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Ole Haagen Nielsen, John Mark Gubatan, Kaija-Leena Kolho, Sarah Elizabeth Streett, Cynthia Maxwell
Lancet, 29.03.2024
Tilføjet 29.03.2024
Inflammatory bowel disease (IBD) affects reproductive planning due to psychological effects and mechanical problems related to surgery. Children of people with IBD have an increased risk of about 10% if one parent has IBD and up to 33% if both parents have IBD. The fertility of people with IBD is similar to the general population, but fertility might be reduced in individuals with active IBD, ileal pouch-anal anastomosis, or perianal Crohn\'s disease. Flaring disease during pregnancy increases complications, such as preterm birth.
Læs mere Tjek på PubMedPierre Bauvin, Claire Delacôte, Line Carolle Ntandja Wandji, Guillaume Lassailly, Violeta Raverdy, François Pattou, Sylvie Deuffic-Burban, Philippe Mathurin
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Pierre Bauvin, Claire Delacôte, Line Carolle Ntandja Wandji, Guillaume Lassailly, Violeta Raverdy, François Pattou, Sylvie Deuffic-Burban, Philippe Mathurin Objective Help public health decision-making requires a better understanding of the dynamics of obesity and type 2 diabetes and an assessement of different strategies to decrease their burdens. Methods Based on 97,848 individual data, collected in the French Health, Health Care and Insurance Survey over 1998–2014, a Markov model was developed to describe the progression of being overweight to obesity, and the onset of type 2 diabetes. This model traces and predicts 2022–2027 burdens of obesity and type 2 diabetes, and lifetime risk of diabetes, according to different scenarios aiming at minimum to stabilize obesity at 5 years. Results Estimated risks of type 2 diabetes increase from 0.09% (normal weight) to 1.56% (obesity II-III). Compared to the before 1995 period, progression risks are estimated to have nearly doubled for obesity and tripled for type 2 diabetes. Consequently, over 2022–2027, the prevalence of obesity and type 2 diabetes will continue to increase from 17.3% to 18.2% and from 7.3% to 8.1%, respectively. Scenarios statibilizing obesity would require a 22%-decrease in the probability of move up (scenario 1) or a 33%-increase in the probability of move down (scenario 2) one BMI class. However, this stabilization will not affect the increase of diabetes prevalence whereas lifetime risk of diabetes would decrease (30.9% to 27.0%). Combining both scenarios would decrease obesity by 9.9%. Only the prevalence of obesity III shows early change able to predict the outcome of a strategy: for example, 6.7%-decrease at one year, 13.3%-decrease at two years with scenario 1 stabilizing obesity at 5 years. Conclusions Prevalences of obesity and type 2 diabetes will still increase over the next 5 years. Stabilizing obesity may decrease lifetime risks of type 2 diabetes without affecting its short-term prevalence. Our study highlights that, to early assess the effectiveness of their program, public health policy makers should rely on the change in prevalence of obesity III.
Læs mere Tjek på PubMedWeilong Wu, Ying Huang, Yuzhou Zhang, Bo Zhou
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Weilong Wu, Ying Huang, Yuzhou Zhang, Bo Zhou Urban agglomerations are emerging as new regional units for national participation in global competition and the international division of labor. However, they face increasingly severe resource and eco-environment pressures during urbanization. The coordination of the relationship between urbanization and the eco-environment has attracted global attention. In this study, we used Coupling Coordination Degree and Vector Autoregression models to examine the dynamic evolution, coupling relationships, coordinated development patterns, and interaction mechanisms between urbanization and the eco-environment. The results indicate that: (1) The level of urbanization in the Chengdu-Chongqing Urban agglomeration was relatively low, and the region showed a good eco-environment background. However, rapid urbanization is gradually straining the carrying capacity of the eco-environment. (2) A close and stable coupling relationship exists between urbanization and the eco-environment, which has reached an advanced coupling stage. The status of coordinated development among cities differs considerably, and multiple stable forms may exist simultaneously. (3) Urbanization has a substantial impact on environmental changes, whereas the restrictive effect of the eco-environment on urbanization development is not particularly notable. (4) Various interactive relationships exist between the urbanization and eco-environment subsystems, including positive promotion and negative constraint effects. The positive promotion effect mainly manifests between the economic, social, and ecological response subsystems, while the negative constraint effect is most evident in the mutual coercion and inhibition between the regional urbanization, economic urbanization, ecological status, and ecological pressure subsystems. These findings have important policy implications for decision makers exploring the path of coordinated and sustainable development in urbanization and the eco-environment in Urban agglomerations.
Læs mere Tjek på PubMedNihad Salifu, Catherine I. Segbefia, Yakubu Alhassan, Lorna A. Renner, Edem M. A. Tette
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Nihad Salifu, Catherine I. Segbefia, Yakubu Alhassan, Lorna A. Renner, Edem M. A. Tette Undernutrition in children with cancer is associated with complications during cancer therapy. The study objective was to determine the association between specific anthropometric parameters and short-term chemotherapy-related complications and mortality. This was a hospital-based, prospective cohort study of children, age ≤12 years, with a new cancer diagnosis at the Paediatric Oncology Unit, Korle Bu Teaching Hospital, Ghana. Socio-demographic information, cancer characteristics and anthropometric measurements were obtained at enrolment. Participants were followed up for twelve weeks from commencement of chemotherapy and selected treatment-related complications such as anaemia and thrombocytopenia requiring transfusions, prolonged neutropenia resulting in treatment delays, febrile neutropenia, mucositis and death were recorded. A total of 133 participants were recruited with a median age of 4.5 years. Eighty-one (60.9%) were diagnosed with solid tumours, 31 (23.3%) had leukaemias and 21 (15.8%) had lymphomas. Of the anthropometric parameters assessed, only arm anthropometry using upper arm muscle area (UAMA) and mid-upper arm circumference (MUAC) were associated with complications. Participants with wasting were more likely to develop anaemia and mucositis. However, the incidence of prolonged neutropenia was significantly higher among participants with average UAMA (p = 0.043) and low average UAMA (p = 0.049) compared to those with low UAMA. Risk of neutropenia was also significantly less among those with wasting by MUAC compared to those well-nourished (p = 0.045). Twenty-three participants (17.3%) died with a greater proportion (11/44; 25%) occurring in those who were wasted using MUAC. These findings underscore the need for nutritional surveillance at diagnosis and during chemotherapy, particularly where co-morbid disease is prevalent.
Læs mere Tjek på PubMedMalaria Journal, 28.03.2024
Tilføjet 28.03.2024
Abstract A Stakeholder engagement meeting on the implementation of post-discharge malaria chemoprevention (PDMC) in Benin, Kenya, Malawi, and Uganda was held in Nairobi, Kenya, on 27 September 2023. Representatives from the respective National Malaria Control Programmes, the World Health Organization (WHO) Geneva, Africa Regional and Kenya offices, research partners, non-governmental organizations, and the Medicines for Malaria Venture participated. PDMC was recommended by the WHO in June 2022 and involves provision of a full anti-malarial treatment course at regular intervals during the post-discharge period in children hospitalized with severe anaemia in areas of moderate-to-high malaria transmission. The WHO recommendation followed evidence from a meta-analysis of three clinical trials and from acceptability, delivery, cost-effectiveness, and modelling studies. The trials were conducted in The Gambia using monthly sulfadoxine-pyrimethamine during the transmission season, in Malawi using monthly artemether-lumefantrine, and in Kenya and Uganda using monthly dihydroartemisinin-piperaquine, showing a significant reduction in all-cause mortality by 77% (95% CI 30–98) and a 55% (95% CI 44–64) reduction in all-cause hospital readmissions 6 months post-discharge. The recommendation has not yet been implemented in sub-Saharan Africa. There is no established platform for PDMC delivery. The objectives of the meeting were for the participating countries to share country contexts, plans and experiences regarding the adoption and implementation of PDMC and to explore potential delivery platforms in each setting. The meeting served as the beginning of stakeholder engagement within the PDMC Saves Lives project and will be followed by formative and implementation research to evaluate alternative delivery strategies in selected countries. Meeting highlights included country consensus on use of dihydroartemisinin-piperaquine for PDMC and expansion of the target group to "severe anaemia or severe malaria", in addition to identifying country-specific options for PDMC delivery for evaluation in implementation research. Further exploration is needed on whether the age group should be extended to school-age children.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
Abstract Concerns regarding toxicity and resistance of current drugs have been reported in visceral leishmaniasis. Anti-microbial peptides are considered as new promising candidates and amongst them, human cathelicidin hCAP18/LL-37 showed significant parasite killing on drug-sensitive and resistant Leishmania promastigotes, coupled with its apoptosis-inducing role. Administration of hCAP18/LL-37 in infected macrophages also decreased parasite survival and increased the host favorable cytokine IL-12. However, 1,25-dihydroxyvitamin D3 (VitD3)-induced endogenous hCAP18/LL-37 production was hampered in infected THP-1 cells. Infection also suppressed the VitD3-receptor (VDR), transcription factor of hCAP18/LL-37. cAMP response element modulator (CREM), the repressor of VDR, was induced in infection resulting in suppression of both VDR and cathelicidin expression. PGE2/cAMP/PKA axis was found to regulate CREM induction during infection and silencing CREM in infected cells and BALB/c mice led to decreased parasite survival. Present study thus documents the anti-leishmanial potential of cathelicidin and further identifies CREM as a repressor of cathelicidin in Leishmania infection.
Læs mere Tjek på PubMedClinical Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
Abstract Background Improved epidemiologic and treatment data for active tuberculosis (TB) with chronic hepatitis B virus (cHBV) infection might inform and encourage screening and vaccination programs focused on persons at risk of having both conditions.Methods We matched the California Department of Public Health TB registry during 2016–2020 to the cHBV registry using probabilistic matching algorithms. We used chi-square analysis to compare the characteristics of persons with TB and cHBV with those with TB only. We compared TB treatment outcomes between these groups using modified Poisson regression models. We calculated the time between reporting of TB and cHBV diagnoses for those with both conditions.Results We identified 8,435 persons with TB, including 316 (3.7%) with cHBV. Among persons with TB and cHBV, 256 (81.0%) were non-U.S.-born Asian vs 4,186 (51.6%) with TB only (P 60 days after cHBV (median 3,411 days).Conclusion Persons with TB and cHBV were found more frequently in certain groups compared with TB only, and infrequently had their conditions diagnosed together. This highlights an opportunity to improve screening and treatment of TB and cHBV in those at high risk for coinfection.
Læs mere Tjek på PubMedClinical Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
Abstract Background There are little data on changes in insulin sensitivity during the first few years of life following in utero human immunodeficiency virus (HIV) and antiretroviral (ARV) exposure.Methods The Tshilo Dikotla study enrolled pregnant persons with HIV (PWH) (receiving tenofovir/emtricitabine or lamivudine plus dolutegravir or efavirenz) and pregnant individuals without HIV, as well as their liveborn children. Newborns were randomized to receive either zidovudine (AZT) or nevirapine (NVP) postnatal prophylaxis. Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) was assessed at birth and 1, 18, 24, and 36 months of life. We fit linear mixed-effects models to evaluate the association between in utero HIV/ARV exposure and average HOMA-IR from birth through 36 months of life, adjusting for confounders.Results A total of 419 children were included (287 with in utero HIV/ARV exposure and uninfected [CHEU] and 132 without in utero HIV/ARV exposure [CHUU]). CHEU were born to older women (29.6 vs 25.3 years of age) with higher gravidity (3 vs 1). HOMA-IR was persistently higher in CHEU versus CHUU in adjusted analyses (mean difference of 0.07 in log10 HOMA-IR, P = .02) from birth through 36 months of life. Among CHEU, no differences in HOMA-IR were observed from birth through 36 months by in utero ARV exposure status or between AZT and NVP infant prophylaxis arms.Conclusions In utero HIV/ARV exposure was associated with lower insulin sensitivity throughout the first 36 months of life, indicating persistent early life metabolic disturbances which may raise concern for poorer metabolic health later in life.
Læs mere Tjek på PubMedMinh Ha NgoJoshua PankracRyan C. Y. HoEmmanuel NdashimyeRahul PawaRenata CeccacciTsigereda BiruAbayomi S. OlabodeKatja KleinYue LiColin KovacsRobert AssadJeffrey M. JacobsonDavid H. CanadayStephen TomusangeSamiri JamiruAggrey AnokTaddeo KityamuweesiPaul BuuleRonald M. GaliwangoSteven J. ReynoldsThomas C. QuinnAndrew D. ReddJessica L. ProdgerJamie F. S. MannEric J. Artsa Department of Microbiology and Immunology, University of Western Ontario, London, Canadab College of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi, Vietnamc Special Immunology Unit and Division of Infectious Diseases, Department of Medicine, Case Western Reserve University, Cleveland, OH, USAd Bristol Veterinary School, University of Bristol, Bristol, UKe Maple Leaf Medical Clinic and Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Canadaf Rakai Health Sciences Program, Kalisizo, Ugandag Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USAh Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
Emerg Microbes Infect, 28.03.2024
Tilføjet 28.03.2024
Ying LiuJiayou ZhangWen LiuYongbing PanShunan RuanXuanxuan NianWei ChenLina SunQiangling YinXin YueQingliang LiFang GuiCong WuShuzhen WangYunkai YangZhaofei JingFeiguang LongZejun WangZeyu ZhangChaolin HuangKai DuanMifang LiangXiaoming Yanga Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of Chinab Hubei Clinical Research Center for Infectious Diseases, Wuhan, People’s Republic of Chinac Hubei Public Health Clinical Center, Wuhan, People’s Republic of Chinad Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Wuhan, People’s Republic of Chinae National Engineering Technology Research Center for Combined Vaccines, Wuhan, People’s Republic of Chinaf Wuhan Institute of Biological Products Co. Ltd., Wuhan, People’s Republic of Chinag National Institute for Viral Disease Control and Prevention, Chinese CDC, Beijing, People’s Republic of Chinah Hubei Provincial Center for Disease Control and Prevention, Wuhan, People’s Republic of Chinai China National Biotec Group Company Limited, Beijing, People’s Republic of China
Emerg Microbes Infect, 28.03.2024
Tilføjet 28.03.2024
Journal of Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
Abstract Escherichia coli K1 is the leading cause of neonatal Gram-negative bacterial meningitis, but the pathogenesis of E. coli K1 meningitis remains unclear. Blood-brain barrier (BBB) penetration is a crucial step in E. coli meningitis development. Here, we uncovered the crucial role of CsiR, a GntR family regulator, in E. coli K1 virulence. During infection, csiR expression was induced due to the derepression by Fur in the blood and human brain microvascular endothelial cells (HBMECs). CsiR positively regulated ilvB expression, which is associated with branched chain amino acid synthesis. Furthermore, we revealed that IlvB activated the FAK/PI3 K pathway of HBMECs to induce actin cytoskeleton rearrangements, thereby promoting the bacterial invasion and penetration of the BBB. Overall, this study reveals a CsiR-mediated virulence regulation pathway in E. coli K1, which may provide a useful target for the prevention or therapy of E. coli meningitis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
Abstract Background The prevalence and distinction between first Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reinfection with the Omicron variant among healthcare workers (HCWs) remain unclear. Methods A cross-sectional study was conducted at a hospital in Southern China. The study included 262 HCWs who were infected with SARS-CoV-2 between April and June 2023, with 101 cases of first infection and 161 ones of reinfection. Student’s t-test, Analysis of Variance (ANOVA), and Mann-Whitney U tests were used based on the distribution of quantitative variables. Pearson’s chi-square and Fisher’s exact tests were used based on the expected frequencies of categorical variables. Results The reinfection rate among HCWs was 11.5% (161/1406). The majority of the infected HCWs were female (212/262, 80.9%, first infection vs. reinfection: 76.2% vs. 83.9%). The nursing staff, had the highest percentage of SARS-CoV-2 infection (42.0%), especially of its reinfection (47.8%). Out of the 262 infected individuals, 257 had received SARS-CoV-2 vaccination, primarily inactivated vaccines (243/257, 91.1%). The first infection group, which received four doses (24, 23.8%), was significantly higher than that in the reinfection group (6, 3.7%) (P
Læs mere Tjek på PubMedErika Renzi, Valentina Baccolini, Antonio Covelli, Leonardo Maria Siena, Antonio Sciurti, Giuseppe Migliara, Azzurra Massimi, Carolina Marzuillo, Corrado De Vito, Leandro Casini, Antonio Angeloni, Ombretta Turriziani, Guido Antonelli, Fabrizio D’Alba, Antonella Polimeni, Collaborating Group, Paolo Villari
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Erika Renzi, Valentina Baccolini, Antonio Covelli, Leonardo Maria Siena, Antonio Sciurti, Giuseppe Migliara, Azzurra Massimi, Carolina Marzuillo, Corrado De Vito, Leandro Casini, Antonio Angeloni, Ombretta Turriziani, Guido Antonelli, Fabrizio D’Alba, Antonella Polimeni, Collaborating Group , Paolo Villari Background During the SARS-CoV-2 testing program offered through the RT-PCR test by Sapienza University of Rome, we conducted a test-negative case-control study to identify risk factors for acquiring SARS-CoV-2 infection among university students. Methods Each SARS-CoV-2-positive case detected was matched to two controls randomly selected from students who tested negative on the same day. 122 positive students and 244 negative students were enrolled in the study. Multivariable conditional logistic regression models were built. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. A second model was limited to students who had attended campus. Results Out of 8223 tests for SARS-CoV-2, 173 students tested positive (2.1%), of whom 122 (71.5%) were included in the case-control study. In the first analysis, being a non-Italian student (aOR: 8.93, 95% CI: 2.71–29.41), having received only the primary vaccination course (aOR: 2.94, 95% CI: 1.24–6.96) compared to the booster dose, known exposure to a COVID-19 case or someone with signs/symptoms suggestive of COVID-19 (aOR: 6.51, 95% CI: 3.48–12.18), and visiting discos (aOR: 4.07, 95% CI: 1.52–10.90) in the two weeks before testing increased the likelihood of SARS-CoV-2 infection. Conversely, students attending in-person lectures on campus seemed less likely to become infected (aOR: 0.34, 95% CI: 0.15–0.77). No association was found with other variables. The results of the second model were comparable to the first analysis. Conclusions This study indicates that if universities adopt strict prevention measures, it is safe for students to attend, even in the case of an infectious disease epidemic.
Læs mere Tjek på PubMedLeann Blake, Patricia Tucker, Leigh M. Vanderloo
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Leann Blake, Patricia Tucker, Leigh M. Vanderloo Screen time for children under 5 is associated with various health risks. Amidst the COVID-19 pandemic, screen use among young children increased significantly. Mothers were more likely than fathers to be the primary caregivers and disproportionally assumed the responsibility of monitoring their children’s screen time. Several studies have examined children’s screen use throughout the pandemic; however, few have addressed mothers’ experiences. Therefore, the current study aimed to investigate mothers’ perceptions regarding the barriers and facilitators faced when trying to reduce their child’s pandemic screen time, as expressed on Reddit (a social media platform for anonymous discussion and information sharing). Two subreddit forums targeted toward mothers, \'mommit\' and \'beyondthebump,\' with 646,000 and 554,000 users, respectively, were examined. Posts were collected using related search terms and screened for inclusion by three independent researchers. Inductive thematic content analysis was leveraged to identify themes. In total, 582 posts were reviewed from March 14th, 2020, to August 31st, 2022. Qualitative analysis yielded 5 themes; 6 barriers and 2 facilitators were derived from themes and/or subthemes, where applicable. Results suggest that mothers faced barriers when trying to reduce their child’s screen time, including their competing work and in-home obligations, using screens to occupy their child during travel, child screen use with other caregivers, offering their child screen time while they needed rest, pandemic changes in routine, and using screens to encourage their child to engage in necessary behaviours. However, facilitating factors, including advice received from other mothers on how to reduce their child’s screen time and the sharing of non-screen alternatives supported mothers in lowering their children’s screen time. These results are important for future interventions, which may utilize the conclusions of this study to address what mothers perceive to be helping or hindering them, thus empowering mothers to successfully limit their children’s screen time.
Læs mere Tjek på PubMedTijan Jobarteh, Jacob Otu, Ensa Gitteh, Francis S. Mendy, Tutty Isatou Faal-Jawara, Boatema Ofori-Anyinam, Binta Sarr, Abi Janet Riley, Abigail Ayorinde, Bouke C. de Jong, Beate Kampmann, Ousman Secka, Florian Gehre
PLoS One Infectious Diseases, 28.03.2024
Tilføjet 28.03.2024
by Tijan Jobarteh, Jacob Otu, Ensa Gitteh, Francis S. Mendy, Tutty Isatou Faal-Jawara, Boatema Ofori-Anyinam, Binta Sarr, Abi Janet Riley, Abigail Ayorinde, Bouke C. de Jong, Beate Kampmann, Ousman Secka, Florian Gehre Background Mycobacterium tuberculosis culturing remains the gold standard for laboratory diagnosis of tuberculosis. Tuberculosis remains a great public health problem in developing countries like The Gambia, as most of the methods currently used for bacterial isolation are either time-consuming or costly. Objective To evaluate the Kudoh swab method in a West African setting in Gambia, with a particular focus on the method’s performance when culturing Mycobacterium africanum West Africa 2 (MAF2) isolates. Method 75 sputum samples were collected in the Greater Banjul Area and decontaminated in parallel with both the standard N-acetyl-L-Cysteine-NaOH (NALC-NaOH) and the Kudoh swab method in the TB diagnostics laboratory in the Medical Research Council Unit The Gambia between 30th December 2017 and 25th February 2018. These samples were subsequently cultured on standard Löwenstein-Jensen and Modified Ogawa media respectively and incubated at 37°C for mycobacterial growth. Spoligotyping was done to determine if the decontamination and culture methods compared could equally detect Mycobacterium tuberculosis, Mycobacterium africanum West Africa 1 and Mycobacterium africanum West Africa 2. Result Among the 50 smear positives, 35 (70%) were culture-positive with Kudoh and 32 (64%) were culture positive with NALC-NaOH, whilst 7(28%) of the 25 smear negative samples were culture positive with both methods (Table 2). There was no significant difference in recovery between both methods (McNemar’s test, p-value = 0.7003), suggesting that the overall positivity rate between the two methods is comparable. There were no differences in time-to-positivity or contamination rate between the methods. However, Kudoh yielded positive cultures that were negative on LJ and vice versa. All findings were irrespective of mycobacterial lineages. Conclusion The Kudoh method has comparable sensitivity to the NALC-NaOH method for detecting Mycobacterium tuberculosis complex isolates. It is easy to perform and could be an add on option for mycobacterial culture in the field in The Gambia, since it requires less biosafety equipment.
Læs mere Tjek på PubMedMalaria Journal, 27.03.2024
Tilføjet 27.03.2024
Abstract Background The Magude Project assessed the feasibility of eliminating malaria in Magude district, a low transmission setting in southern Mozambique, using a package of interventions, including long-lasting insecticidal nets (LLINs). As the efficacy of LLINs depends in part on their physical integrity, this metric was quantified for Olyset® Nets post mass-distribution, in addition to net use, care and handling practices and other risk factors associated with net physical integrity. Methods Nets were collected during a cross-sectional net evaluation, nine months after the Magude project commenced, which was 2 years after the nets were distributed by the National Malaria Control Programme (NMCP). The physical integrity of the nets was assessed by counting and sizing the holes at different positions on each net. A structured questionnaire was administered to assess how the selected net was used and treated (care, wash and repair). Net bio-efficacy was assessed following the standard World Health Organization (WHO) cone bioassay procedures. Results Out of the 170 Olyset® Nets included in the analysis, 63.5% had been used the night before. The main reason for not using a net was the notion that there were no mosquitoes present. The average number of people using each net was 1.79. Two thirds of the nets had only been washed once or twice since distribution. Most nets (80.9%) were holed and 18% were torn, but none of the risk factors were significantly associated with net integrity, except for presence of mice in the household. Less than half of the participants noticed holes in holed nets, and of those only 38.6% attempted to repair those. None of the six nets that were tested for bio-efficacy passed the WHO threshold of 80% mosquito mortality. Conclusion Overall the majority of Olyset® Nets were in serviceable condition two years post-distribution, but their insecticidal effect may have been lost. This study—together with previous evidence on suboptimal access to and use of LLINs in Magude district—highlights that LLINs as an intervention could have been optimized during the Magude project to achieve maximum intervention impact.
Læs mere Tjek på PubMedLindsay E. CleggOleg StepanovHenning SchmidtWeifeng TangHuixia ZhangChris WebberTaylor S. CohenMark T. EsserMats Någård1Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology & Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland, USA2Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology & Safety Sciences, R&D, AstraZeneca, Cambridge, United Kingdom3IntiQuan GmBH, Basel, Switzerland4Clinical Development, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom5Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 27.03.2024
Tilføjet 27.03.2024
Maria Vittoria CossuAntonio D'AvolioCristina GervasoniAndrea GiacomelliDario CattaneoDavide Moschese1Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy2Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy, James E. Leggett
Antimicrobial Agents And Chemotherapy, 27.03.2024
Tilføjet 27.03.2024
Talha Burki
Lancet Respiratory Medicine, 27.03.2024
Tilføjet 27.03.2024
In places where conflict and displacement are a constant threat, Médecins Sans Frontières (MSF) has a straightforward way of ensuring that the people being treated for tuberculosis do not leave without their medication. MSF keeps a stock of so-called runaway kits containing sufficient drugs for each patient to finish their course. “If it seems likely that people are going to be displaced, we hand out the kits”, Animesh Sinha (HIV/TB/Hepatitis Advisor, MSF, London, UK) told The Lancet Respiratory Medicine.
Læs mere Tjek på PubMedMohsen Ahmadi, Danial Javaheri, Matin Khajavi, Kasra Danesh, Junbeom Hur
PLoS One Infectious Diseases, 27.03.2024
Tilføjet 27.03.2024
by Mohsen Ahmadi, Danial Javaheri, Matin Khajavi, Kasra Danesh, Junbeom Hur Alzheimer’s disease is the most prevalent form of dementia, which is a gradual condition that begins with mild memory loss and progresses to difficulties communicating and responding to the environment. Recent advancements in neuroimaging techniques have resulted in large-scale multimodal neuroimaging data, leading to an increased interest in using deep learning for the early diagnosis and automated classification of Alzheimer’s disease. This study uses machine learning (ML) methods to determine the severity level of Alzheimer’s disease using MRI images, where the dataset consists of four levels of severity. A hybrid of 12 feature extraction methods is used to diagnose Alzheimer’s disease severity, and six traditional machine learning methods are applied, including decision tree, K-nearest neighbor, linear discrimination analysis, Naïve Bayes, support vector machine, and ensemble learning methods. During training, optimization is performed to obtain the best solution for each classifier. Additionally, a CNN model is trained using a machine learning system algorithm to identify specific patterns. The accuracy of the Naïve Bayes, Support Vector Machines, K-nearest neighbor, Linear discrimination classifier, Decision tree, Ensembled learning, and presented CNN architecture are 67.5%, 72.3%, 74.5%, 65.6%, 62.4%, 73.8% and, 95.3%, respectively. Based on the results, the presented CNN approach outperforms other traditional machine learning methods to find Alzheimer severity.
Læs mere Tjek på PubMedMalaria Journal, 27.03.2024
Tilføjet 27.03.2024
Abstract Background The degree to which Anopheles mosquitoes prefer biting humans over other vertebrate hosts, i.e. the human blood index (HBI), is a crucial parameter for assessing malaria transmission risk. However, existing techniques for identifying mosquito blood meals are demanding in terms of time and effort, involve costly reagents, and are prone to inaccuracies due to factors such as cross-reactivity with other antigens or partially digested blood meals in the mosquito gut. This study demonstrates the first field application of mid-infrared spectroscopy and machine learning (MIRS-ML), to rapidly assess the blood-feeding histories of malaria vectors, with direct comparison to PCR assays. Methods and results Female Anopheles funestus mosquitoes (N = 1854) were collected from rural Tanzania and desiccated then scanned with an attenuated total reflectance Fourier-transform Infrared (ATR-FTIR) spectrometer. Blood meals were confirmed by PCR, establishing the ‘ground truth’ for machine learning algorithms. Logistic regression and multi-layer perceptron classifiers were employed to identify blood meal sources, achieving accuracies of 88%–90%, respectively, as well as HBI estimates aligning well with the PCR-based standard HBI. Conclusions This research provides evidence of MIRS-ML effectiveness in classifying blood meals in wild Anopheles funestus, as a potential complementary surveillance tool in settings where conventional molecular techniques are impractical. The cost-effectiveness, simplicity, and scalability of MIRS-ML, along with its generalizability, outweigh minor gaps in HBI estimation. Since this approach has already been demonstrated for measuring other entomological and parasitological indicators of malaria, the validation in this study broadens its range of use cases, positioning it as an integrated system for estimating pathogen transmission risk and evaluating the impact of interventions.
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.03.2024
Tilføjet 26.03.2024
Abstract Background Asymptomatic SARS-CoV-2 infection in children is highly prevalent but its acute and chronic implications have been minimally described.Methods In this controlled case-ascertained household transmission study, we recruited asymptomatic children
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.03.2024
Tilføjet 26.03.2024
Abstract Background Streptococcal bacteremia is associated with high mortality. The study aims to identify predictors of mortality among patients with streptococcal bacteremia.Methods This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included episodes of streptococcal bacteremia among adult patients from 2015 to 2023.Results During the study period, 861 episodes of streptococcal bacteremia were included. The majority of episodes were categorized in the Mitis group (348 episodes; 40%), followed by the Pyogenic group (215; 25%). Endocarditis was the most common source of bacteremia (164; 19%). The overall 14-day mortality rate was 8% (65 episodes). The results from the Cox multivariable regression model showed that a Charlson comorbidity index >4 (P 0.001; HR 2.87, CI 1.58-5.22), S. pyogenes (P 0.011; HR 2.54, CI 1.24-5.21), sepsis (P
Læs mere Tjek på PubMedMohamed, S. F., Kisia, L., Mashiashi, I., Mair, F., Wisdom, J. P., Bunn, C., Gray, C., Kibe, P. M., Sanya, R. E., Karugu, C. H., Mtenga, S. M., Binyaruka, P., Asiki, G.
BMJ Open, 26.03.2024
Tilføjet 26.03.2024
BackgroundThe COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises. MethodsWe undertook a desk review of pre-existing and newly developed national frameworks, policy models and guidelines for addressing NCDs including type 2 diabetes. This was followed by 13 key informant interviews with stakeholders involved in NCD decision-making: six in Kenya and seven in Tanzania. Thematic analysis was used to analyse the documents. ResultsSeventeen guidance documents were identified (Kenya=10; Tanzania=7). These included pre-existing and/or updated policies/strategic plans, guidelines, a letter, a policy brief and a report. Neither country had comprehensive policies/guidelines to ensure continuity of NCD care before the COVID-19 pandemic. However, efforts were made to update pre-existing documents and several more were developed during the pandemic to guide NCD care. Some measures were put in place during the COVID-19 period to ensure continuity of care for patients with NCDs such as longer supply of medicines. Inadequate attention was given to monitoring and evaluation and implementation issues. ConclusionKenya and Tanzania developed and updated some policies/guidelines to include continuity of care in emergencies. However, there were gaps in the documents and between policy/guideline documents and practice. Health systems need to establish disaster preparedness plans that integrate attention to NCD care to enable them to better handle severe disruptions caused by emergencies such as pandemics. Such guidance needs to include contingency planning to enable adequate resources for NCD care and must also address evaluation of implementation effectiveness.
Læs mere Tjek på PubMedAdsul, N., Tyagi, J., Bhaumik, S.
BMJ Open, 26.03.2024
Tilføjet 26.03.2024
IntroductionCOVID-19 exposed the fragility of health systems, where even the most basic health services in high-income and low-income and middle-income nations could not withstand the health systems shock due to the pandemic. Community health workers (CHWs) can contribute to improving the resilience of health systems, specifically to withstand shocks and emergencies and to avoid disruptions of routine service delivery. We aim to explore and understand the ‘individual’ and ‘systems-level’ resilience factors that shaped the involvement of CHWs in the COVID-19 response. Methods and analysisWe will search five electronic databases (PubMed, Cochrane Library, EMBASE, CINAHL and SciELO (Spanish)) and conduct citation screening to identify studies on CHWs’ response during the COVID-19 pandemic. Two review authors will independently screen the studies for inclusion and to extract data. The software Rayyan will be used to assist in screening the relevant literature. A thematic analysis approach will be followed to analyse and synthesise the qualitative evidence. The quality of the included studies will be critically assessed using the Critical Skills Appraisal Programme Tool. We will use the GRADE CERQual(Grading of Recommendations, Assessment, Development, and Evaluations - Confidence in the Evidence from Reviews of Qualitative Research) approach to assess certainty in the synthesised findings of the qualitative evidence. Ethics and disseminationThis study will be conducted on published evidence, with no living participants; thus, no ethical approval is required. The final review will be submitted and published in a peer-reviewed journal. We will also develop a policy brief to communicate the review findings to the stakeholders.
Læs mere Tjek på PubMedLiu, J., Wang, R., Qiu, J., Su, T.
BMJ Open, 26.03.2024
Tilføjet 26.03.2024
IntroductionAcute kidney injury (AKI) is a critical condition with a complex aetiology and different outcomes, where haemodynamic dysfunction, renal hypoperfusion and inflammation serve as key contributors to its development and progression. Early and accurate diagnosis is vital for initiating targeted treatments like fluid resuscitation, vasoactive agents or steroid therapy, which are essential for improving patient outcomes. Intravoxel incoherent motion (IVIM) MRI assesses both capillary perfusion and tissue water diffusion, while arterial spin labelling (ASL) MRI measures renal blood flow without the need for contrast. Research on combined use of IVIM and ASL MRI in patients with AKI is rare. This study aims to investigate the MRI characteristics of IVIM and ASL in patients with tubulointerstitial nephritis (TIN) and to explore their relationship with pathological findings and renal recovery. Methods and analysisSingle-centre, prospective, observational cohort study of 30 patients with biopsy-proven TIN. Participants will undergo renal IVIM and ASL MRI within 7 days post-biopsy. The pathological assessments of active and chronic tubulointerstitial injuries will be semiscored using modified Banff criteria. The estimated glomerular filtration rate (eGFR) during follow-up and prevalence of chronic kidney disease at 3 and 6 months will be reported. An eGFR below 45 mL/min is considered a poor renal outcome. Ethics and disseminationThe study has been reviewed and approved by the Ethics Committee of Peking University First Hospital and written informed consent will be obtained from all participants (2022Y503). The study results will be disseminated through publication in a relevant peer-reviewed journal and presentation at academic meetings to increase awareness and share findings with the scientific community.
Læs mere Tjek på PubMedRagnhild Reehorst Lereim, Petra Nytrova, Astrid Guldbrandsen, Eva Kubala Havrdova, Kjell-Morten Myhr, Harald Barsnes, Frode S. Berven
PLoS One Infectious Diseases, 26.03.2024
Tilføjet 26.03.2024
by Ragnhild Reehorst Lereim, Petra Nytrova, Astrid Guldbrandsen, Eva Kubala Havrdova, Kjell-Morten Myhr, Harald Barsnes, Frode S. Berven Background Multiple sclerosis is an inflammatory and degenerative disease of the central nervous system leading to demyelination and axonal loss. Relapsing-remitting multiple sclerosis (RRMS) is commonly treated by anti-inflammatory drugs, where one of the most effective drugs to date is the monoclonal antibody natalizumab. Methods The cerebrospinal fluid (CSF) proteome was analyzed in 56 patients with RRMS before and after natalizumab treatment, using label-free mass spectrometry and a subset of the changed proteins were verified by parallel reaction monitoring in a new cohort of 20 patients, confirming the majority of observed changes. Results A total of 287 differentially abundant proteins were detected including (i) the decrease of proteins with roles in immunity, such as immunoglobulin heavy constant mu, chitinase-3-like protein 1 and chitotriosidase, (ii) an increase of proteins involved in metabolism, such as lactate dehydrogenase A and B and malate-dehydrogenase cytoplasmic, and (iii) an increase of proteins associated with the central nervous system, including lactadherin and amyloid precursor protein. Comparison with the CSF-PR database provided evidence that natalizumab counters protein changes commonly observed in RRMS. Furthermore, vitamin-D binding protein and apolipoprotein 1 and 2 were unchanged during treatment with natalizumab, implying that these may be involved in disease activity unaffected by natalizumab. Conclusions Our study revealed that some of the previously suggested biomarkers for MS were affected by the natalizumab treatment while others were not. Proteins not previously suggested as biomarkers were also found affected by the treatment. In sum, the results provide new information on how the natalizumab treatment impacts the CSF proteome of MS patients, and points towards processes affected by the treatment. These findings ought to be explored further to disclose potential novel disease mechanisms and predict treatment responses.
Læs mere Tjek på PubMedGizachew Tadele Tiruneh, Nebreed Fesseha, Dessalew Emaway, Wuleta Betemariam, Tsinuel Girma Nigatu, Hema Magge, Lisa Ruth Hirschhorn
PLoS One Infectious Diseases, 26.03.2024
Tilføjet 26.03.2024
by Gizachew Tadele Tiruneh, Nebreed Fesseha, Dessalew Emaway, Wuleta Betemariam, Tsinuel Girma Nigatu, Hema Magge, Lisa Ruth Hirschhorn Background In Ethiopia, neonatal mortality is persistently high. The country has been implementing community-based treatment of possible serious bacterial infection (PSBI) in young infants when referral to a hospital is not feasible since 2012. However, access to and quality of PSBI services remained low and were worsened by COVID-19. From November 2020 to June 2022, we conducted implementation research to mitigate the impact of COVID-19 and improve PSBI management implementation uptake and delivery in two woredas in Ethiopia. Methods In April-May 2021, guided by implementation research frameworks, we conducted formative research to understand the PSBI management implementation challenges, including those due to the COVID-19 pandemic. Through a participatory process engaging stakeholders, we designed adaptive implementation strategies to bridge identified gaps using mechanism mapping to achieve implementation outcomes. Strategies included training and coaching, supportive supervision and mentorship, technical support units, improved supply of essential commodities, and community awareness creation about PSBI and COVID-19. We conducted cross-sectional household surveys in the two woredas before (April 2021) and after the implementation of strategies (June 2022) to measure changes in targeted outcomes. Results We interviewed 4,262 and 4,082 women who gave live birth 2–14 months before data collection and identified 374 and 264 PSBI cases in April 2021 and June 2022, respectively. The prevalence of PSBI significantly decreased (p-value = 0.018) from 8.7% in April 2021 to 6.4% while the mothers’ care-seeking behavior from medical care for their sick newborns increased significantly from 56% to 91% (p-value
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.03.2024
Tilføjet 25.03.2024
Abstract Background Pakistan witnessed five waves of COVID-19 infections during the pandemic. Punjab, the largest province of Pakistan, remained the epicentre due to a high infection rate. Administrative data for five waves of the pandemic was analyzed to determine the rate of infections and the significance of pharmacological and non-pharmacological interventions on the severity and duration of infection. Methodology COVID-19 data from March 2020 to May 2023 was obtained from the Provincial Public Health Reference Laboratory (PPHRL), Punjab AIDS Control Program, Lahore. The data included samples from index cases, contacts, and recovered patients. A total of 36,252,48 cases were screened for COVID-19, and 90,923 (2.50%) were detected positive by RT-PCR, accounting for 5.69% of the cases reported positive throughout the country. Results Among the positive cases, 50.86% (n = 46,244) cases were new cases (registered for the first time), 40.41% (n = 36751) were the contact cases traced from the newly identified cases and 8.62% (n = 7842) repeated cases. The positivity rates among index cases were reported to be 2.37%, 2.34%, 4.61%, 2.09%, and 1.19%, respectively, for the five respective COVID-19 pandemic waves. Distribution by gender indicated that 64% of males and 35% of females were infected during the pandemic. The age factor demonstrated the most susceptibility to infection in women aged 19-29 years, whereas most males between the ages of 29-39 had an infection. Susceptibility to COVID-19 infection was observed to be equally likely between males and females; however, clinical outcomes indicated that infections in males were more severe and often resulted in fatalities as compared to those in females. This trend was also reflected in the viral titer as measured by the Ct values, where 40% of males had Ct values < 25 (an indicator of high viral titers) compared to 30% of females with Ct values < 25. Conclusion Overall, our data indicated that infection rates remained stable throughout the pandemic except for 3rd wave, which showed a higher incidence of infection rate of 4%. Additionally, data showed a positive impact of masking, social distancing, and immunization, as indicated by the shorter window of high infection rates.
Læs mere Tjek på PubMedClinical Infectious Diseases, 25.03.2024
Tilføjet 25.03.2024
Abstract Background A barrier to hepatitis C virus (HCV) cure is conventional testing. The aim of this study was to evaluate the effect of HCV antibody and RNA point-of-care-testing (POCT) on testing rates, linkage to care, treatment and acceptability of testing in three priority settings in Australia.Methods Participants were enrolled in an interventional cohort study at a reception prison, inpatient mental health service (MHS), and inpatient alcohol and other drug (AOD) unit—between October 2020 and December 2021. HCV POCT was performed using SD Bioline HCV antibody fingerstick test and a reflexive Xpert® HCV Viral Load Fingerstick test using capillary blood samples. A retrospective audit of HCV testing and treatment data was performed at each site for the preceding 12-month period to generate a historical control.Results 1,549 participants received a HCV antibody test with 17% (264/1,549) receiving a positive result, of which 21% (55/264) tested HCV RNA positive. Across all settings the rate of testing per year significantly increased between the historical controls and the study intervention period by three-fold (RR:2.57 95% CI: 2.32, 2.85) for HCV antibody testing and four-fold (RR:1.62; 95% CI:1.31, 2.01) for RNA testing. Treatment uptake was higher during the POCT intervention (86%, 47/55; P=0.010) compared to the historical controls (61%, 27/44).Conclusions This study demonstrated across three settings that the use of HCV antibody and RNA POCT increased testing rates, treatment uptake linkage to care. The testing model was highly acceptable for most participants.Clinical Trial Registration ACTRN-12621001578897
Læs mere Tjek på PubMedLiu, W., Wang, J., Wang, M., Ding, X., Wang, M., Liu, M.
BMJ Open, 24.03.2024
Tilføjet 24.03.2024
ObjectiveThis study aimed to systematically investigate the relationship between immune-inflammatory indexes with lower urinary tract symptoms (LUTSs). DesignCross-sectional study. SettingNational Health and Nutrition Examination Survey (NHANES) (2005–2008). ParticipantsA total of 2709 men with complete information for immune-inflammatory indexes and LUTSs were included from NHANES 2005–2008. Outcomes and analysesAutomated haematology analysing devices are used to measure blood cell counts, and LUTSs were presented by standard questionnaires. Non-linear and logistic regression analyses were used to estimate their association after adjustment for confounders. ResultsMultivariate logistic regression showed that pan-immune-inflammation value (OR (95% CI)=1.60 (1.14 to 2.23)), systemic inflammation response index (SIRI) (OR (95% CI)=1.82 (1.21 to 2.73)), neutrophil/lymphocyte ratio (NLR) (OR (95% CI)=1.81 (1.31 to 2.49)), derived NLR (dNLR) (OR (95% CI)=1.91 (1.35 to 2.70)) and C reactive protein (CRP) (OR (95% CI)=1.71 (1.05 to 2.79)) was positively associated with LUTS. Additionally, composite immune-inflammation markers exhibited a stronger association with LUTS than any single index, with the ORs for high SIRI+high CRP, high NLR+high CRP and high dNLR+high CRP being 2.26, 2.44 and 2.16, respectively (all p
Læs mere Tjek på PubMedZhang, M., Htun, N. S. N., Islam, S., Sen, A., Islam, A., Neogi, A. K., Tripura, R., Dysoley, L., Perrone, C., Chew, R., Batty, E. M., Thongpiam, W., Wongsantichon, J., Menggred, C., Zaman, S. I., Waithira, N., Blacksell, S., Liverani, M., Lee, S., Maude, R. J., Day, N. P. J., Lubell, Y., Peto, T. J.
BMJ Open, 24.03.2024
Tilføjet 24.03.2024
IntroductionIn low-income and middle-income countries in Southeast Asia, the burden of diseases among rural population remains poorly understood, posing a challenge for effective healthcare prioritisation and resource allocation. Addressing this knowledge gap, the South and Southeast Asia Community-based Trials Network (SEACTN) will undertake a survey that aims to determine the prevalence of a wide range of non-communicable and communicable diseases, as one of the key initiatives of its first project—the Rural Febrile Illness project (RFI). This survey, alongside other RFI studies that explore fever aetiology, leading causes of mortality, and establishing village and health facility maps and profiles, will provide an updated epidemiological background of the rural areas where the network is operational. Methods and analysisDuring 2022–2023, a cross-sectional household survey will be conducted across three SEACTN sites in Bangladesh, Cambodia and Thailand. Using a two-stage cluster-sampling approach, we will employ a probability-proportional-to-size sample method for village, and a simple random sample for household, selection, enrolling all members from the selected households. Approximately 1500 participants will be enrolled per country. Participants will undergo questionnaire interview, physical examination and haemoglobin point-of-care testing. Blood samples will be collected and sent to central laboratories to test for chronic and acute infections, and biomarkers associated with cardiovascular disease, and diabetes. Prevalences will be presented as an overall estimate by country, and stratified and compared across sites and participants’ sociodemographic characteristics. Associations between disease status, risk factors and other characteristics will be explored. Ethics and disseminationThis study protocol has been approved by the Oxford Tropical Research Ethics Committee, National Research Ethics Committee of Bangladesh Medical Research Council, the Cambodian National Ethics Committee for Health Research, the Chiang Rai Provincial Public Health Research Ethical Committee. The results will be disseminated via the local health authorities and partners, peer-reviewed journals and conference presentations. Trial registration numberNCT05389540.
Læs mere Tjek på PubMedJ. Stanley, B. Sullivan, A.W. Dowsey, K. Jones, C.R. Beck
Clinical Microbiology and Infection, 23.03.2024
Tilføjet 23.03.2024
Between 2016-19, the proportion of Escherichia coli bloodstream infection (BSI) with resistance to at least one antibiotic increased nationally. Public health interventions implemented in response to the coronavirus disease 2019 (COVID-19) pandemic changed population contact patterns and healthcare systems, with consequent effects on epidemiological trends of numerous pathogens. We investigated the impact of COVID-19 restrictions on epidemiological trends of E. coli BSI antimicrobial resistance (AMR) across South West England.
Læs mere Tjek på PubMedCrowell, Trevor A.; Ritz, Justin; Zheng, Lu; Naqvi, Asma; Cyktor, Joshua C.; Puleo, Joseph; Clagett, Brian; Lama, Javier R.; Kanyama, Cecilia; Little, Susan J.; Cohn, Susan E.; Riddler, Sharon A.; Collier, Ann C.; Heath, Sonya L.; Tantivitayakul, Pornphen; Grinsztejn, Beatriz; Arduino, Roberto C.; Rooney, James F.; van Zyl, Gert U.; Coombs, Robert W.; Fox, Lawrence; Ananworanich, Jintanat; Eron, Joseph J.; Sieg, Scott F.; Mellors, John W.; Daar, Eric S.; for the AIDS Clinical Trials Group (ACTG) A5354/EARLIER Study Team
AIDS, 23.03.2024
Tilføjet 23.03.2024
Objective: To assess how antiretroviral therapy (ART) initiation during acute or early HIV infection (AEHI) affects the viral reservoir and host immune responses. Design: Single-arm trial of ART initiation during AEHI at 30 sites in the Americas, Africa, and Asia. Methods: HIV DNA was measured at week 48 of ART in 5 million CD4+ T cells by sensitive qPCR assays targeting HIV gag and pol. Peripheral blood mononuclear cells were stimulated with potential HIV T cell epitope peptide pools consisting of env, gag, nef, and pol peptides and stained for expression of CD3, CD4, CD8, and intracellular cytokines/chemokines. Results: From 2017 to 2019, 188 participants initiated ART during Fiebig stages I (n = 6), II (n = 43), III (n = 56), IV (n = 23), and V (n = 60). Median age was 27 years (interquartile range 23–38), 27 (14%) participants were female, and 180 (97%) cisgender. Among 154 virally suppressed participants at week 48, 100% had detectable HIV gag or pol DNA. Participants treated during Fiebig I had the lowest HIV DNA levels (P 0.025). At week 48, the magnitude, but not polyfunctionality, of HIV-specific T cell responses was moderately reduced among participants who initiated ART earliest. Conclusion: Earlier ART initiation during AEHI reduced but did not eliminate the persistence of HIV-infected cells in blood. These findings explain the rapid viral rebound observed after ART cessation in early-treated individuals with undetectable HIV DNA by less sensitive methods. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMaha Farhat, Helen Cox, Marwan Ghanem, Claudia M. Denkinger, Camilla Rodrigues, Mirna S. Abd El Aziz, Handaa Enkh-Amgalan, Debrah Vambe, Cesar Ugarte-Gil, Jennifer Furin, Madhukar Pai
Nat Rev Microbiol, 23.03.2024
Tilføjet 23.03.2024
Leire Ambrosio, Jacqui Morris, Danielle Lambrick, James Faulkner, Eric Compton, Mari Carmen Portillo
PLoS One Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
by Leire Ambrosio, Jacqui Morris, Danielle Lambrick, James Faulkner, Eric Compton, Mari Carmen Portillo
Læs mere Tjek på PubMedPaulina Guzmán-Guzmán, Eduardo Valencia-Cantero, Gustavo Santoyo
PLoS One Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
by Paulina Guzmán-Guzmán, Eduardo Valencia-Cantero, Gustavo Santoyo Trichoderma uses different molecules to establish communication during its interactions with other organisms, such as effector proteins. Effectors modulate plant physiology to colonize plant roots or improve Trichoderma’s mycoparasitic capacity. In the soil, these fungi can establish relationships with plant growth–promoting bacteria (PGPBs), thus affecting their overall benefits on the plant or its fungal prey, and possibly, the role of effector proteins. The aim of this study was to determine the induction of Trichoderma atroviride gene expression coding for effector proteins during the interaction with different PGPBs, Arabidopsis or the phytopathogen Fusarium brachygibbosum, and to determine whether PGPBs potentiates the beneficial effects of T. atroviride. During the interaction with F. brachygibbosum and PGPBs, the effector coding genes epl1, tatrx2 and tacfem1 increased their expression, especially during the consortia with the bacteria. During the interaction of T. atroviride with the plant and PGPBs, the expression of epl1 and tatrx2 increased, mainly with the consortium formed with Pseudomonas fluorescens UM270, Bacillus velezensis AF12, or B. halotolerans AF23. Additionally, the consortium formed by T. atroviride and R. badensis SER3 stimulated A. thaliana PR1:GUS and LOX2:GUS for SA- and JA-mediated defence responses. Finally, the consortium of T. atroviride with SER3 was better at inhibiting pathogen growth, but the consortium of T. atroviride with UM270 was better at promoting Arabidopsis growth. These results showed that the biocontrol capacity and plant growth-promoting traits of Trichoderma spp. can be potentiated by PGPBs by stimulating its effector functions.
Læs mere Tjek på PubMedSharifa Ezat Wan Puteh, Mohd Shafiq Aazmi, Muhammad Nazri Aziz, Noor ‘Adilah Kamarudin, Jamal I-Ching Sam, Ravindran Thayan, Wan Rozita Wan Mahiyuddin, Wan Noraini Wan Mohamed Noor, Adelina Cheong, Clotilde El Guerche-Séblain, Jean Khor, Eva Nabiha Zamri, Jia-Yong Lam, Zamberi Sekawi
PLoS One Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
by Sharifa Ezat Wan Puteh, Mohd Shafiq Aazmi, Muhammad Nazri Aziz, Noor ‘Adilah Kamarudin, Jamal I-Ching Sam, Ravindran Thayan, Wan Rozita Wan Mahiyuddin, Wan Noraini Wan Mohamed Noor, Adelina Cheong, Clotilde El Guerche-Séblain, Jean Khor, Eva Nabiha Zamri, Jia-Yong Lam, Zamberi Sekawi Background and objectives While influenza circulates year-round in Malaysia, research data on its incidence is scarce. Yet, this information is vital to the improvement of public health through evidence-based policies. In this cross-sectional study, we aimed to determine the trends and financial costs of influenza. Methods Data for the years 2016 through 2018 were gathered retrospectively from several sources. These were existing Ministry of Health (MOH) influenza sentinel sites data, two teaching hospitals, and two private medical institutions in the Klang Valley, Malaysia. Expert consensus determined the final estimates of burden for laboratory-confirmed influenza-like illness (ILI) and severe acute respiratory infection (SARI). Economic burden was estimated separately using secondary data supplemented by MOH casemix costing. Results Altogether, data for 11,652 cases of ILI and 5,764 cases of SARI were extracted. The influenza B subtype was found to be predominant in 2016, while influenza A was more prevalent in 2017 and 2018. The distribution timeline revealed that the highest frequency of cases occurred in March and April of all three years. The costs of influenza amounted to MYR 310.9 million over the full three-year period. Conclusions The study provides valuable insights into the dynamic landscape of influenza in Malaysia. The findings reveal a consistent year-round presence of influenza with irregular seasonal peaks, including a notable influenza A epidemic in 2017 and consistent surges in influenza B incidence during March across three years. These findings underscore the significance of continuous monitoring influenza subtypes for informed healthcare strategies as well as advocate for the integration of influenza vaccination into Malaysia’s national immunization program, enhancing overall pandemic preparedness.
Læs mere Tjek på PubMedHuining Yan, Hua Li, Qiubai Sun, Yuxi Jiang
PLoS One Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
by Huining Yan, Hua Li, Qiubai Sun, Yuxi Jiang To study the propagation pattern of congestion risk in the traffic network and enhance risk control capabilities, a model has been developed. This model takes into account the probabilities of five threats (the risk occurrence probability; the risk of loss; the unpredictability of risk; the uncontrollability of risk; the transferability of risk) in the traffic network to define the risk entropy and determine the risk capacity, analyze the mechanism of congestion risk propagation, and explore the impact of risk resistance, the average degree of risk capacity at intersections, and the degree of correlation on congestion risk propagation. Further, a control method model for risk propagation is proposed. Numerical simulation results demonstrate that the risk resistance parameter θ can inhibit the propagation of congestion risk during traffic congestion. The highest efficiency in controlling risk propagation is achieved when θ reaches a threshold value θ*. Furthermore, the average degree of intersection risk capacity α shows a positive correlation with θ* and a negative correlation with control efficiency. However, the degree of association ω has a negative effect on risk propagation control, decreasing the degree of association between nodes aids in risk propagation control.
Læs mere Tjek på PubMedMalaria Journal, 22.03.2024
Tilføjet 22.03.2024
Abstract Background The burden of Malaria in Zambia remains a challenge, with the entire population at risk of contracting this infectious disease. Despite concerted efforts by African countries, including Zambia, to implement malaria policies and strategies aimed at reducing case incidence, the region faces significant hurdles, especially with emerging pandemics such as COVID-19. The efforts to control malaria were impacted by the constraints imposed to curb its transmission during the COVID-19 pandemic. The aim of the study was to assess the effect of the COVID-19 pandemic on malaria cases in Zambia and the factors associated by comparing the COVID-19 period and the pre-COVID-19 era. Methods This was a cross-sectional panel study in which routinely collected programmatic data on malaria was used. The data were extracted from the Health Management Information System (HMIS) for the period January 2018 to January 2022. The period 2018 to 2022 was selected purely due to the availability of data and to avoid the problem of extrapolating too far away from the period of interest of the study. A summary of descriptive statistics was performed in which the number of cases were stratified by province, age group, and malaria cases. The association of these variables with the COVID-19 era was checked using the Wilcoxon rank-sum test and Kruskal‒Wallis test as applicable. In establishing the factors associated with the number of malaria cases, a mixed-effect multilevel model using the Poisson random intercept and random slope of the COVID-19 panel. The model was employed to deal with the possible correlation of the number of cases in the non-COVID-19 panel and the expected correlation of the number of cases in the COVID-19 panel. Results A total of 18,216 records were extracted from HMIS from January 2018 to January 2022. Stratifying this by the COVID-19 period/era, it was established that 8,852 malaria cases were recorded in the non-COVID-19 period, whereas 9,364 cases were recorded in the COVID-19 era. Most of the people with malaria were above the age of 15 years. Furthermore, the study found a significant increase in the relative incidence of the COVID-19 panel period compared to the non-COVID-19 panel period of 1.32, 95% CI (1.18, 1.48, p
Læs mere Tjek på PubMedFlorina Regele, Frederik Haupenthal, Konstantin Doberer, Irene Görzer, Sebastian Kapps, Robert Strassl, Gregor Bond
Journal of Medical Virology, 22.03.2024
Tilføjet 22.03.2024
BMC Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
Abstract Background Vagococcal infections are extremely rare in humans. There are limited studies on the optimal methods for identification, antimicrobial susceptibility testing, and clinical manifestations of vagococcal infections. Herein, we report a patient with a urinary tract infection who had Vagococcus fluvialis in the urine. Case presentation An 84-year-old man presented to our urology department with a fever that had persisted for several days. He previously worked as a zoo clerk. The patient underwent a left nephroureterectomy for ureteral cancer 5 years ago, and total cystectomy and right cutaneous ureterostomy for muscle-invasive bladder cancer 1 year prior. He was empirically treated with 500 mg of levofloxacin intravenously every 24 h for the urinary tract infection. V. fluvialis was detected in his urine samples and Pseudomonas aeruginosa was detected in his urine and blood samples. Two bacterial species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. He was administered intravenous levofloxacin for approximately 1 week, followed by oral levofloxacin for another week, after which the infections were eradicated. Conclusions To the best of our knowledge, this is the first report of V. fluvialis detected in human urine in Japan. Vagococcus spp. is commonly isolated from fish or animals, and based on the patient’s work history, it is possible that the patient was a carrier because of transmission from animals.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
Abstract Background Tuberculous sepsis is uncommon in individuals without human immunodeficiency virus (HIV) infection, and some patients may not exhibit clinical signs and symptoms of suspected sepsis upon admission, leading to delayed diagnosis and treatment. Case presentation This report present the case of a 60-year-old female patient who presented with erythema, edema, and pain in her right upper limb accompanied by fever and chills. Further evaluation revealed multiple intermuscular abscesses caused by suspected gram-positive bacteria. Despite receiving anti-infection treatment, the patient rapidly progressed to septic shock and respiratory failure. Metagenomic next-generation sequencing (mNGS) analysis of blood samples detected Mycobacterium tuberculosis complex groups (11 reads). Additionally, mNGS analysis of fluid obtained from puncture of the abscess in the right upper extremity also suggested Mycobacterium tuberculosis complex groups (221 981 reads). Consequently, the patient was diagnosed with tuberculous sepsis resulting from hematogenous dissemination of Mycobacterium tuberculosis. Following the administration of anti-tuberculosis treatment, a gradual recovery was observed during the subsequent follow-up period. Conclusion It is noteworthy that atypical hematogenous disseminated tuberculosis can be prone to misdiagnosis or oversight, potentially leading to septic shock. This case illustrates the importance of early diagnosis and treatment of tuberculosis sepsis. Advanced diagnostic techniques such as mNGS can aid clinicians in the early identification of pathogens for definitive diagnosis.
Læs mere Tjek på PubMedBMC Infectious Diseases, 22.03.2024
Tilføjet 22.03.2024
Abstract Background Data on the characteristics of individuals with mild and asymptomatic infections with different SARS-CoV-2 variants are limited. We therefore compared the characteristics of individuals infected with ancestral, Beta and Delta SARS-CoV-2 variants in South Africa. Methods We conducted a prospective cohort study in a rural and an urban site during July 2020-August 2021. Mid-turbinate nasal swabs were collected twice-weekly from household members irrespective of symptoms and tested for SARS-CoV-2 using real-time reverse transcription polymerase chain reaction (rRT-PCR). Differences in demographic and clinical characteristics, shedding and cycle threshold (Ct) value of infection episodes by variant were evaluated using multinomial regression. Overall and age-specific incidence rates of infection were compared by variant. Results We included 1200 individuals from 222 households and 648 rRT-PCR-confirmed infection episodes (66, 10% ancestral, 260, 40% Beta, 322, 50% Delta). Symptomatic proportion was similar for ancestral (7, 11%), Beta (44, 17%), and Delta (46, 14%) infections (p=0.4). After accounting for previous infection, peak incidence shifted to younger age groups in successive waves (40-59 years ancestral, 19-39 years Beta, 13-18 years Delta). On multivariable analysis, compared to ancestral, Beta infection was more common in individuals aged 5-12 years (vs 19-39)(adjusted odds ratio (aOR) 2.6, 95% confidence interval (CI)1.1-6.6) and PCR cycle threshold (Ct) value 35)(aOR 3.2, 95%CI 1.3-7.9), while Delta was more common in individuals aged
Læs mere Tjek på PubMedTobias Weirauch, Gerrit Burger, Dániel Cadar, Martin Gabriel, Julia Koepsell, Gundolf Schüttfort, Philipp de Leuw, Markus Bickel, Maria J.G.T. Vehreschild, Timo Wolf, Nils Wetzstein
International Journal of Infectious Diseases, 21.03.2024
Tilføjet 21.03.2024
Yellow fever (YF) is a potentially lethal viral hemorrhagic fever transmitted to humans by Haemagogous and Aedes spp., (mainly Aedes aegypti). The risk of a YF infection for unvaccinated people during a two week stay in West Africa is about 50:100.000 and 5:100.000 in South America. Case fatality rates reach up to 40-60% in South America but are estimated at 20% in Africa [1]. The 17D live attenuated YF vaccine, which was developed in 1937 by Max Theiler, proved to be a highly effective method in preventing an outbreak of the symptomatic disease, but can also cause severe adverse reactions like YF vaccine-associated neurotropic disease (YEL-AND) or YF vaccine-associated viscerotropic disease (YEL-AVD) [2].
Læs mere Tjek på PubMedGuilherme C. Fröhlich, Tatiana S. Gregianini, Felipe G. Pinheiro, Rodrigo Nascimento, Thiago M. Cezar, Veridiane M. Pscheidt, Tainá Selayaran, Letícia G. Martins, Marcelo Ferreira da Costa Gomes, Richard S. Salvato, Elisa C. Pereira, Victor Guimarães‐Ribeiro, Letícia de Paula Scalioni, Marilda M. Siqueira, Paola C. Resende, Ana B. G. Veiga, LACEN‐RS Team
Journal of Medical Virology, 21.03.2024
Tilføjet 21.03.2024
Maria Luisa Arruda Correia, Fernando Maia Peixoto Filho, Saint Clair Gomes Júnior, Guilherme Ramires de Jesus
PLoS One Infectious Diseases, 21.03.2024
Tilføjet 21.03.2024
by Maria Luisa Arruda Correia, Fernando Maia Peixoto Filho, Saint Clair Gomes Júnior, Guilherme Ramires de Jesus Objective To evaluate the maternal-fetal hemodynamic effects after osteopathic manipulative treatment by measuring vital signs and Doppler velocimetry in third-trimester pregnant women. Materials and methods This is a prospective study with pregnant women undergoing outpatient follow-up and hospitalized in a ward at Instituto Fernandes Figueira/Fiocruz, between August 2021 to August 2022, during the SARS-CoV-2 pandemic. This study was registered in REBEC under Register Number RBR-9q7kvg and approved by the ethics committee under number 32216620.0.0000.5269. The study population was composed of 51 pregnant women between 28 and 40 weeks of gestation, over 18 years of age, allocated in a single group. Pregnancies with multiple fetuses, malformations, premature rupture of the membrane, and active labor were excluded. The procedures evaluated maternal-fetal hemodynamics using three consecutive measures of ultrasound examination with Doppler velocimetry, and three maternal vital signs measured by an electronic blood pressure monitor. Results Most vital signs changed after osteopathic treatment. However, only the systolic blood pressure (109.92 ±14.42 to 110.71±12.8, p = 0.033), diastolic blood pressure (79.8±11.54 to 77.57±9.44, p = 0.018) and heart rate (87.59±11.93 to 81.12±10.26, p = 0.000) in the sitting position, systolic blood pressure (110.75±13.26 to 108.59±13.07; p = 0.034) in the supine, and heart rate (83.22±11.29 to 80.39±11.0; p = 0.013) in left lateral decubitus reached statistical significance. The oximetry measures (98.55±0.64 to 98.67±0.68; p = 0.098) stayed stable during all three positions.All artery values remained stable after treatment, and no statistically significant difference was recorded in the artery results. Conclusion Responses to osteopathic treatment in women in the third trimester of pregnancy did not affect uteroplacental and fetoplacental circulation. However, some maternal vital signs had statistically significant results, with a decrease in diastolic blood pressure and heart rate, and an increase in systolic blood pressure in the sitting position, a decrease of heart rate in the left lateral decubitus position, and systolic blood pressure in the supine position. All the results observed were maintained in the normal parameters. The study responses attest to the safety of using the osteopathic manipulative treatment for the fetus and for pregnant women with comorbidities.
Læs mere Tjek på PubMedPing Chen, Tingting Hu, Zheng Zheng, Robert E. Garfield, Jinying Yang
PLoS One Infectious Diseases, 21.03.2024
Tilføjet 21.03.2024
by Ping Chen, Tingting Hu, Zheng Zheng, Robert E. Garfield, Jinying Yang Objective The mechanism of cervical ripening in late pregnancy is still unclear. The vaginal microbiome has been reported to correlate with the preterm birth and short cervix in pregnant women. However, the associations between the cervical maturity and the vaginal microbiome are still poorly understood. We aim to analyze the cervicovaginal microflora in women with ripe cervix and in those who are unripe when delivering at term. Methods Cervicovaginal swabs were collected between 40 and 41 weeks of gestation from the following 2 different groups of patients: ripe group (n = 25) and unripe group (n = 25). Samples were tested using 16S ribosomal RNA gene high-throughput sequencing and analyzed by bioinformatics platform. Results This study highlights the relationship between cervical maturity during late pregnancy and the composition of the cervicovaginal microflora. Both α- and β-diversity analyses demonstrated significant differences between women with a ripe cervix and those with an unripe cervix. Notably, the Lactobacillus profile was found to be closely linked to cervical maturity. There was a significant difference in the vaginal community state type, with CST IV being more prevalent in women with an unripe cervix. Furthermore, the association between CST IV and the unripe cervix group, as indicated by the odds ratio of 8.6, underscores its relevance in evaluating cervical maturity, when compared to other Lactobacillus-dominant community state types. Additionally, several bacterial taxa, particularly Lactobacillus, exhibited differential relative abundances between the two groups. Conclusion This study provided significant evidence regarding the relationship between the vaginal microbiome and cervical maturity, highlighting the differential diversity, community state types, and specific bacterial taxa, such as Lactobacillus, that are associated with cervical maturation status. These findings contributed to our understanding of the dynamics of the cervicovaginal microflora during late pregnancy and its implications for cervical health.
Læs mere Tjek på PubMedLindsay H. Dewa, Lily Roberts, Elizabeth Choong, Caroline Crandell, Ola Demkowicz, Emma Ashworth, Catia Branquinho, Steph Scott
PLoS One Infectious Diseases, 21.03.2024
Tilføjet 21.03.2024
by Lindsay H. Dewa, Lily Roberts, Elizabeth Choong, Caroline Crandell, Ola Demkowicz, Emma Ashworth, Catia Branquinho, Steph Scott Background The impact of the Covid-19 pandemic on young people’s (YP) mental health has been mixed. Systematic reviews to date have focused predominantly on quantitative studies and lacked involvement from YP with lived experience of mental health difficulties. Therefore, our primary aim was to conduct a qualitative systematic review to examine the perceived impact of the Covid-19 pandemic on YP’s (aged 10–24) mental health and wellbeing across Europe. Methods and findings We searched MEDLINE, PsycINFO, Embase, Web of Science, MEDRXIV, OSF preprints, Google, and voluntary sector websites for studies published from 1st January 2020 to 15th November 2022. European studies were included if they reported qualitative data that could be extracted on YP’s (aged 10–24) own perspectives of their experiences of Covid-19 and related disruptions to their mental health and wellbeing. Screening, data extraction and appraisal was conducted independently in duplicate by researchers and YP with lived experience of mental health difficulties (co-researchers). Confidence was assessed using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approach. We co-produced an adapted narrative thematic synthesis with co-researchers. This study is registered with PROSPERO, CRD42021251578. We found 82 publications and included 77 unique studies in our narrative synthesis. Most studies were from the UK (n = 50; 65%); and generated data during the first Covid-19 wave (March-May 2020; n = 33; 43%). Across the 79,491 participants, views, and experiences of YP minoritised by ethnicity and sexual orientation, and from marginalised or vulnerable YP were limited. Five synthesised themes were identified: negative impact of pandemic information and restrictions on wellbeing; education and learning on wellbeing; social connection to prevent loneliness and disconnection; emotional, lifestyle and behavioural changes; and mental health support. YP’s mental health and wellbeing across Europe were reported to have fluctuated during the pandemic. Challenges were similar but coping strategies to manage the impact of these challenges on mental health varied across person, study, and country. Short-term impacts were related to the consequences of changing restrictions on social connection, day-to-day lifestyle, and education set-up. However, YP identified potential issues in these areas going forward, and therefore stressed the importance of ongoing long-term support in education, learning and mental health post-Covid-19. Conclusions Our findings map onto the complex picture seen from quantitative systematic reviews regarding the impact of Covid-19 on YP’s mental health. The comparatively little qualitative data found in our review means there is an urgent need for more high-quality qualitative research outside of the UK and/or about the experiences of minoritised groups to ensure all voices are heard and everyone is getting the support they need following the pandemic. YP’s voices need to be prioritised in decision-making processes on education, self-care strategies, and mental health and wellbeing, to drive impactful, meaningful policy changes in anticipation of a future systemic crisis.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 20.03.2024
Tilføjet 20.03.2024
Abstract HIV-1 RNA genetic diversity predicts time since infection which is important for clinical care and research. It\'s unclear, however, whether proviral DNA genetic diversity sampled under suppressive antiretroviral therapy can be used for this purpose. We tested whether proviral genetic diversity from NGS sequences predicts time since infection and recency in 221 people with HIV-1 with known infection time. Proviral diversity was significantly associated with time since infection (p
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