optimize performance. Comparative studies found new species or pathways that were more enriched in elites than sedentary controls. In addition, sport-specific and performance-level-specific microbiome features have been identified. However, the results remain inconclusive and indicate the need for further assessment. In this case-control study, we tested two athletic populations (i.e. strength athletes, endurance athletes) and a non-athletic, but physically active, control group across two acute exercise bouts, separated by a 2-week period, that measured explosive and high intensity fitness level (repeated 30-s all-out Wingate test (WT)) and cardiorespiratory fitness level (Bruce Treadmill Test). While we did not identify any group differences in alpha and beta diversity or significant differential abundance of microbiome components at baseline, one-third of the species identified were unique to each group. Longitudinal sample (pre- and post-exercise) analysis revealed an abundance of Alistipes communis in the strength group during the WT and 88 species with notable between-group differences during the Bruce Test. SparCC recognized Bifidobacterium longum and Bifidobacterium adolescentis, short-chain fatty acid producers with probiotic properties, species strongly associated with VO2max. Ultimately, we identified several taxa with different baseline abundances and longitudinal changes when comparing individuals based on their VO2max, average power, and maximal power parameters. Our results confirmed that the health status of individuals are consistent with assumptions about microbiome health. Furthermore, our findings indicate that microbiome features are associated with better performance previously identified in elite athletes.
Læs mere Tjek på PubMedMariella Bodemeier Loayza Careaga, T. John Wu
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Mariella Bodemeier Loayza Careaga, T. John Wu Although acute stressors are known for stimulating the production of glucocorticoids and pro-inflammatory cytokines in rodents, the effects of chronic stressors on cytokine levels and the activation of the hypothalamic-pituitary-adrenal (HPA) axis, especially in response to a subsequent challenge, are less clear. In this study, male and female mice were exposed to 6 weeks of chronic variable stress (CVS) and the peripheral and central levels of IL-1β, IL-6, and TNF-α, as well as the HPA axis reactivity, were measured after an acute injection of LPS. The findings indicate that the pro-inflammatory profile in the plasma, regardless of stress exposure, was similar between male and female animals, whereas there was a region-, sex-, and stress-dependent pattern in the brain. Exposure to chronic stressors blunted the HPA reactivity to the LPS challenge, indicating a modulatory effect on the stress axis responsiveness.
Læs mere Tjek på PubMedMatthew VanOrmer, Maranda Thompson, Melissa Thoene, Jean-Jack Riethoven, Sathish Kumar Natarajan, Corrine Hanson, Ann Anderson-Berry
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Matthew VanOrmer, Maranda Thompson, Melissa Thoene, Jean-Jack Riethoven, Sathish Kumar Natarajan, Corrine Hanson, Ann Anderson-Berry Objective The gastrointestinal microbiome in preterm infants exhibits significant influence on optimal outcomes–with dysbiosis shown to substantially increase the risk of the life-threatening necrotizing enterocolitis. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurodevelopment. However, excess colonic iron exhibits potent oxidation capacity and alters the gut microbiome–potentially facilitating the proliferation of pathological bacterial strains. Breastfed preterm infants routinely receive iron supplementation starting 14 days after delivery and are highly vulnerable to morbidities associated with gastrointestinal dysbiosis. Therefore, we set out to determine if routine iron supplementation alters the preterm gut microbiome. Methods After IRB approval, we collected stool specimens from 14 infants born
Læs mere Tjek på PubMedHeather Leggett, Karen Vinall-Collier, Julia Csikar, Sophy Barber, Rachel Carr, Amrit Bhatti, Sue Pavitt
PLoS One Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
by Heather Leggett, Karen Vinall-Collier, Julia Csikar, Sophy Barber, Rachel Carr, Amrit Bhatti, Sue Pavitt Background The Covid-19 pandemic had a profound effect on the delivery of healthcare research. Covid-19 research was prioritised and many non-essential trials were paused. This study explores the engagement experiences of trial participants’, PPIE contributors’ and trial staff during the Covid-19 pandemic and towards recovery and restoring a diverse and balanced UK clinical trials portfolio. Methods Interviews and focus groups were undertaken with PPIE contributors, trial participants and trial staff members from NIHR research trials across the UK (November 2020-June 2021) across portfolio specialities: Cancer, Oral and Dental Health, Musculoskeletal Disorders, Cardiovascular Disease, Neurological Disorders, Primary Care, and Conditions associated with susceptibility to Covid-19 (Diabetes, Stroke, Respiratory Disorders). Topic guides were developed for each participant group and interviews were conducted over Zoom. The transcripts were analysed using codebook thematic analysis in NVivo (V.12). Results 106 participants comprising, 45 PPIE contributors, 27 trial participants and 34 trial staff members were recruited. Three themes to engagement with trials during Covid-19 were developed. 1) Ensuring continued contact. Continued and tailored communication, having a trial point of contact and regular updates all enhanced trial engagement and retention. Patients’ unfamiliarity with materials being sent electronically reduced engagement and trust. 2) A balanced move to remote consultations. Remote follow-up and monitoring were convenient and allowed for wider recruitment across the UK. Participants were more likely to discuss personal subjects in their own homes. Remote visits lacked a personal touch, some concerns over missed diagnoses or being unable to appreciate the situation, technical abilities or equipment failures were seen as barriers, especially for disadvantaged or older people. 3) The importance of feeling fully informed. Factors that supported attendance were knowledge about trial conduct adherence to Covid-19 regulations, social distancing, clear signage at the site and opportunities to ask questions. Barriers included not knowing what to expect and not feeling safe with rules and regulations. Conclusions Our findings highlight a number of ways to future proof trial delivery against future pandemics or disruptions such as offering online options to participate in research, ensuring consistent communication between participants and the research team, making sure participants feel fully informed and the continued reassurance of safety in the clinical setting.
Læs mere Tjek på PubMedJames Donnelly, Helene McDermott, Sadhbh Gash, Ciara O'Connor, Karina O'Connell, Sinead O'Donnell, Binu Dinesh, Karen Burns, Fidelma Fitzpatrick
International Journal of Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
The recently published 2023 update from the European Society of Cardiology (ESC) regarding the management of infective endocarditis introduces many welcome changes. Commendable are the transition towards outpatient care and the adoption of oral therapeutic regimens for carefully selected and clinically stable patients [1]. However, the management of these patients still presents numerous challenges, particularly in the context of selecting the most appropriate antimicrobial regimen.
Læs mere Tjek på PubMedChris Kenyon
International Journal of Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Three randomized controlled trials have found that doxycycline post exposure prophylaxis (doxy-PEP) can reduce the incidence of gonorrhoea, chlamydia and syphilis in men who have sex with men (MSM) [1]. As a result, a number of international organizations suggest that doxy-PEP should be considered for use by MSM at risk [1].
Læs mere Tjek på PubMedLixue Huang, Xunliang Tong, Jia Cui, Xiaoman Du, Yixuan Liao, Xiaoming Tan, Yang Ju, Xuefeng Zhong, Wei Zhou, Xiaomao Xu, Yanming Li
International Journal of Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Whilst persistent or recurrent COVID-19 infection is well described among some immunosuppressed patient cohort, to date there have been no reports of this phenomenon in the context of repeatedly negative SARS-CoV-2 testing in the upper respiratory tract. We reported 6 follicular lymphoma developed recurrent symptomatic COVID-19 infection. They tested persistently negative for SARS-CoV-2 on pharyngeal swabs and ultimately confirmed by BALF metagenomics next generation sequencing. All 6 patients presented with lymphopenia and B-cell depletion, and 5 of them received the anti-CD 20 treatment in the last year.
Læs mere Tjek på PubMedNina S. Groeneveld, Sabine E. Olie, Douwe H. Visser, Linde Snoek, Diederik van de Beek, Matthijs C. Brouwer, Merijn W. Bijlsma, NOGBS study group
International Journal of Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Neonatal and infant meningitis and sepsis are associated with substantial mortality and long-term morbidity.[1] Early detection of meningitis in suspected sepsis patients is important because of the difference in empiric antibiotic regimen, dosage and duration of antibiotic treatment. Also, it influences the need for monitoring of complications during hospitalization, as well as the risk of long-term neurodevelopmental impairment.[2] The interpretation of CSF parameters in neonates can be difficult due to considerable overlap of CSF characteristics between sepsis and meningitis.
Læs mere Tjek på PubMedJessie J. Goldsmith, Christy Vu, Ziheng Zhu, Jennifer MacLachlan, Tilda N. Thomson, Patricia Therese Campbell, Katherine B. Gibney
International Journal of Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Invasive group A streptococcal disease (iGAS) is a rare and life-threatening infection. It occurs when group A Streptococcus bacteria (GAS, Streptococcus pyogenes) invade otherwise sterile sites of the body, such as the blood and cerebrospinal fluid.[1] Globally, it is estimated that 15–25% of iGAS cases are fatal.[1] Severe manifestations such as sepsis, streptococcal toxic shock syndrome (STSS) and necrotising fasciitis have higher case fatality rates, even in well-resourced settings.[1, 2] iGAS is managed with antibiotics, and often requires surgery and supportive care for organ dysfunction.[2] However, patients frequently experience rapid clinical progression and urgent medical attention is critical.[2] It is imperative that the factors that increase the risk of iGAS are well understood to support early diagnosis and rapid institution of life-saving medical care.
Læs mere Tjek på PubMedLaukka, D., Paturi, J., Rahi, M., Saraste, A., Parkkola, R., Kivelev, J., Gardberg, M., Kuhmonen, J., Rinne, J.
BMJ Open, 21.02.2024
Tilføjet 21.02.2024
IntroductionPositron emission tomography (PET) imaging can be used to evaluate arterial wall inflammation in extracranial vascular diseases. However, the application of PET imaging in unruptured intracranial aneurysms (UIA) remains unexplored. Our objective is to investigate feasibility of PET imaging using 18F-FDG and 68Ga-DOTANOC tracers to evaluate arterial wall inflammation in UIA. Methods and analysisThis PET imaging feasibility study will enrol patients scheduled for surgical treatment of UIA. The study subjects will undergo PET imaging of the intracranial arteries within 1 month before planned surgery. The imaging protocol includes 18F-FDG PET MRI, MRA with gadolinium enhancement, and 68Ga-DOTANOC PET CT. The study will also involve preoperative blood samples, intraoperative cerebrospinal fluid (CSF) samples, and aneurysm sac biopsy. Planned sample size is at least 18 patients. Primary outcome is uptake of 18F-FDG or 68Ga-DOTANOC in intracranial arterial aneurysms compared with contralateral normal vessel as maximum standardised uptake value or target-to-blood pool ratio and correlation of uptake of 18F-FDG or 68Ga-DOTANOC to aneurysm histological findings. Secondary outcomes include estimating the correlations between uptake of 18F-FDG or 68Ga-DOTANOC and histological findings with blood and CSF miRNA-levels, arterial wall enhancement in gadolinium enhanced MRA, aneurysm size and shape, smoking, hypertension, and location of the aneurysm. Ethics and disseminationThis study is approved by the Human Research Ethics Committee of the Hospital District of Southwest Finland, Finnish Medicines Agency Fimea, and Turku University Hospital. Findings will be disseminated through peer-reviewed journal articles and presentations at national and international conferences. Trial registration numberNCT04715503
Læs mere Tjek på PubMedHaile, T. G., Benova, L., Mirkuzie, A. H., Asefa, A.
BMJ Open, 21.02.2024
Tilføjet 21.02.2024
ObjectivesDespite a remarkable decline, childhood morbidity and mortality in Ethiopia remain high and inequitable. Thus, we estimated the effective coverage of curative child health services in Ethiopia. DesignWe conducted a cross-sectional analysis of data from the 2016 Ethiopia Demographic and Health Survey (DHS) and the 2014 Ethiopia Service Provision Assessment Plus (SPA+) survey. SettingNationally representative household and facility surveys. Participants and outcomesWe included a sample of 2096 children under 5 years old (from DHS) who had symptoms of one or more common childhood illnesses (diarrhoea, fever and acute respiratory infection) and estimated the percentage of sick children who were taken to a health facility (crude coverage). To construct a quality index of child health services, we used the SPA+ survey, which was conducted in 1076 health facilities and included observations of care for 1980 sick children and surveys of 1908 mothers/caregivers and 5328 health providers. We applied the Donabedian quality of care framework to identify 58 quality parameters (structure, 31; process, 16; and outcome, 11) and used the weighted additive method to estimate the overall quality of care index. Finally, we multiplied the crude coverage by the quality of care index to estimate the effective coverage of curative child health services, nationally and by region. ResultsAmong the 2096 sick children, only 38.4% (95% CI: 36.5 to 40.4) of them were taken to a health facility. The overall quality of care was 54.4%, weighted from structure (30.0%), process (9.2%) and outcome (15.2%). The effective coverage of curative child health services was estimated at 20.9% (95%CI: 19.9 to 22.0) nationally, ranging from 16.9% in Somali to 34.6% in Dire Dawa regions. ConclusionsSystem-wide interventions are required to address both demand-side and supply-side bottlenecks in the provision of child health services if child health-related targets are to be achieved in Ethiopia.
Læs mere Tjek på PubMedZhuang, Y.-D., Chen, Y.-Z., Lin, Q.-Y., Chen, Y.-X., Zhong, S.-Q., Lei, D., Chen, C.-M.
BMJ Open, 21.02.2024
Tilføjet 21.02.2024
IntroductionThe lumbar puncture (LP) technique is widely used for diagnostic and therapeutic purposes. In recent years, the paramedian approach technique (PAT) has gained increasing interest due to its advantages over the conventional midline approach technique (MAT) that has been traditionally employed in clinical practice for LP. However, there have been inconsistent discussions regarding the efficacy of different LP techniques. Based on digital virtual human and computer simulation techniques, a new approach called computerised modified PAT (CMPAT) was proposed. Therefore, the aim of this study is to discuss a randomised controlled trial (RCT) protocol to investigate and compare the effects of CMPAT and MAT in patients undergoing LP. Methods and analysisWe will conduct a prospective, multicentre RCT. The study will recruit 84 patients aged 18–99 years who require LP. Participants will be randomly assigned to either the CMPAT treatment group (group A) or the MAT treatment group (group B). The primary outcome measure will be the number of needle insertion attempts required for a successful LP. Secondary outcomes will include the puncture success rate, pain assessment in the back, head, and legs, and the occurrence of complications. The measurement of these secondary outcomes will be taken during the procedure, as well as at specific time points: 30 min, 6 hours, 1 day, 3 days, 7 days, 2 weeks and 4 weeks after the procedure. Pain levels will be assessed using a Numerical Rating Scale. Ethics and disseminationEthical approval (2022YF052-01) has been obtained from the Ethics Committee of Fujian Medical University Union Hospital, Fuzhou, China. The research findings will be published in an international peer-reviewed scientific journal and presented at scientific conferences. Trial registration numberChiCTR2300067937.
Læs mere Tjek på PubMedWyer, M., Hor, S.-y., Barratt, R., Garrahy, P., Moore, C., Williams Veazey, L., Degeling, C., Gilbert, G. L.
BMJ Open, 21.02.2024
Tilføjet 21.02.2024
ObjectivesDuring a precommissioning inspection of a new biocontainment centre, radiographers noted structural features of quarantine rooms that could compromise staff and patient safety and the X-ray image quality, even after significant modifications had been made to an earlier radiography protocol. The aim of this study was to explore the safety and effectiveness of the modified protocol, in the new space, and identify improvements, if required. DesignA qualitative study using in situ simulation and video-reflexive methods. SettingA newly built biocontainment centre, prior to its commissioning in 2021, in a large, tertiary hospital in Sydney, Australia. ParticipantsFive radiographers, and a nurse and a physician from the biocontainment centre, consented to participate. All completed the study. InterventionsTwo simulated mobile X-ray examinations were conducted in the unit prior to its commissioning; simulations were videoed. Participants and other stakeholders analysed video footage, collaboratively, and sessions were audio recorded, transcribed and analysed thematically. Problems and potential solutions identified were collated and communicated to the hospital executive, for endorsement and actioning, if possible. ResultsFour themes were identified from the data: infection exposure risks, occupational health and exposure risks, communication and X-ray image quality. Facilitated group reviews of video footage identified several important issues, across these four areas of risk, which had not been identified previously. ConclusionsIn situ simulation is used, increasingly, to evaluate and improve healthcare practices. This study confirmed the added value of video-reflexive methods, which provided experienced participants with a richer view of a familiar protocol, in a new setting. Video footage can be examined immediately, or later if required, by a broader group of stakeholders, with diverse experience or expertise. Using video reflexivity, clinicians identified potential safety risks, which were collated and reported to the hospital executive, who agreed to implement modifications.
Læs mere Tjek på PubMedAlexiou, E., Wijk, H., Akerström, M., Jonsdottir, I. H., Degl Innocenti, A., Ahlstrom, L.
BMJ Open, 21.02.2024
Tilføjet 21.02.2024
ObjectivesIn this study, we explored healthcare workers’ (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic. DesignA web-based multimethods survey including multiple choice and open-ended questions was used. SettingThe study was conducted at a university hospital in Sweden. ParticipantsAll HCWs who were working during the first wave of the COVID-19 pandemic in March–June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents). Main outcomes measuresWorry perception and its association with work conditions among HCWs. Results29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: ‘ambiguity of feeling safe and secure’, ‘being obliged to adapt to a new reality’ and ‘into the unknown’. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends. ConclusionsWorries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.
Læs mere Tjek på PubMedJiaren LiYouyou LiLiang ZhouHongming LiTengfei WanJin TangLei ZhouHui XieLong Wanga Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, Chinab Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
Virulence, 21.02.2024
Tilføjet 21.02.2024
Jingsheng HuangWeichao KangDandan YiShuxin ZhuYifei XiangChengzhi LiuHan LiDejia DaiJieyu SuJiakang HeZhengmin LiangCollege of Animal Science and Technology, Guangxi University, Nanning, China
Virulence, 21.02.2024
Tilføjet 21.02.2024
Hajar Miranzadeh MahabadiY. C. James LinNatacha S. OgandoEman W. MoussaNazanin MohammadzadehOliver JulienNeal M. AltoRyan S. NoyceDavid H. EvansChristopher PoweraDepartment of Medicine, University of Alberta, Edmonton, AB T5N 2S2, CanadabDepartment of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB T5N 2S2, CanadacDepartment of Biochemistry, University of Alberta, Edmonton, AB T5N 2S2, CanadadDepartment of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX 75390-8816eLi Ka Shing Institute of Virology, University of Alberta, Edmonton, AB T5N 2S2, Canada
Proceedings of the National Academy of Sciences, 21.02.2024
Tilføjet 21.02.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 8, February 2024.
Læs mere Tjek på PubMedJiapeng LiuKatherine R. FikeChristie DapperMichael KlembaaDepartment of Biochemistry, Virginia Tech, Blacksburg, VA 24061
Proceedings of the National Academy of Sciences, 21.02.2024
Tilføjet 21.02.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 8, February 2024.
Læs mere Tjek på PubMedM. Zuhaib QayyumMasahiko ImashimizuMiron LeancaRishi K. VishwakarmaAmber Riaz-BradleyYulia YuzenkovaKatsuhiko S. MurakamiaDepartment of Biochemistry and Molecular Biology, The Center for RNA Molecular Biology, The Center for Structural Biology, The Pennsylvania State University, University Park, PA 16802bCellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba 305-8565, JapancThe Centre for Bacterial Cell Biology, Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
Proceedings of the National Academy of Sciences, 21.02.2024
Tilføjet 21.02.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 8, February 2024.
Læs mere Tjek på PubMedKaustav Das GuptaJames E. B. CursonAbdullah A. TariqueRonan KapetanovicMark A. SchembriEmmanuelle FantinoPeter D. SlyMatthew J. SweetaInstitute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, AustraliabAustralian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD 4072, AustraliacChild Health Research Centre, The University of Queensland, Brisbane, QLD 4101, AustraliadFriedrich Miescher Institute for Biomedical Research, Basel, BS 4058, SwitzerlandeInstitut national de recherche pour l’agriculture, l’alimentation et l’environnement (INRAE), Université de Tours, Infectiologie et Santé Publique (ISP), Nouzilly 37380, FrancefSchool of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia
Proceedings of the National Academy of Sciences, 21.02.2024
Tilføjet 21.02.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 8, February 2024.
Læs mere Tjek på PubMedStephen A. RainsAdam S. RichardsaDepartment of Communication, University of Arizona, Tucson, AZ 85721-0025bDepartment of Communication Studies, Furman University, Greenville, SC 29613-1000
Proceedings of the National Academy of Sciences, 21.02.2024
Tilføjet 21.02.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 8, February 2024.
Læs mere Tjek på PubMedEugene V. KooninaNational Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894
Proceedings of the National Academy of Sciences, 21.02.2024
Tilføjet 21.02.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 8, February 2024.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract Uncompensated work in academic infectious diseases (ID) may be high-value (e.g., important for academic promotion or necessary for advancement to leadership roles) or low-value (e.g., not aligning with or contributing to professional goals and aspirations). “Curbside” consultations, participation in hospital committees outside of professional interests, and other “citizenship” tasks are common examples of threats to our valuable time as ID providers. Herein, we define the scope of the problem of low-value uncompensated work in academic ID and outline a six-step program to minimize these threats. Collaboration with professional sponsors, such as division chiefs, to align individual and team goals and utilization of a “value vs. compensation” matrix to prioritize activities may help us establish our own agendas and reclaim our professional autonomy.
Læs mere Tjek på PubMedClinical Infectious Diseases, 21.02.2024
Tilføjet 21.02.2024
Abstract Background Group A Streptococcus (GAS) causes an estimated 5.2 million outpatient visits for pharyngitis annually in the United States (U.S.) with incidence peaking in winter, but the annual spatiotemporal pattern of GAS pharyngitis across the U.S. is poorly characterized.Methods We used outpatient claims data from individuals with private medical insurance between 2010-2018 to quantify GAS pharyngitis visit rates across U.S. census regions, subregions, and states. We evaluated seasonal and age-based patterns of geographic spread and the association between school start dates and the summertime upward inflection in GAS visits.Results The South had the most visits per person (yearly average 39.11 visits per 1000 people, 95% CI: 36.21-42.01), and the West had the fewest (yearly average 17.63 visits per 1000 people, 95% CI: 16.76-18.49). Visits increased earliest in the South and in school-age children. Differences in visits between the South and other regions were most pronounced in the late summer through early winter. Visits peaked earliest in central southern states, in December to January, and latest on the coasts, in March. The onset of the rise in GAS pharyngitis visits correlated with, but preceded, average school start times.Conclusions The burden and timing of GAS pharyngitis varied across the continental U.S., with the South experiencing the highest overall rates and earliest onset and peak in outpatient visits. Understanding the drivers of these regional differences in GAS pharyngitis will help in identifying and targeting prevention measures.
Læs mere Tjek på PubMedYuanjie Liu, Elena S. Kim, Haitao Guo
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Salvatore Chirumbolo, Umberto Tirelli
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Marta del Pino, Alex Vorsters, Elmar A. Joura, John Doorbar, Marta Haniszewski, Irene Asensio Gudina, Petya Kodjamanova, Christine Velicer, Rosybel Drury
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Debsopan Roy, Aroni Chatterjee, Lopamudra Mishra, Nilanjan Chakraborty
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Fei Zhao, Fengwen Xu, Xinming Wang, Rui Song, Yamei Hu, Liang Wei, Yu Xie, Yu Huang, Shan Mei, Liming Wang, Lingwa Wang, Zhao Gao, Li Guo, Jugao Fang, Lili Ren, Ronghua Jin, Jianwei Wang, Fei Guo
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Sien Ombelet, Diego Castanares‐Zapatero, Fabian Desimpel, Frank Hulstaert, Sabine Stordeur, Dominique Roberfroid
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Thoi C. Truong, Heekuk Park, Jong‐Hwa Kim, Van Trung Tran, Wonyong Kim
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Aymeric Cantais, Nadine Annino, Charlotte Thuiller, Louise Tripodi, Philippine Cesana, Eloise Seigle‐Ferrand, Franck Zekre, Sylvie Pillet, Bruno Pozzetto
Journal of Medical Virology, 21.02.2024
Tilføjet 21.02.2024
Christopher PhamShuaiqi GuoXiao HanLaurynn ColemanChing Wooen SzeHuizhi WangJun LiuChunhao Li1Department of Oral Craniofacial Molecular Biology, Virginia Commonwealth University, Richmond, Virginia, USA2Department of Microbial Pathogenesis, Yale School of Medicine, New Haven, Connecticut, USA3Microbial Sciences Institute, Yale University, West Haven, Connecticut, USA4Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia, USA, Marvin Whiteley
Infection and Immunity, 21.02.2024
Tilføjet 21.02.2024
David PlotnikJennifer E. SagerMadhukar AryalMarie C. FangetAlessia PeterMichael A. SchmidDeborah CebrikErik MogalianKeith BoundyWendy W. YehPaul GriffinMaribel Reyes1Vir Biotechnology, San Francisco, California, USA2Humabs BioMed, SA, Vir Biotechnology, Bellinzona, Switzerland3Mater Health and University of Queensland, Queensland, Australia, James E. Leggett
Antimicrobial Agents And Chemotherapy, 21.02.2024
Tilføjet 21.02.2024