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47 ud af 47 tidsskrifter valgt, søgeord (urin) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
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BMC Infectious Diseases, 8.12.2023
Tilføjet 8.12.2023
Abstract Background Amid the COVID-19 pandemic, extensive testing was undertaken by independent clinical laboratories (ICLs), yet limited research exists on this matter. Drawing from Green Cross Laboratories (GC Labs)\' pandemic response experience, this study seeks to offer insights for preparation for the next pandemic. Methods This retrospective study analyzed the outcomes of SARS-CoV-2 real-time reverse transcription polymerase chain reaction (SARS-CoV-2 rRT PCR) tests administered by GC Labs for COVID-19 diagnosis, upon request by different organizations, between February 2020 and April 2022. The distribution of institutions that requested the tests, the type of tests, and the positive rate were analyzed. We investigated resource allocation details. Results ICLs were responsible for conducting 85.6% of all tests carried out under South Korea’s COVID-19 testing policy during the pandemic. The availability of free testing regardless of symptoms led to a significant increase in the use of pooled tests, which accounted for more than 80% of all tests conducted after August 2021. The gender and age distribution of COVID-19 cases nationwide and GC Labs’ positive cases were similar. When we analyzed the positive rate by requesting organizations during the COVID-19 pandemic, despite an overall nationwide positivity rate of 35%, high-risk facilities exhibited a positivity rate of less than 5% by maintaining preemptive testing. The most notable increase in resources during the pandemic was seen in human resource input. Conclusions South Korea\'s ICLs were able to conduct large volumes of testing during the COVID-19 pandemic because of their logistics and computer systems, scalable testing space, and trained testing personnel. They also had the flexibility to bring in additional resources to expand testing capacity because they are specialized testing organizations. Hence, ICLs could execute the pooled test that the government had introduced for extensive general population screening. The preemptive periodic testing of high-risk populations kept the positive rate much lower than in the general population. This study\'s findings will aid in refining mass testing-based policies for the next pandemic.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.12.2023
Tilføjet 8.12.2023
Abstract Background Herpes zoster (HZ) is the clinical syndrome associated with reactivation of latent varicella-zoster virus (VZV). Several factors have been implicated to promote VZV reactivation; these include immunosuppression, older age, mechanical trauma, physiologic stress, lymphopenia, and more recently, infection with severe acute respiratory syndrome coronavirus-2 (SARS- CoV-2). Recent reports suggest an increase in the number of HZ cases in the general population during the global COVID-19 pandemic. However, it is unknown what proportion of HZ during the pandemic is due to reactivation of wild-type or vaccine-strain VZV. Case Here we report the first known case of HZ concomitant with SARS-CoV2 infection in a 20-month-old female who was treated with a single dose of dexamethasone, due to reactivation of the vaccine-type strain of VZV after presenting with a worsening vesicular rash. Conclusion In this case, we were able to show vaccine-strain VZV reactivation in the context of a mild acute symptomatic COVID-19 infection in a toddler. Being able to recognize HZ quickly and effectively in a pediatric patient can help stave off the significant morbidity and mortality associated with disease process.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.12.2023
Tilføjet 8.12.2023
Abstract Background To ensure emergency infection prevention and control (IPC) can be fully supervised and monitored in coronavirus disease (COVID-19) epidemic period, a three-level inspector mechanism called "Internal self-check, Departmental cross-check, and Verification of outstanding key and difficult issues" was established in southwest China. The present study aimed to explore the effectiveness of inspector mechanism for the emergency IPC. Methods A self-control real-world study was conducted during COVID-19 epidemic period from 2020 to 2022. An innovative designed mobile phone application was used to realize paperless information transmission and data management. Data were compared between inspection levels using SPSS 19.0 software. Results A total of 2,800,132 supervision records were collected, including 149,137 comprehensive epidemic IPC projects, 1,410,093 personal protective equipment (PPE) use, 1,223,595 wearing and removing process of PPE and 17,307 ultraviolet light-detectable fluorescent (UV/F) surface marker. During the study period, the inspectors and subjects explored many optimized IPC measures. The compliance rate of check items has exceeded 98%, and internal self-check has a statistically significant higher rate than departmental cross-check (99.95% versus 98.74%, χ2 = 26111.479, P < 0.001). Compare with the failure rate in internal self check, the failure rate of PPE usage and wearing/removing process was statistically higher in departmental cross-check (χ2 = 1957.987, P < 0.001, χ2 = 465.610, P < 0.001, respectively). The overall clearance rate of UV/F surface markers is 87.88%, but there is no statistically significant difference over the three years of the present study (F = 2.902, P = 0.071). Conclusions Inspector mechanism for the emergency IPC completed an incredible inspection workload and offered creative assistance to combat the COVID-19 outbreak. These methods and accumulated experiences should be helpful for us to strengthen IPC for future epidemic.
Læs mere Tjek på PubMedBiao Yuan, Jonas Scholz, Jiri Wald, Roland Thuenauer, Rory Hennell James, Irina Ellenberg, Sabine Windhorst, Jan Faix, Thomas C. Marlovits
Science Advances, 8.12.2023
Tilføjet 8.12.2023
Tino Krell, Miguel A. Matilla
Trends in Microbiology, 8.12.2023
Tilføjet 8.12.2023
Pseudomonas aeruginosa is a ubiquitous Gram-negative bacterium that can be isolated from a wide range of environmental niches and hosts. This ecological success primarily lies in its metabolic versatility, adaptability to changing environments, and ability to survive in challenging habitats. P. aeruginosa infections are associated with high morbidity and mortality rates, being a pathogen of high clinical relevance mainly in immunocompromised patients or with chronic conditions (e.g., cystic fibrosis, cancer, acquired immunodeficiency syndrome, bronchiectasis, chronic wounds, chronic urinary tract infections).
Læs mere Tjek på PubMedBrooks, Hannah L.; Graves, Erin; De Schacht, Caroline; Emílio, Almiro; Matino, Ariano; Aboobacar, Arifo; Audet, Carolyn M.
Journal of Acquired Immune Deficiency Syndromes, 8.12.2023
Tilføjet 8.12.2023
Walle, A. D., Hunde, M. K., Demsash, A. W.
BMJ Open, 8.12.2023
Tilføjet 8.12.2023
ObjectiveTo assess healthcare providers’ intentions and the associated factors to use mobile phone-based short message service (SMS) to support adherence and care of tuberculosis (TB) patients in the Oromia region of southwest Ethiopia. Study designAn institutional-based cross-sectional study was conducted from October to November 2022. Study settingThe study was conducted in public hospitals which include Mettu Karl referral hospital, Dembi Hospital, Bedelle Hospital, Darimu Hospital and Chora Hospital in Ilu Aba Bor and Buno Bedelle zones. ParticipantsA total of 625 (54.9% male and 45.1% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All health professionals permanently working in Ilu Aba Bor and Buno Bedelle zone hospitals were included in this study. However, health professionals with less than 6 months of experience and those who were not present during the data collection period were excluded from this study. Outcome measureThe intention to use mobile phone-based SMS to support TB patients. ResultsHealthcare professionals’ intention to use mobile SMS was 54.4%. Effort expectancy had a significant direct effect on attitude (β=0.162, p
Læs mere Tjek på PubMedFortuna, D., Caselli, L., Berti, E., Moro, M. L.
BMJ Open, 8.12.2023
Tilføjet 8.12.2023
ObjectivesWe aimed to provide a region-wide comprehensive account of the indirect effects of COVID-19 on patients with chronic disease, in terms of non-COVID-19 mortality, and access to both inpatient and outpatient health services over a 2-year pandemic period. DesignPopulation-based retrospective study. SettingAdult patients, affected by at least 1 of 32 prevalent chronic conditions, residing in the Emilia-Romagna Region in Italy, during the years 2020 (N=1 791 189, 47.7% of the overall adult regional population) and 2021 (N=1 801 071, 47.8%). ResultsOverall, non-COVID-19 mortality among patients with chronic disease during the pandemic (2.7%) did not differ substantially from the expected mortality (2.5%), based on a 3 years prepandemic period (2017–2019) and adjusting for the demographic and clinical characteristics of the population under study. Indeed, while the first pandemic wave was characterised by a significant non-COVID-19 excess mortality (March: +35%), the subsequent phases did not show such disruptive variations in non-COVID-19 deaths, which remained around or even below the excess mortality threshold. End-of-life care of patients with chronic disease, especially for non-COVID-19 cases, significantly shifted from hospitalisations (–19%), to homecare (ADI: +7%; w/o ADI: +9%). Overall, healthcare of patients without COVID-19 chronic disease decreased, with similar negative trends in hospitalisations (–15.5%), major procedures (–19.6%) and ER accesses (–23.7%). Homecare was the least affected by the pandemic, with an overall reduction of –9.8%. COVID-19 outbreak also impacted on different types of outpatient care. Rehabilitation therapies, specialist visits, diagnostic and lab tests were considerably reduced during the first pandemic wave and consequent lockdown, with access rates of patients without COVID-19 chronic disease below –60%. ConclusionsThis work thoroughly describes how a large and well-defined population of patients without COVID-19 chronic disease has been affected by the changes and reorganisation in the healthcare system during 2 years of the pandemic, highlighting health priorities and challenges in chronic disease management under conditions of limited resources.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.12.2023
Tilføjet 8.12.2023
Abstract Background To ensure emergency infection prevention and control (IPC) can be fully supervised and monitored in coronavirus disease (COVID-19) epidemic period, a three-level inspector mechanism called "Internal self-check, Departmental cross-check, and Verification of outstanding key and difficult issues" was established in southwest China. The present study aimed to explore the effectiveness of inspector mechanism for the emergency IPC. Methods A self-control real-world study was conducted during COVID-19 epidemic period from 2020 to 2022. An innovative designed mobile phone application was used to realize paperless information transmission and data management. Data were compared between inspection levels using SPSS 19.0 software. Results A total of 2,800,132 supervision records were collected, including 149,137 comprehensive epidemic IPC projects, 1,410,093 personal protective equipment (PPE) use, 1,223,595 wearing and removing process of PPE and 17,307 ultraviolet light-detectable fluorescent (UV/F) surface marker. During the study period, the inspectors and subjects explored many optimized IPC measures. The compliance rate of check items has exceeded 98%, and internal self-check has a statistically significant higher rate than departmental cross-check (99.95% versus 98.74%, χ2 = 26111.479, P < 0.001). Compare with the failure rate in internal self check, the failure rate of PPE usage and wearing/removing process was statistically higher in departmental cross-check (χ2 = 1957.987, P < 0.001, χ2 = 465.610, P < 0.001, respectively). The overall clearance rate of UV/F surface markers is 87.88%, but there is no statistically significant difference over the three years of the present study (F = 2.902, P = 0.071). Conclusions Inspector mechanism for the emergency IPC completed an incredible inspection workload and offered creative assistance to combat the COVID-19 outbreak. These methods and accumulated experiences should be helpful for us to strengthen IPC for future epidemic.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 7.12.2023
Tilføjet 7.12.2023
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 109 Issue: 6 Pages: 1233-1237
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.12.2023
Tilføjet 7.12.2023
Abstract Background Amid the COVID-19 pandemic, extensive testing was undertaken by independent clinical laboratories (ICLs), yet limited research exists on this matter. Drawing from Green Cross Laboratories (GC Labs)\' pandemic response experience, this study seeks to offer insights for preparation for the next pandemic. Methods This retrospective study analyzed the outcomes of SARS-CoV-2 real-time reverse transcription polymerase chain reaction (SARS-CoV-2 rRT PCR) tests administered by GC Labs for COVID-19 diagnosis, upon request by different organizations, between February 2020 and April 2022. The distribution of institutions that requested the tests, the type of tests, and the positive rate were analyzed. We investigated resource allocation details. Results ICLs were responsible for conducting 85.6% of all tests carried out under South Korea’s COVID-19 testing policy during the pandemic. The availability of free testing regardless of symptoms led to a significant increase in the use of pooled tests, which accounted for more than 80% of all tests conducted after August 2021. The gender and age distribution of COVID-19 cases nationwide and GC Labs’ positive cases were similar. When we analyzed the positive rate by requesting organizations during the COVID-19 pandemic, despite an overall nationwide positivity rate of 35%, high-risk facilities exhibited a positivity rate of less than 5% by maintaining preemptive testing. The most notable increase in resources during the pandemic was seen in human resource input. Conclusions South Korea\'s ICLs were able to conduct large volumes of testing during the COVID-19 pandemic because of their logistics and computer systems, scalable testing space, and trained testing personnel. They also had the flexibility to bring in additional resources to expand testing capacity because they are specialized testing organizations. Hence, ICLs could execute the pooled test that the government had introduced for extensive general population screening. The preemptive periodic testing of high-risk populations kept the positive rate much lower than in the general population. This study\'s findings will aid in refining mass testing-based policies for the next pandemic.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.12.2023
Tilføjet 7.12.2023
Abstract Background Herpes zoster (HZ) is the clinical syndrome associated with reactivation of latent varicella-zoster virus (VZV). Several factors have been implicated to promote VZV reactivation; these include immunosuppression, older age, mechanical trauma, physiologic stress, lymphopenia, and more recently, infection with severe acute respiratory syndrome coronavirus-2 (SARS- CoV-2). Recent reports suggest an increase in the number of HZ cases in the general population during the global COVID-19 pandemic. However, it is unknown what proportion of HZ during the pandemic is due to reactivation of wild-type or vaccine-strain VZV. Case Here we report the first known case of HZ concomitant with SARS-CoV2 infection in a 20-month-old female who was treated with a single dose of dexamethasone, due to reactivation of the vaccine-type strain of VZV after presenting with a worsening vesicular rash. Conclusion In this case, we were able to show vaccine-strain VZV reactivation in the context of a mild acute symptomatic COVID-19 infection in a toddler. Being able to recognize HZ quickly and effectively in a pediatric patient can help stave off the significant morbidity and mortality associated with disease process.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.12.2023
Tilføjet 7.12.2023
Abstract Background Opioid use disorder (OUD) has been associated with adverse health outcomes, and its potential impact on COVID-19 outcomes is of significant concern. This study aimed to assess the susceptibility and clinical outcomes of hospitalized COVID-19 patients with OUD using a propensity score-matched design. Methods A historical cohort study was conducted in Alborz province, Iran, during the early months of the COVID-19 pandemic. Patients aged 18 years and above with confirmed COVID-19 were included in the study. OUD was defined as a compulsive urge to use opioids or opioid-derivative drugs. Non-opioid abusers with COVID-19 were selected as the control group. Data on demographics, clinical characteristics, laboratory factors, comorbidities, and vital signs were collected. Propensity score matching (PSM) was used to balance the groups and assess the impact of OUD on ICU admission, mortality, the need for intubation, and the severity of pulmonary involvement on CT scans. Results A total of 442 patients were included in the study, with 351 discharged and 34 deceased. The PSM analysis showed that OUD was not significantly associated with ICU admission (OR: 1.87, 95% CI: 0.22–2.91, p = 0.631). However, opium users had an increased risk of mortality (OR: 2.38, 95% CI: 1.30–4.35, p = 0.005) and a higher likelihood of requiring intubation (OR: 3.57, 95% CI: 1.38–9.39, p = 0.009) compared to non-opioid abusers. The severity of pulmonary involvement on CT scans did not show a significant association with OUD. Conclusion OUD among hospitalized COVID-19 patients was associated with an increased risk of mortality and the need for intubation. These findings highlight the importance of addressing OUD as a potential risk factor in the management and treatment of COVID-19 patients. Further research is warranted to explore the underlying mechanisms and develop appropriate interventions to mitigate the impact of OUD on COVID-19 outcomes.
Læs mere Tjek på PubMedSongting Zhang, Yichao Wu, Wen Bao
PLoS One Infectious Diseases, 6.12.2023
Tilføjet 6.12.2023
by Songting Zhang, Yichao Wu, Wen Bao The COVID-19 epidemic had an appropriate impact on tourists’ trip psychology and their subsequent behavior in participating in rural tourism activities. The purpose of this paper is to explore the types of motivations Chinese tourists have for participating in rural tourism in the context of COVID-19, and to comparatively analyze the similarities and differences in motivations for rural tourism during the epidemic and in normal times. An interpretive paradigm qualitative data collection method was used: semi-structured interviews and focus group discussions. Respondents were 21 tourists, who were selected through purposive and snowball sampling. Through content analysis, we found that rural tourism motivations during the epidemic included both diversified and singular motivations. The pull effect of rural destinations is related to distance and ease of realization. For rural areas in close proximity, a single motivation is sufficient to drive tourists. In addition, we found that there was no \'altruistic motivation\' for rural tourism during the COVID-19 period, but \'altruistic feelings\' for the preservation of ancient villages were generated during rural tourism. Finally, we discuss the theoretical and practical significance of this study and make suggestions for future research. The study explains tourists’ companionship preferences, activity choices, and affective changes, and provides a basis for the operation and advertising strategies of rural destinations to attract tourists and promote their sustainable development.
Læs mere Tjek på PubMedJournal of the American Medical Association, 6.12.2023
Tilføjet 6.12.2023
Bilateral renal agenesis is historically considered to be universally fatal, due to pulmonary hypoplasia resulting from failure to maintain adequate amniotic fluid from fetal urine production in the first half of pregnancy. This fundamental dictum from perinatal-neonatal medicine has been challenged by the RAFT trial in this issue of JAMA. The authors performed a multicenter nonrandomized clinical trial of pregnancies complicated by bilateral renal agenesis and anhydramnios due to fetal anuria to assess whether the infants of participants who agreed to serial amnioinfusions initiated prior to 26 weeks’ gestation to promote lung development would survive to 14 days of life or longer and receive placement of dialysis access. Even before the RAFT trial results were published, there was controversy about serial amnioinfusions for fetal bilateral renal agenesis. A key concern has been whether the goal for survival benefit is worth the risks (eg, complications associated with prematurity, dialysis, life-limiting kidney disease). In the RAFT trial, study participants were assessed, treated, delivered, and followed up at 1 of 9 US fetal therapy centers. Of the 18 participants who underwent serial amnioinfusions, all delivered preterm, and 82% of neonates met the primary outcome of survival to at least 14 days and receipt of access to dialysis. However, of the survivors, only 35% (n = 6) survived to discharge; 2 died after discharge of infectious complications and cardiac arrest, respectively, and 3 had a stroke. There were no surviving neonates among the 3 participants who selected expectant management. The authors conclude that they were able to mitigate pulmonary hypoplasia, but at what cost?
Læs mere Tjek på PubMedRamy E. El-Ansary, Samy Kasem, Mohamed A. M. El-Tabakh, Yassien Badr, Ahmed S. Abdel-Moneim
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Ramy E. El-Ansary, Samy Kasem, Mohamed A. M. El-Tabakh, Yassien Badr, Ahmed S. Abdel-Moneim Foot-and-mouth Disease (FMD) is a highly contagious viral disease affecting all hoof-cloven animals. Serotypes A, O and SAT 2 of the foot-and-mouth disease virus (FMDV) are circulating in Egypt. The present study aimed to identify and molecularly characterize the FMDV strains circulating in Northern Egypt during an epidemic that struck the nation in 2022. RNA was extracted from the epithelial specimens, vesicular fluid from affected cattle. The samples were screened using real-time reverse-transcription polymerase chain reaction (RT-PCR) targeting the RNA-dependent RNA polymerase (RdRp) gene. Positive samples underwent individual serotype-specific amplification using primers designed for VP1 of O, A, and SAT 2 serotypes. Subsequently, direct sequencing was performed on the positive samples. The real-time RT-PCR detected positive samples from epithelial and vesicular fluid samples, but not in the blood of infected animals. Out of the 16 samples, seven tested positive for FMDV serotype A. Of these seven positive samples, six were categorized as serotype A-African topotype-G-IV, and these positive samples were isolated in BHK-21 cells, yielding an overt cytopathic effect caused by the virus. In conclusion, it is necessary to sustain continuous surveillance of the evolution of circulating FMDV strains to facilitate the assessment and aid in the selection of vaccine strains for the effective control of FMDV in Egypt.
Læs mere Tjek på PubMedDesale Bihonegn Asmamaw, Yohannes Ayanaw Habitu, Eskedar Getie Mekonnen, Wubshet Debebe Negash
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Desale Bihonegn Asmamaw, Yohannes Ayanaw Habitu, Eskedar Getie Mekonnen, Wubshet Debebe Negash Background World Health Organization (WHO) recommends that every pregnant woman receive quality care throughout pregnancy, childbirth, and the postnatal period. It is estimated that institutional delivery could reduce 16% to 33% of maternal deaths. Despite the importance of giving birth at a health institution, in Ethiopia, according to the Ethiopian Demographic Health Survey report, nearly half of the ANC-booked mothers gave birth at home. Therefore, this study aimed to determine the prevalence and associated factors of home delivery among antenatal care-booked women in their last pregnancy during the era of COVID-19. Methods A community-based cross-sectional study was conducted from March 30 to April 29, 2021. A simple random technique was employed to select 770 participants among women booked for antenatal care. Interviewer-administered questionnaires were used to collect the data. A binary logistic regression model was fitted. Adjusted odds ratios with its respective 95% confidence interval were used to declare the associated factors. Results The prevalence of home delivery was 28.8% (95% CI: 25.7, 32.2). Rural residence (AOR = 2.02, 95% CI: 1.23, 3.34), unmarried women (AOR = 11.16, 95% CI: 4.18, 29.79), husband education (AOR = 2.60, 95% CI: 1.72, 3.91), not being involved in the women’s development army (AOR = 1.64, 95% CI: 1.01, 2.65), and fear of COVID-19 infection (AOR = 3.86, 95% CI: 2.31, 6.44) were significantly associated factors of home delivery. Conclusion Even though the government tried to lower the rate of home delivery by accessing health institutions in remote areas, implementing a women’s development army, and introducing maternal waiting home utilization, nearly one in every three pregnant women gave birth at home among ANC booked women in their last pregnancy. Thus, improving the husband’s educational status, providing information related to health institution delivery benefits during antenatal care, and strengthening the implementation of the women’s development army, particularly among rural and unmarried women, would decrease home childbirth practices.
Læs mere Tjek på PubMedAna Rubio-Garcia, Aldert L. Zomer, Ruoshui Guo, John W. A. Rossen, Jan H. van Zeijl, Jaap A. Wagenaar, Roosmarijn E. C. Luiken
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Ana Rubio-Garcia, Aldert L. Zomer, Ruoshui Guo, John W. A. Rossen, Jan H. van Zeijl, Jaap A. Wagenaar, Roosmarijn E. C. Luiken Animal rehabilitation centres provide a unique opportunity to study the microbiome of wild animals because subjects will be handled for their treatment and can therefore be sampled longitudinally. However, rehabilitation may have unintended consequences on the animals’ microbiome because of a less varied and suboptimal diet, possible medical treatment and exposure to a different environment and human handlers. Our study describes the gut microbiome of two large seal cohorts, 50 pups (0–30 days old at arrival) and 23 weaners (more than 60 days old at arrival) of stranded harbour seals admitted for rehabilitation at the Sealcentre Pieterburen in the Netherlands, and the effect of rehabilitation on it. Faecal samples were collected from all seals at arrival, two times during rehabilitation and before release. Only seals that did not receive antimicrobial treatment were included in the study. The average time in rehabilitation was 95 days for the pups and 63 days for the weaners. We observed that during rehabilitation, there was an increase in the relative abundance of some of the Campylobacterota spp and Actinobacteriota spp. The alpha diversity of the pups’ microbiome increased significantly during their rehabilitation (p-value
Læs mere Tjek på PubMedBagdat Tekkus, Fatma Mutluay
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Bagdat Tekkus, Fatma Mutluay Objective This study investigates the impact of community-based exercises with action observation therapy (AOT) on the physical and cognitive performance of older adults experiencing social isolation during the COVID-19 pandemic. Methods One hundred participants aged 65–80 years were randomly divided into two groups: the AOT group, which engaged in balance, strengthening, and mobility exercises guided by 15-minute action observation videos before a 45-minute exercise session, and the control group, which performed the same exercises without action observation. Both groups underwent three sessions per week for eight weeks (24 sessions in total). The assessment tools used in this study included the following: For evaluating mobility and fall risk in older adults, the Timed Up-and-Go (TUG) Test was employed. To assess functional strength of lower extremities, balance, and fall risk, the Five Times Sit-to-Stand (5XSST) Test was administered. Balance and gait were measured using the Tinetti Balance and Gait Assessment (TBGA), utilizing the Tinetti Scale. Individuals’ confidence in performing daily activities without falling or losing balance was assessed using the Activities-Specific Balance Confidence Scale (ABC). Furthermore, cognitive functions across multiple domains, including attention-concentration, executive function, memory, language, visual construction skills, abstract thinking, calculation, and orientation, were evaluated using the Montreal Cognitive Assessment (MoCA) Tests. Results Results revealed significant improvements in both groups. Group I, which received Action Observation Therapy (AOT) in addition to exercise, demonstrated superior outcomes in the 5XSit-to-Stand test (Δ = -1.92, p < 0.0001, Cohen’s d = 0.77), Tinetti Balance and Gait Scale (Balance: Δ = 2.77, p < 0.0001, Cohen’s d = 0.91), and Timed Up and Go test (Δ = -1.98, p < 0.0005, Cohen’s d = 0.83). On the other hand, Group II, which received exercise only, exhibited substantial gains in the Tinetti Balance and Gait Scale (Walking: Δ = 0.52, p < 0.01, Cohen’s d = 0.27) and Activity-Specific Balance Confidence Scale (Δ = 5.77, p < 0.0001, Cohen’s d = 0.26). Conclusion These findings underscore the effectiveness of AOT-enhanced community-based exercises in enhancing both physical and cognitive performance among older adults facing social isolation during the pandemic, with Group I (AOT + exercise) showing particularly promising results. Trial registration This study was registered with ClinicalTrials.gov Identifier: NCT04759690, ClinicalTrials Protocol ID: p3957ghb.
Læs mere Tjek på PubMedSoeurette Policar, Alana Sharp, Joanne Isidor Hyppolite, Gérald Marie Alfred, Eva Steide, Leïnadine Lucien, Naiké Ledan, Matthew Kavanagh
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Soeurette Policar, Alana Sharp, Joanne Isidor Hyppolite, Gérald Marie Alfred, Eva Steide, Leïnadine Lucien, Naiké Ledan, Matthew Kavanagh Background Failure to retain people living with HIV (PLHIV) in care remains a significant barrier to achieving epidemic control in Haiti, with as many as 30% lost from care within one year of starting treatment. Community-led monitoring (CLM) is an emerging approach of improving healthcare and accountability to service users, through a cycle of monitoring and advocacy. In 2020, a CLM program was launched in Haiti to identify barriers to retention and advocating for better health services. Methods Data from the community-led monitoring program in Haiti were analyzed, from a sample of 65 healthcare facilities in the Nord, Artibonite, and Ouest departments collected from April 2021 to February 2022. Qualitative data from six community-based focus groups and 45 semi-structured individual interviews were analyzed. Results Confidentiality and stigmatization emerged as barriers to care, particularly due to the separation of PLHIV from other patients in view of community members. To avoid identification, patients described traveling long distances, with the reimbursement of transportation costs described as being insufficient or unavailable. Costs of non-HIV clinical services were a frequent concern and respondents described a need for clinics to provide food during all patient visits. Stock-outs were a regular challenge; by contrast, treatment literacy did not emerge as a major barrier to retention. Conclusions These findings represent the first instance, to our knowledge, of original data from a community-led monitoring program being published in any country. These findings suggest that improving treatment retention for PLHIV is dependent on improving the acceptability and affordability of healthcare services. Ensuring confidentiality is critical, particularly where stigma is high. Retention could be improved by systematically strengthening patient confidentiality protections throughout the healthcare system, providing patients with sufficient travel compensation and other incentives, and delivering wraparound services provided for free. Addressing these challenges will require ongoing advocacy for community-developed recommendations and solutions.
Læs mere Tjek på PubMedBingyu Zhang, Ruiling Zhang, Hongdu Deng, Ping Cui, Chunyan Li, Fan Yang, Mohammad Farris Iman Leong Bin Abdullah
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Bingyu Zhang, Ruiling Zhang, Hongdu Deng, Ping Cui, Chunyan Li, Fan Yang, Mohammad Farris Iman Leong Bin Abdullah Background and aim Primarily, this study compares the efficacy of probiotic and acceptance and commitment therapy (ACT) in alleviating the severity of alcohol craving and alcohol use disorder (AUD) among patients who had undergo two weeks of in-patient detoxification. Secondarily, this study compares the efficacy of probiotic and ACT in mitigating the severity of comorbid depression and anxiety symptoms; decreasing serum level of pro-inflammatory cytokines, such as interleukin 1β (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α); changing the event-related potential in electroencephalogram (EEG) and restoring microbiota flora in the gut of AUD patients. Methods and analysis Initially, during Phase I of the study, the serum level of IL-1β, IL-6 and TNF-α; ERP changes in the EEG and fecal microbiota content will be compared between 120 AUD patients and 120 healthy controls. Subsequently in Phase II of the study, 120 AUD patients will be randomized by stratified permuted block randomization into the probiotic, ACT and placebo groups in a 1:1:1 ratio. Participants in the probiotic and placebo groups will be administered one sachet per day of Lactobacillus spp. probiotic and placebo, respectively for 12 weeks. While those in the ACT group will receive one session per week of ACT for 8 weeks. Outcome measures will be administered at four timepoints, such as t0 = baseline assessment prior to intervention, t1 = 8 weeks after intervention began, t2 = 12 weeks after intervention and t3 = 24 weeks after intervention. Primary outcomes are the degrees of alcohol craving, alcohol withdrawal during abstinence and AUD. Secondary outcomes to be assessed are the severity of co-morbid depression and anxiety symptoms; the serum levels of IL-1β, IL-6 and TNF-α; changes in ERP and fecal microbiota content. Trial registration number NCT05830708 (ClinicalTrials.gov). Registered on April 25, 2023.
Læs mere Tjek på PubMedYuntao Bai, Lan Wang, Shuang Xu
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Yuntao Bai, Lan Wang, Shuang Xu In 2020, COVID-19 became a global pandemic. Older people are less resistant to the novel coronavirus. In order to ensure the health of the elderly population, the governments of five Central Asian countries should provide home medical services for the elderly or provide \'green channel\' to medical services. This \'green channel\' means providing a special service and treatment for the elderly in the hospital to ensure that they can safely and easily access the medical services they need. In order to study the application scope of various modes, this article constructs three modes of differential game: no special care, home medical care and \'green channel\'. And the equilibrium results are compared and analyzed. Research shows that when the additional medical costs associated with house calls or \'green channel\' gradually increase, the social benefits to both the elderly and the government gradually decrease, and eventually it is less than the social benefits under the no-special care model. The greater the credibility of the government under the \'green channel\' service model, the greater the social benefits of the government. However, the greater the credibility of the government under the home medical service model, the smaller the social benefits of the government.
Læs mere Tjek på PubMedGabriel Morey-León, Paulina M. Mejía-Ponce, Juan Carlos Granda Pardo, Karen Muñoz-Mawyin, Juan Carlos Fernández-Cadena, Evelyn García-Moreira, Derly Andrade-Molina, Cuauhtémoc Licona-Cassani, Luisa Berná
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Gabriel Morey-León, Paulina M. Mejía-Ponce, Juan Carlos Granda Pardo, Karen Muñoz-Mawyin, Juan Carlos Fernández-Cadena, Evelyn García-Moreira, Derly Andrade-Molina, Cuauhtémoc Licona-Cassani, Luisa Berná Introduction Tuberculosis (TB) is among the deadliest diseases worldwide, and its impact is mainly due to the continuous emergence of resistant isolates during treatment due to the laborious process of resistance diagnosis, nonadherence to treatment and circulation of previously resistant isolates of Mycobacterium tuberculosis. In this study, we evaluated the performance and functionalities of web-based tools, including Mykrobe, TB-profiler, PhyResSE, KvarQ, and SAM-TB, for detecting resistance in 88 Ecuadorian isolates of Mycobacterium tuberculosis drug susceptibility tested previously. Statistical analysis was used to determine the correlation between genomic and phenotypic analysis. Our results showed that with the exception of KvarQ, all tools had the highest correlation with the conventional drug susceptibility test (DST) for global resistance detection (98% agreement and 0.941 Cohen’s kappa), while SAM-TB, PhyResSE, TB-profiler and Mykrobe had better correlations with DST for first-line drug analysis individually. We also identified that in our study, only 50% of mutations characterized by the web-based tools in the rpoB, katG, embB, pncA, gyrA and rrs regions were canonical and included in the World Health Organization (WHO) catalogue. Our findings suggest that SAM-TB, PhyResSE, TB-profiler and Mykrobe were efficient in determining canonical resistance-related mutations, but more analysis is needed to improve second-line detection. Improving surveillance programs using whole-genome sequencing tools for first-line drugs, MDR-TB and XDR-TB is essential to understand the molecular epidemiology of TB in Ecuador. Importance Tuberculosis, an infectious disease caused by Mycobacterium tuberculosis, most commonly affects the lungs and is often spread through the air when infected people cough, sneeze, or spit. However, despite the existence of effective drug treatment, patient adherence, long duration of treatment, and late diagnosis have reduced the effectiveness of therapy and increased drug resistance. The increase in resistant cases, added to the impact of the COVID-19 pandemic, has highlighted the importance of implementing efficient and timely diagnostic methodologies worldwide. The significance of our research is in evaluating and identifying a more efficient and user-friendly web-based tool to characterize resistance in Mycobacterium tuberculosis by whole-genome sequencing, which will allow more routine application to improve TB strain surveillance programs locally.
Læs mere Tjek på PubMedMalaria Journal, 5.12.2023
Tilføjet 5.12.2023
Abstract Background Children in sub-Saharan Africa (SSA) remain the most vulnerable to malaria and malaria mortality. This study estimated the disease burden and distribution of Plasmodium falciparum malaria among children with age categories (0 to
Læs mere Tjek på PubMedCarolina A.D. Santos, Artemis P. Paula, Gentil G. Fonseca Filho, Manoella M. Alves, Andréia F. Nery, Monise G.A. Pontes, Erianna Y.L. Macedo, Ruy M. Oliveira Jr, Sabrinna M. Freitas, Sarah Lima, Fernanda V.C. Varela, Andrezza L.S. Viana, Aline L.P. Silva, Érika G.C. Silva, Lília D'Souza-Li
International Journal of Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
SARS-CoV-2 has infected over 620 million people and killed more than 6 million worldwide. [1] Since the beginning of the pandemic, Brazil has reported a disproportionately large number of infections and deaths of pregnant women attributed to COVID-19, [2] arguably caused by the disastrous response to the pandemic in its early months, with national policies contrary to scientific recommendations and against international infectious disease societies guidelines. [3]
Læs mere Tjek på PubMedDi HanYulan JiSaixue YangPei SongYihong ShiDongyan ShaoXianqing ChenLi ShangJunling ShiChunmei Jiang1School of Life Sciences, Northwestern Polytechnical University, Xi’an, Shaanxi Province, China2School of Medicine, Xi’an International University, Xi’an, China3State Key Laboratory of Solidification Processing, Center for Nano Energy Materials, School of Materials Science and Engineering, Northwestern Polytechnical University, Xi’an, Shaanxi Province, China, Damian J. Krysan
Antimicrobial Agents And Chemotherapy, 5.12.2023
Tilføjet 5.12.2023
BMC Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
Abstract Background Opioid use disorder (OUD) has been associated with adverse health outcomes, and its potential impact on COVID-19 outcomes is of significant concern. This study aimed to assess the susceptibility and clinical outcomes of hospitalized COVID-19 patients with OUD using a propensity score-matched design. Methods A historical cohort study was conducted in Alborz province, Iran, during the early months of the COVID-19 pandemic. Patients aged 18 years and above with confirmed COVID-19 were included in the study. OUD was defined as a compulsive urge to use opioids or opioid-derivative drugs. Non-opioid abusers with COVID-19 were selected as the control group. Data on demographics, clinical characteristics, laboratory factors, comorbidities, and vital signs were collected. Propensity score matching (PSM) was used to balance the groups and assess the impact of OUD on ICU admission, mortality, the need for intubation, and the severity of pulmonary involvement on CT scans. Results A total of 442 patients were included in the study, with 351 discharged and 34 deceased. The PSM analysis showed that OUD was not significantly associated with ICU admission (OR: 1.87, 95% CI: 0.22–2.91, p = 0.631). However, opium users had an increased risk of mortality (OR: 2.38, 95% CI: 1.30–4.35, p = 0.005) and a higher likelihood of requiring intubation (OR: 3.57, 95% CI: 1.38–9.39, p = 0.009) compared to non-opioid abusers. The severity of pulmonary involvement on CT scans did not show a significant association with OUD. Conclusion OUD among hospitalized COVID-19 patients was associated with an increased risk of mortality and the need for intubation. These findings highlight the importance of addressing OUD as a potential risk factor in the management and treatment of COVID-19 patients. Further research is warranted to explore the underlying mechanisms and develop appropriate interventions to mitigate the impact of OUD on COVID-19 outcomes.
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
AbstractBackgroundMetallo-β-lactamases (MBL)-producing Enterobacterales are increasing worldwide. Our aim was to describe clinical features, treatments and outcomes of infections by MBL-Enterobacterales.MethodsProspective observational study conducted in the Pisa University Hospital (Jan 2019-Oct 2022) including patients with MBL-producing Enterobacterales infections. The primary outcome measure was 30-day mortality. A multivariable Cox regression analysis was performed to identify factors associated with 30-day mortality. Adjusted hazard ratio (aHR) (95% confidence intervals, CI) were calculated.Results343 patients were included: 15 VIM- and 328 NDM-producing Enterobacterales infections. Overall, 199 (58%) were bloodstream infections, 60 (17.5%) hospital-acquired/ventilator-associated pneumonias, 60 (17.5%) complicated urinary tract infections, 13 (3.8%) intra-abdominal infections, 11 (3.2%) skin and soft tissue infections. Thirty-day mortality was 29.7%. Thirty-two patients did not receive in vitro active antibiotic therapy, 215/343 (62.7%) received ceftazidime-avibactam (CZA) plus aztreonam (ATM), 33/343 (9.6%) cefiderocol-containing regimens, 26/343 (7.6%) colistin-containing regimens and 37 (10.8%) other active antibiotics. On multivariable analysis, septic shock (aHR 3.57, 95% CI 2.05-6.23, p
Læs mere Tjek på PubMedClinical Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
AbstractBackgroundNeutropenia may limit use of valganciclovir treatment for cytomegalovirus (CMV) infection following hematopoietic cell transplant (HCT). A phase 2 study indicated efficacy of maribavir with fewer treatment-limiting toxicities than valganciclovir.MethodsIn this multicenter, double-blind, phase 3 study, patients with first asymptomatic CMV infection post-HCT were stratified and randomized 1:1 to maribavir 400 mg twice daily or valganciclovir (dose-adjusted for renal clearance) for 8 weeks with 12 weeks follow-up. Primary endpoint was confirmed CMV viremia clearance at week 8 (primary hypothesis of non-inferiority margin of 7.0%). Key secondary endpoint was a composite of the primary endpoint with no findings of CMV tissue-invasive disease at week 8, through week 16. Treatment-emergent adverse events (TEAEs) were assessed.ResultsAmong patients treated (273 maribavir; 274 valganciclovir), the primary endpoint of non-inferiority of maribavir was not met (maribavir, 69.6%; valganciclovir, 77.4%; adjusted difference [95% confidence interval (CI)]: −7.7% [−14.98, −0.36]; lower limit of 95% CI of treatment difference exceeded −7.0%). At week 16, 52.7% and 48.5% of patients treated (maribavir and valganciclovir, respectively) maintained CMV viremia clearance without tissue-invasive disease (adjusted difference [95% CI]: 4.4% [−3.91, 12.76]). With maribavir (versus valganciclovir), fewer patients experienced neutropenia (16.1% and 52.9%) or discontinued due to TEAEs (27.8% and 41.2%). Discontinuations were mostly due to neutropenia (maribavir, 4.0%; valganciclovir, 17.5%).ConclusionsAlthough non-inferiority of maribavir to valganciclovir for the primary endpoint was not achieved based on the prespecified non-inferiority margin, maribavir demonstrated comparable CMV viremia clearance during post-treatment follow-up, with fewer discontinuations due to neutropenia.Clinical trials registrationNCT02927067 [AURORA]
Læs mere Tjek på PubMedGeorgia Bisbas
Lancet Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
“History has the power to shape not only what we remember, but what we forget.” In the final paragraph of the introduction to In Her Hands, Women\'s Fight Against AIDS in the United States, historian Emma Day perfectly sums up the message behind her book. Day seeks to readdress the narrative around women\'s fight against HIV/AIDS and the political systems that overlooked, mistreated, and maligned them during the 1980s epidemic of the disease. It is her intention to ensure that we remember the struggles that women faced with accuracy and in their entirety, as no one subgroup of sufferers should take precedence in the history books when we recall the scale and severity of this disease.
Læs mere Tjek på PubMedTomoko Fujitani, Mariko Harada Sassa, Zhaoqing Lyu, Yukiko Fujii, Kouji H. Harada
PLoS One Infectious Diseases, 5.12.2023
Tilføjet 5.12.2023
by Tomoko Fujitani, Mariko Harada Sassa, Zhaoqing Lyu, Yukiko Fujii, Kouji H. Harada Lignan polyphenols derived from plants are metabolized by bacteria in the gut to mammalian lignans, such as enterolactone (ENL) and enterodiol (END). Mammalian lignan intake has been reported to be associated with obesity and low blood glucose levels. However, the factors that are responsible for individual differences in the metabolic capacity for ENL and END are not well understood. In the present study, the effects of enterotypes of isoflavone metabolism, equol producers (EQP) and O-desmethylangolensin producers (O-DMAP), on lignan metabolism were examined. EQP was defined by urinary daidzein (DAI) and equol concentrations as log(equol/DAI) ≥ –1.42. O-DMAP was defined by urinary DAI and O-DMA concentrations as O-DMA/DAI > 0.018. Isoflavone and lignan concentrations in urine samples from 440 Japanese women were measured by gas chromatography-mass spectrometry. Metabolic enterotypes were determined from the urinary equol and O-DMA concentrations. Urinary END and ENL concentrations were compared in four groups, combinations of EQP (+/–) and O-DMAP (+/–). The urinary lignan concentration was significantly higher in the O-DMAP/EQP group (ENL: P
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundAntimalarial drug resistance surveillance and containment are crucial for countries aiming to eliminate malaria. Monitoring resistance evolution through studies before and after treatment policy changes is crucial.MethodA total of 939 P. falciparum-positive blood samples were collected between 2014 and 2015 across ten sites in India, categorized into four geographic clusters. PCR-amplified products were sequenced to identify point mutations at drug-resistance-conferring genes (Pfdhfr, Pfdhps, Pfmdr1, Pfk13).ResultTriple Pfdhfr mutants were found only in northeast India bordering Myanmar, while the wildtype was dominant in central India. Pfdhps wildtypes were prevalent in all areas, and no double mutants were found. Except in Northwest India, Pfmdr1 wildtype was dominant in all clusters. Nonsynonymous double mutations were only found in northwest India. Only synonymous mutations occurred in Pfk13. These were found in Central India at low frequency. The pattern of linkage disequilibrium and principal component analysis reflects low pressure for drug resistance and heterogeneity between the geographic clusters.ConclusionResistance levels were highest in Northeast India, close to the Myanmar border, where resistance is common. Primaquine has been widely used as a gametocidal and schizonticidal drug, has likely contributed to maintaining low drug resistance levels and preventing strong selection for resistance.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundThe 2022-2023 United States influenza season had unusually early influenza activity with high hospitalization rates. Vaccine-matched A(H3N2) viruses predominated, with lower levels of A(H1N1)pdm09 activity also observed.MethodsUsing the test-negative design, we evaluated influenza vaccine effectiveness (VE) during the 2022-2023 season against influenza-A-associated emergency department/urgent care (ED/UC) visits and hospitalizations from October 2022-March 2023 among adults (age ≥18 years) with acute respiratory illness (ARI). VE was estimated by comparing odds of seasonal influenza vaccination among case-patients (influenza A test-positive by molecular assay) and controls (influenza test-negative), applying inverse-propensity-to-be-vaccinated weights.ResultsThe analysis included 85,389 ED/UC ARI encounters (17.0% influenza-A-positive; 37.8% vaccinated overall) and 19,751 hospitalizations (9.5% influenza-A-positive; 52.8% vaccinated overall). VE against influenza-A-associated ED/UC encounters was 44% (95% confidence interval [95%CI]: 40-47%) overall and 45% and 41% among adults aged 18-64 and ≥65 years, respectively. VE against influenza-A-associated hospitalizations was 35% (95%CI: 27-43%) overall and 23% and 41% among adults aged 18-64 and ≥65 years, respectively.ConclusionsVE was moderate during the 2022-2023 influenza season, a season characterized with increased burden of influenza and co-circulation with other respiratory viruses. Vaccination is likely to substantially reduce morbidity, mortality, and strain on healthcare resources.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundParasitic infections challenge vertebrate health worldwide, and off-target effects of antiparasitic treatments may be an additional obstacle to recovery. However, there have been few investigations of the effects of antiparasitics on the gut microbiome in the absence of parasites.MethodsWe investigated whether two common antiparasitics—albendazole and metronidazole—significantly alter the gut microbiome of parasite-free mice. We treated mice with albendazole or metronidazole daily for seven days and sampled the fecal microbiota immediately before and after treatment, and again after a two-week recovery period.ResultsAlbendazole did not immediately change the gut microbiota, while metronidazole decreased microbial richness by 8.5% and significantly changed community structure during treatment. The structural changes caused by metronidazole included depletion of the beneficial family Lachnospiraceae, and predictive metagenomic analysis revealed that these losses likely depressed microbiome metabolic function. Separately, we compared the fecal microbiotas of treatment groups after recovery, and there were minor differences in community structure between the albendazole, metronidazole, and sham-treated control groups.ConclusionsThese results suggest that a healthy microbiome is resilient after metronidazole-induced depletions of beneficial gut microbes and albendazole may cause slight, latent shifts in the microbiota but does not deplete healthy gut microbiota diversity.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundThe key correlate of protection of respiratory syncytial virus (RSV) vaccines and monoclonal antibodies (mAb) is virus neutralization, measured using sera obtained through venipuncture. Dried blood obtained with a finger prick can simplify acquisition, processing, storage, and transport in trials, and thereby reduce costs. In this study we validate an assay to measure RSV neutralization in dried capillary blood.MethodsFunctional antibodies were compared between matched serum and dried blood samples from a phase I trial with RSM01, an investigational anti-RSV Prefusion F mAb. Hep-2 cells were infected with a serial dilution of sample-virus mixture using RSV-A2-mKate to determine half-maximal inhibitory concentration. Stability of dried blood was evaluated over time and during temperature stress.ResultsFunctional antibodies in dried blood were highly correlated with serum (R2 = 0.98, p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 4.12.2023
Tilføjet 4.12.2023
AbstractBackgroundChronic inflammation persists in some people living with HIV (PLWH) during antiretroviral therapy and is associated with premature aging. The gp120 subunit of HIV-1 envelope sheds and can be detected in plasma, showing immunomodulatory properties even in the absence of detectable viremia. We evaluated whether plasmatic soluble gp120 (sgp120) and a family of gp120-specific anti-cluster A antibodies, linked to CD4 depletion in vitro, contribute to chronic inflammation, immune dysfunction, and sub-clinical cardiovascular disease in participants of the Canadian HIV and Aging cohort (CHACS) with undetectable viremia.MethodsCross-sectional assessment of sgp120 and anti-cluster A antibodies was performed in 386 individuals from CHACS. Their association with pro-inflammatory cytokines and subclinical coronary artery disease was assessed using linear regression models.ResultsHigh levels of sgp120 and anti-cluster A antibodies inversely correlated with CD4 count and CD4:CD8 ratio. The presence of sgp120 was associated with increased levels of IL-6. In participants with detectable atherosclerotic plaque and detectable sgp120, anti-cluster A antibodies and their combination with sgp120 levels correlated positively with the total volume of atherosclerotic plaques.Conclusionssgp120 may act as a pan toxin causing immune dysfunction and sustained inflammation in a subset of PLWH, contributing to the development of premature comorbidities.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract Background Protection against SARS-CoV-2 is mediated by humoral and T cell responses. Pakistan faced relatively low morbidity and mortality from COVID-19 through the pandemic. To examine the role of prior immunity in the population, we studied IgG antibody response levels, virus neutralizing activity and T cell reactivity to Spike protein in a healthy control group (HG) as compared with COVID-19 cases and individuals from the pre-pandemic period (PP). Methods HG and COVID-19 participants were recruited between October 2020 and May 2021. Pre-pandemic sera was collected before 2018. IgG antibodies against Spike and its Receptor Binding Domain (RBD) were determined by ELISA. Virus neutralization activity was determined using a PCR-based micro-neutralization assay. T cell – IFN-γ activation was assessed by ELISpot. Results Overall, the magnitude of anti-Spike IgG antibody levels as well as seropositivity was greatest in COVID-19 cases (90%) as compared with HG (39.8%) and PP (12.2%). During the study period, Pakistan experienced three COVID-19 waves. We observed that IgG seropositivity to Spike in HG increased from 10.3 to 83.5% during the study, whilst seropositivity to RBD increased from 7.5 to 33.3%. IgG antibodies to Spike and RBD were correlated positively in all three study groups. Virus neutralizing activity was identified in sera of COVID-19, HG and PP. Spike reactive T cells were present in COVID-19, HG and PP groups. Individuals with reactive T cells included those with and without IgG antibodies to Spike. Conclusions Antibody and T cell responses to Spike protein in individuals from the pre-pandemic period suggest prior immunity against SARS-CoV-2, most likely from cross-reactive responses. The rising seroprevalence observed in healthy individuals through the pandemic without known COVID-19 may be due to the activation of adaptive immunity from cross-reactive memory B and T cells. This may explain the more favourable COVID-19 outcomes observed in this population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract Respiratory syncytial virus (RSV) is the most common pathogen associated with acute lower respiratory tract infections in infants and young children worldwide. RSV commonly presents as bronchiolitis in young children; however, it can sometimes progress to pneumonia, respiratory failure, apnoea and even death. Although mucin1 (MUC1), a type of transmembrane glycoprotein present on airway epithelial surfaces, plays a crucial anti-inflammatory role in airway infections; however, its roles in RSV-associated acute lower respiratory tract infections have rarely been explored. In this study, we first revealed very high MUC1 protein levels in the exacerbation phase in sputum samples from children with RSV bronchiolitis. Because MUC1 is the downstream target of tumour necrosis factor-alpha (TNF-α) in RSV-infected A549 cells, we observed the inhibition of NF-κB activity, main downstream signalling of TNF-α and remarkably reduced levels of MUC1 in RSV-infected and TNF-α treated A549 cells. Furthermore, the cyclic adenosine monophosphate (cAMP) analogue (dbcAMP) downregulated the protein levels of p-IκBα and MUC1 in TNF-α-treated A549 cells. By contrast, a protein kinase A inhibitor (KT5720) up-regulated the levels of those proteins. dbcAMP and KT5720 had the same effects on MUC1 protein levels in RSV-infected A549 cells. In conclusion, we found that the cAMP-PKA-NF-κB pathway may play a role in the regulation of MUC-1 over-expression during RSV infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract Background Whether different anti-hepatitis B virus (HBV) drugs have different effects on COVID-19 is controversial. We aimed to evaluate the incidence of COVID-19 in chronic hepatitis B (CHB) patients receiving anti-HBV treatment, and to compare the impact of entecavir (ETV) and tenofovir disoproxil fumarate (TDF) on the severity of COVID-19. Methods CHB outpatients were enrolled from December 2022 to February 2023. Questionnaires were used to collect whether subjects were currently or previously had COVID-19 within the past 2 months, and the information of symptoms, duration, and severity if infected. Results Six hundred thirty CHB patients were enrolled, 64.3% (405/630) patients were currently or previously had COVID-19. No COVID-19 patient required hospitalization, intensive care unit admission, oxygen support or died. Majority of patients reported mild (32.8% [133/405]) and moderate (48.1% [195/405]) symptoms. After propensity score matching, 400 matched patients were obtained (ETV: 238; TDF: 162), among which the incidences of COVID-19 were comparable between ETV and TDF-treated patients (60.1% [143/238] vs. 64.2% [104/162], p = 0.468). The proportion of patients complicated with any symptom caused by COVID-19 were also similar (ETV vs. TDF: 90.9% [130/143] vs. 91.3% [95/104], p = 1.000). In addition, the severity of overall symptom was comparable between ETV and TDF-treated patients, in terms of proportion of patients complicated with severe symptom (9.8% vs. 8.7%, p = 0.989), symptom duration (4.3 vs. 4.3 days, p = 0.927), and symptom severity score (4.1 vs. 4.0, p = 0.758). Subgroup analysis supported these results. Conclusions During the current pandemic, the vast majority of CHB patients experienced non-severe COVID-19, and ETV and TDF did not affect COVID-19 severity differently.
Læs mere Tjek på PubMedBMC Infectious Diseases, 3.12.2023
Tilføjet 3.12.2023
Abstract Background Considering the fact that COVID-19 has undergone various changes over time, its symptoms have also varied. The aim of this study is to describe and compare the changes in personal characteristics, symptoms, and underlying conditions of individuals infected with different strains of COVID-19. Methods This descriptive-analytical study was conducted on 46,747 patients who underwent PCR testing during a two-year period from February 22, 2020 to February 23, 2022, in South Khorasan province, Iran. Patient characteristics and symptoms were extracted based on self-report and the information system. The data were analyzed using logistic regression and artificial neural network approaches. The R software was used for analysis and a significance level of 0.05 was considered for the tests. Results Among the 46,747 cases analyzed, 23,239 (49.7%) were male, and the mean age was 51.48 ± 21.41 years. There was a significant difference in symptoms among different variants of the disease (p
Læs mere Tjek på PubMedBennet S. Cho, Scott C. Fligor, Gillian L. Fell, Jordan D. Secor, Savas T. Tsikis, Amy Pan, Lumeng J. Yu, Victoria H. Ko, Duy T. Dao, Lorenzo Anez-Bustillos, Thomas I. Hirsch, Jenny Lund, Arild C. Rustan, David A. Fraser, Kathleen M. Gura, Mark Puder
PLoS One Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
by Bennet S. Cho, Scott C. Fligor, Gillian L. Fell, Jordan D. Secor, Savas T. Tsikis, Amy Pan, Lumeng J. Yu, Victoria H. Ko, Duy T. Dao, Lorenzo Anez-Bustillos, Thomas I. Hirsch, Jenny Lund, Arild C. Rustan, David A. Fraser, Kathleen M. Gura, Mark Puder Background Parenteral (intravenous) nutrition is lifesaving for patients with intestinal failure, but long-term use of parenteral nutrition often leads to liver disease. SEFA-6179 is a synthetic medium-chain fatty acid analogue designed to target multiple fatty acid receptors regulating metabolic and inflammatory pathways. We hypothesized that SEFA-6179 would prevent hepatosteatosis and lipotoxicity in a murine model of parenteral nutrition-induced hepatosteatosis. Methods Two in vivo experiments were conducted. In the first experiment, six-week-old male mice were provided an ad lib fat-free high carbohydrate diet (HCD) for 19 days with orogastric gavage of either fish oil, medium-chain triglycerides, or SEFA-6179 at a low (0.3mmol/kg) or high dose (0.6mmol/kg). In the second experiment, six-week-old mice were provided an ad lib fat-free high carbohydrate diet for 19 days with every other day tail vein injection of saline, soybean oil lipid emulsion, or fish oil lipid emulsion. Mice then received every other day orogastric gavage of medium-chain triglyceride vehicle or SEFA-6179 (0.6mmol/kg). Hepatosteatosis was assessed by a blinded pathologist using an established rodent steatosis score. Hepatic lipid metabolites were assessed using ultra-high-performance liquid chromatography-mass spectrometry. Effects of SEFA-6179 on fatty acid oxidation, lipogenesis, and fatty acid uptake in human liver cells were assessed in vitro. Results In the first experiment, mice receiving the HCD with either saline or medium-chain triglyceride treatment developed macrovesicular steatosis, while mice receiving fish oil or SEFA-6179 retained normal liver histology. In the second experiment, mice receiving a high carbohydrate diet with intravenous saline or soybean oil lipid emulsion, along with medium chain triglyceride vehicle treatment, developed macrovescular steatosis. Treatment with SEFA-6179 prevented steatosis. In each experiment, SEFA-6179 treatment decreased arachidonic acid metabolites as well as key molecules (diacylglycerol, ceramides) involved in lipotoxicity. SEFA-6179 increased both β- and complete fatty oxidation in human liver cells, while having no impact on lipogenesis or fatty acid uptake. Conclusions SEFA-6179 treatment prevented hepatosteatosis and decreased toxic lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis. An increase in both β- and complete hepatic fatty acid oxidation may underlie the reduction in steatosis.
Læs mere Tjek på PubMedIzabel Alves das Chagas Valóta, Rafael Rodrigo da Silva Pimentel, Ana Paula Neroni Stina Saura, Rodrigo Marques da Silva, Ana Lucia Siqueira Costa Calache, Marcelo José dos Santos
PLoS One Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
by Izabel Alves das Chagas Valóta, Rafael Rodrigo da Silva Pimentel, Ana Paula Neroni Stina Saura, Rodrigo Marques da Silva, Ana Lucia Siqueira Costa Calache, Marcelo José dos Santos The aim of this study was to analyze levels of fatigue and resilience of Brazilian graduate students during the COVID-19 pandemic and to determine whether there is an association between fatigue and resilience and sociodemographic and academic factors. Data were analyzed using descriptive and inferential statistics, and it was discovered that the variables associated with higher levels of resilience were age; having children; being retired; receiving income above five minimum wages; having had greater problems in other phases of the research schedule; coming from private universities; being from the north of Brazil; studying the area of Health; and having their research schedule unaffected during the pandemic. On the other hand, lack of resilience was associated with not having children; being less well-off financially; being younger; being a woman; studying in a public university; and having to postpone part of the research during the pandemic. The conclusion of the study indicated the need for graduate programs to design strategies to deal with fatigue and promote resilience in Master’s and PhD students.
Læs mere Tjek på PubMedMalaria Journal, 2.12.2023
Tilføjet 2.12.2023
Abstract Background Pregnant women have an increased risk of Plasmodium infections and disease. Malaria in pregnancy is a major public health problem in endemic areas. Assessment of the burden and risk factors of malaria in pregnancy across different malaria transmission settings is required to guide control strategies and for malaria elimination. Thus, the current study is generating such evidence from parturient women in northwest Ethiopia. Methods A cross-sectional study was conducted among 526 pregnant women admitted to the delivery rooms of selected health facilities in Jawi district, northwest Ethiopia, between November 2021 and July 2022. Data on the socio-demographic, clinical, obstetric, and malaria prevention practices of pregnant women were collected using interviewer-administered questionnaires and from women’s treatment cards. Malaria was diagnosed by light microscopy, rapid diagnostic test, and multiplex real-time polymerase chain reaction. Risk factors for malaria were evaluated using bivariable and multivariable logistic regression models. A P-value of
Læs mere Tjek på PubMedFox, D., Hall, M., Thibodeau, C., Coldwell, K., Lauder, L., Dewell, S., Davidson, S.
BMJ Open, 2.12.2023
Tilføjet 2.12.2023
BackgroundNavigating the organ donation and transplantation system in Canada can be challenging for individuals on transplant journeys. Although it is likely that the COVID-19 pandemic has further contributed to these challenges, the experiences of individuals during the pandemic in Canada have not been well elicited. ObjectiveTo illuminate how the COVID-19 pandemic has impacted individuals on transplant journeys in Canada. DesignConvergent parallel mixed-methods study. SettingCanada. ParticipantsAdult patients, caregivers, and donors on transplant journeys across Canada. Data collectionEight focus groups and an online survey between May and November 2021. Focus group transcripts were analysed using an inductive conventional content analysis approach. Survey data were analysed using descriptive statistics. The study was guided by individuals with lived experience of organ donation and transplantation. ResultsA total of 830 participants completed three COVID-19 related survey questions, with 21 participating in the focus groups. Survey results: over 50% of patients and caregivers reported that the pandemic impacted their access to their healthcare team, their mental health (60% and 65%, respectively) and their comfort going out in public (80% and 75%, respectively). Although many donors reported several factors that impacted their transplant journey, the impact appeared to be greater for patients and caregivers. Qualitative results: three themes emerged from the qualitative data that contextualise participant’s experiences: compounding isolation, disruption amid uncertainty and unforeseen benefits. ConclusionThe COVID-19 pandemic has exacerbated many of the challenges that individuals on transplant journeys experience. It will be critical for transplant programmes to consider these factors in future care provision.
Læs mere Tjek på PubMedFox, D., Hall, M., Thibodeau, C., Coldwell, K., Lauder, L., Dewell, S., Davidson, S.
BMJ Open, 2.12.2023
Tilføjet 2.12.2023
BackgroundNavigating the organ donation and transplantation system in Canada can be challenging for individuals on transplant journeys. Although it is likely that the COVID-19 pandemic has further contributed to these challenges, the experiences of individuals during the pandemic in Canada have not been well elicited. ObjectiveTo illuminate how the COVID-19 pandemic has impacted individuals on transplant journeys in Canada. DesignConvergent parallel mixed-methods study. SettingCanada. ParticipantsAdult patients, caregivers, and donors on transplant journeys across Canada. Data collectionEight focus groups and an online survey between May and November 2021. Focus group transcripts were analysed using an inductive conventional content analysis approach. Survey data were analysed using descriptive statistics. The study was guided by individuals with lived experience of organ donation and transplantation. ResultsA total of 830 participants completed three COVID-19 related survey questions, with 21 participating in the focus groups. Survey results: over 50% of patients and caregivers reported that the pandemic impacted their access to their healthcare team, their mental health (60% and 65%, respectively) and their comfort going out in public (80% and 75%, respectively). Although many donors reported several factors that impacted their transplant journey, the impact appeared to be greater for patients and caregivers. Qualitative results: three themes emerged from the qualitative data that contextualise participant’s experiences: compounding isolation, disruption amid uncertainty and unforeseen benefits. ConclusionThe COVID-19 pandemic has exacerbated many of the challenges that individuals on transplant journeys experience. It will be critical for transplant programmes to consider these factors in future care provision.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
Abstract Background Protection against SARS-CoV-2 is mediated by humoral and T cell responses. Pakistan faced relatively low morbidity and mortality from COVID-19 through the pandemic. To examine the role of prior immunity in the population, we studied IgG antibody response levels, virus neutralizing activity and T cell reactivity to Spike protein in a healthy control group (HG) as compared with COVID-19 cases and individuals from the pre-pandemic period (PP). Methods HG and COVID-19 participants were recruited between October 2020 and May 2021. Pre-pandemic sera was collected before 2018. IgG antibodies against Spike and its Receptor Binding Domain (RBD) were determined by ELISA. Virus neutralization activity was determined using a PCR-based micro-neutralization assay. T cell – IFN-γ activation was assessed by ELISpot. Results Overall, the magnitude of anti-Spike IgG antibody levels as well as seropositivity was greatest in COVID-19 cases (90%) as compared with HG (39.8%) and PP (12.2%). During the study period, Pakistan experienced three COVID-19 waves. We observed that IgG seropositivity to Spike in HG increased from 10.3 to 83.5% during the study, whilst seropositivity to RBD increased from 7.5 to 33.3%. IgG antibodies to Spike and RBD were correlated positively in all three study groups. Virus neutralizing activity was identified in sera of COVID-19, HG and PP. Spike reactive T cells were present in COVID-19, HG and PP groups. Individuals with reactive T cells included those with and without IgG antibodies to Spike. Conclusions Antibody and T cell responses to Spike protein in individuals from the pre-pandemic period suggest prior immunity against SARS-CoV-2, most likely from cross-reactive responses. The rising seroprevalence observed in healthy individuals through the pandemic without known COVID-19 may be due to the activation of adaptive immunity from cross-reactive memory B and T cells. This may explain the more favourable COVID-19 outcomes observed in this population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.12.2023
Tilføjet 2.12.2023
Abstract Background Protection against SARS-CoV-2 is mediated by humoral and T cell responses. Pakistan faced relatively low morbidity and mortality from COVID-19 through the pandemic. To examine the role of prior immunity in the population, we studied IgG antibody response levels, virus neutralizing activity and T cell reactivity to Spike protein in a healthy control group (HG) as compared with COVID-19 cases and individuals from the pre-pandemic period (PP). Methods HG and COVID-19 participants were recruited between October 2020 and May 2021. Pre-pandemic sera was collected before 2018. IgG antibodies against Spike and its Receptor Binding Domain (RBD) were determined by ELISA. Virus neutralization activity was determined using a PCR-based micro-neutralization assay. T cell – IFN-γ activation was assessed by ELISpot. Results Overall, the magnitude of anti-Spike IgG antibody levels as well as seropositivity was greatest in COVID-19 cases (90%) as compared with HG (39.8%) and PP (12.2%). During the study period, Pakistan experienced three COVID-19 waves. We observed that IgG seropositivity to Spike in HG increased from 10.3 to 83.5% during the study, whilst seropositivity to RBD increased from 7.5 to 33.3%. IgG antibodies to Spike and RBD were correlated positively in all three study groups. Virus neutralizing activity was identified in sera of COVID-19, HG and PP. Spike reactive T cells were present in COVID-19, HG and PP groups. Individuals with reactive T cells included those with and without IgG antibodies to Spike. Conclusions Antibody and T cell responses to Spike protein in individuals from the pre-pandemic period suggest prior immunity against SARS-CoV-2, most likely from cross-reactive responses. The rising seroprevalence observed in healthy individuals through the pandemic without known COVID-19 may be due to the activation of adaptive immunity from cross-reactive memory B and T cells. This may explain the more favourable COVID-19 outcomes observed in this population.
Læs mere Tjek på PubMedNaomi F. Sugie, Kristin Turney, Keramet Reiter, Rebecca Tublitz, Daniela Kaiser, Rebecca Goodsell, Erin Secrist, Ankita Patil, Monik Jiménez
Science Advances, 1.12.2023
Tilføjet 1.12.2023
Clinical Infectious Diseases, 1.12.2023
Tilføjet 1.12.2023
In January 2020, it was clear we would soon begin seeing patients with what we called at the time the novel coronavirus infection. My infection control and -prevention team began to meet with leaders of our medical center and heads of the many operational units at San Francisco General Hospital. We started tracking data emerging worldwide, and began preparing to handle this new threat that we assumed would soon arrive in San Francisco and cause infections. Looking back on these early meetings, as an infection control leader, I remember experiencing a long series of many knowns and unknowns. I believed strongly we were about to face an unprecedented threat both medically and operationally, and that we would be called upon to use well-established principles for keeping our environment safe. But I also felt my work in infection control was about to cross into many unknowns I had never imagined.
Læs mere Tjek på PubMedClinical Infectious Diseases, 1.12.2023
Tilføjet 1.12.2023
AbstractBackgroundRecent cases of clinical failure in UK malaria patients treated with artemether-lumefantrine have implications for malaria chemotherapy worldwide.MethodsParasites were isolated from an index case of confirmed Plasmodium falciparum treatment failure after standard treatment, and from comparable travel-acquired UK malaria cases. Drug susceptibility in vitro and genotypes at six resistance-associated loci were determined for all parasite isolates and compared with clinical outcomes for each parasite donor.ResultsA traveller, who returned to the UK from Uganda in 2022 with Plasmodium falciparum malaria, twice failed treatment with full courses of artemether-lumefantrine. Parasites from the patient exhibited significantly reduced susceptibility to artemisinin (ring-stage survival 17.3%; 95% C.I. 13.6 - 21.1 %; P
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