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Malaria Journal, 25.10.2024
Tilføjet 25.10.2024
Abstract Background Pulmonary oedema is a feared and difficult to predict complication of severe malaria that can emerge after start of antimalarial treatment. Proinflammatory mediators are thought to play a central role in its pathogenesis. Methods An exploratory study was conducted to evaluate the predictive capacity of biomarkers for development of clinical pulmonary oedema in patients with severe falciparum malaria at two hospitals in Bangladesh. Plasma concentrations of interleukin-6 (IL-6), IL-8, tumour necrosis factor (TNF), soluble Receptor of Advanced Glycation End-products (sRAGE), surfactant protein-D (SP-D), club cell secretory protein (CC16), and Krebs von den Lungen-6 (KL-6) on admission were compared with healthy controls. Correlations between these biomarker and plasma lactate and Plasmodium falciparum histidine-rich protein 2 (PfHRP2) levels were evaluated. Receiver Operating Characteristic (ROC) curves were constructed to assess the predictive capacity for clinical pulmonary oedema of the biomarkers of interest. Results Of 106 screened patients with falciparum malaria, 56 were classified as having severe malaria with a mortality rate of 29%. Nine (16%) patients developed clinical pulmonary oedema after admission. Plasma levels of the biomarkers of interest were higher in patients compared to healthy controls. IL-6, IL-8, TNF, sRAGE, and CC16 levels correlated well with plasma PfHRP2 levels (rs = 0.39; P = 0.004, rs = 0.43; P = 0.001, rs = 0.54; P
Læs mere Tjek på PubMedJ. SnobreC. J. MeehanW. MuldersL. RigoutsR. BuylB. C. de JongA. Van RieO. Tzfadia1Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium2Department of Biosciences, Nottingham Trent University, Nottingham, United Kingdom3Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium4Vrije Universiteit Brussel, Brussels, BelgiumSean Wasserman
Antimicrobial Agents And Chemotherapy, 25.10.2024
Tilføjet 25.10.2024
Johan H. MelendezVonetta L. EdwardsAdamaris Muniz TiradoJustin HardickAditya MehtaJain AluvathingalAdonis D'MelloCharlotte A. GaydosYukari C. ManabeHervé Tettelin1Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA2Department of Microbiology and Immunology, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USABoudewijn L. de Jonge
Antimicrobial Agents And Chemotherapy, 25.10.2024
Tilføjet 25.10.2024
Infection, 25.10.2024
Tilføjet 25.10.2024
Infection, 25.10.2024
Tilføjet 25.10.2024
Abstract Purpose Antibiotics are often only available in predefined pack sizes, which may not align with guideline recommendations. This can result in leftover pills, leading to inappropriate self-medication or waste disposal, which can both foster the development of antibiotic resistance. The magnitude of inappropriate pack sizes is largely unknown. The objective of this study was to evaluate the potential non-conformity of prescribed antibiotic pack sizes. Methods This retrospective observational study was based on claims data from a large Swiss health insurance company. The study analysed the prescriptions of eleven different antibiotic substances recommended for the five most common indications for antibiotics in Switzerland. All prescriptions for adult outpatients issued by general practitioners in 2022 were included and extrapolated to the entire Swiss population. Potential non-conformity was defined as a mismatch between the total dosage in a pack and the total dosage recommended. Results A total of n = 947,439 extrapolated prescriptions were analysed. In 10 of 23 of all analysed substance/indication combinations none of the prescribed packs aligned with the respective guideline recommendation. Considering pack sizes in which the total prescribed dosage of a substance did not correspond to any of the total dosages recommended in at least one of the guidelines, 31.6% of prescriptions were potentially non-conform and an estimated number of 2.7 million tablets were overprescribed. Conclusions We found a large discrepancy between prescribed pack sizes and guideline recommendations. Since inadequately prepacked antibiotics may lead to antibiotic resistance and unnecessary waste, efforts are needed to implement alternatives like exact pill dispensing.
Læs mere Tjek på PubMedInfection, 25.10.2024
Tilføjet 25.10.2024
Abstract Purpose Although guidelines recommend adjunctive rifampin and gentamicin use for patients with staphylococcal prosthetic valve endocarditis (PVE), evidence behind the recommendation is limited and conflicting. Methods We performed a retrospective cohort study of all patients with staphylococcal PVE within the Veterans Health Administration during 2003–2021. Patients were identified with diagnostic codes for prosthetic valves and positive blood cultures for Staphylococcus species and confirmed via manual chart reviews. The primary outcome was the composite of all-cause mortality or recurrence of staphylococcal PVE within one year from diagnosis. Inverse probability of treatment weighting (IPTW) was used to estimate the probability of individuals receiving rifampin using propensity scores. IPTW-adjusted multivariable Cox regression analysis was used to compare outcomes between patients who received rifampin and gentamicin, and those did not. Results Among 373 patients with staphylococcal PVE, 275 (73.7%) and 225 (60.3%) received at least one dose of rifampin and gentamicin, respectively. The incidence of staphylococcal PVE increased from 0.47 (2003-11) to 0.77 (2012-21) per 10,000 hospitalizations. Gentamicin use declined over time (70.1% in 2003–2011 to 54.8% in 2012–2021, p = 0.04) while rifampin use did not change significantly (76.1% in 2003–2011 to 72.4% in 2012–2021, p = 0.43). The composite outcome was observed in 209 (56.0%). Neither rifampin use (adjusted hazard ratio [HR] 0.77, 95% CI 0.48–1.24) and gentamicin use (adjusted HR 1.11, 95% CI 0.71–1.74) was associated with the composite outcome. Conclusion No significant association was observed between adjunctive rifampin or gentamicin use and improved outcomes.
Læs mere Tjek på PubMedInfection, 25.10.2024
Tilføjet 25.10.2024
Abstract Purpose The worldwide prevalence of Chagas Cardiomyopathy (CCM) as well as the trends in the prevalence of CCM over time have not been well characterized. Methods An analysis of the Global Burden of Disease (GBD) data from 1990 to 2019 was conducted to assess the burden of CCM. This study focused on determining the prevalence of CCM, along with its age-standardized prevalence rate (ASR) per 1,00,000 people, considering various patient demographics and geographical regions as defined in the GBD. Additionally, the study examined the temporal trends over this 30-year period by calculating the estimated annual percentage change (EAPC) in CCM prevalence for the global population and specific subgroups. Results Worldwide, the GBD reported 220,166 individuals with CCM in 1990 and 2,83,236 individuals in 2019, with a decline in the ASR from 5.23 (3.34–7.47) to 3.42 (2.2–4.91) per 1,00,000 individuals during that period. In 2019, the prevalence was highest in individuals over age 70 and in males compared to females. Among available geographic classifications in 2019, Latin American regions had the highest rates (ASR of 39.49–61.15/1,00,000), while high income North American and Western European regions had the lowest rates (ASRs of 0.67 and 0.34/1,00,000, respectively). Between 1990 and 2019, the worldwide prevalence of CCM per 1,00,000 decreased (EAPC of −0.35, −0.37 to −0.32), with similar trends among most regions and subgroups. Conclusion This analysis of the GBD data reveals both global and country-specific patterns in the prevalence and trends of CCM. Notably, CCM shows the highest prevalence in Latin American countries, although it’s also significantly present in regions beyond Latin America. Notably, the global age-standardized rate of CCM is on the decline, suggesting improvements in healthcare strategies or lifestyle changes across the world.
Læs mere Tjek på PubMedInfection, 25.10.2024
Tilføjet 25.10.2024
BMC Infectious Diseases, 25.10.2024
Tilføjet 25.10.2024
Abstract Mathematical modelling of (re)emerging infectious respiratory diseases among humans poses multiple challenges for modellers, which can arise as a result of limited data and surveillance, uncertainty in the natural history of the disease, as well as public health and individual responses to outbreaks. Here, we propose a COVID-19-inspired health state diagram (HSD) to serve as a foundational framework for conceptualising the modelling process for (re)emerging respiratory diseases, and public health responses, in the early stages of their emergence. The HSD aims to serve as a starting point for reflection on the structure and parameterisation of a transmission model to assess the impact of the (re)emerging disease and the capacity of public health interventions to control transmission. We also explore the adaptability of the HSD to different (re)emerging diseases using the characteristics of three respiratory diseases of historical public health importance. We outline key questions to contemplate when applying and adapting this HSD to (re)emerging infectious diseases and provide reflections on adapting the framework for public health-related interventions.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2024
Tilføjet 25.10.2024
Abstract Background Dexamethasone is currently administered for Coronavirus disease 2019(COVID-19); however, there are concerns about its effect on specific antibodies’ production. The aim of this study was to evaluate whether specific antibodies were affected by COVID-19 severity and corticosteroid treatment. Methods Of 251 confirmed COVID-19 patients admitted to our hospital between January 26 and August 10, 2020, the early period of the pandemic, 75 patients with sera within 1 month of onset and 1 month or longer were included in the research. A total of 253 serum samples from these patients were collected. The levels of specific antibodies for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), immunoglobulin G (IgG) and M (IgM), were measured retrospectively. The results were compared separately of each COVID-19 severity, and with or without corticosteroid treatment. Results Among the 75 patients, 47, 18, and 10 had mild, moderate, and severe disease, respectively. The median age was 53.0 years and 22 (29%) were women. The most common comorbidities were hypertension and dyslipidemia. Corticosteroids were administered to 20 (27%) and 10 (53%), patients with moderate and severe disease, respectively. The positivity rates IgM increased first, and IgG was almost always positive after day 16, regardless of the severity of COVID-19. On days 6–10, both IgG and IgM positivity rates were higher in patients with moderate disease than in those with mild or severe disease. In patients with moderate disease, IgG positivity was similar over time, regardless of corticosteroid treatment. Conclusions In COVID-19 patients, specific IgG is positive and maintained for a long period of time, even after corticosteroid treatment. The effect of corticosteroid treatment in a COVID-19 epidemiological study using specific IgG antibodies was considered minor. COVID-19 patients were more likely to receive oxygen if IgM was positive 1 week after onset, but not mechanical ventilation. IgM measurement 1 week after onset may predict COVID-19 severity.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2024
Tilføjet 25.10.2024
Abstract Background Chikungunya cases was reported to be on the rise in Malaysia from 2019 to 2021. Although potential endemicity was described previously, genotype shift during 2008 outbreak originating from the 2004 Indian Ocean Islands outbreak presents the probability of current CHIKV spread from neighboring countries. This is due to the prevalence of the new IOL sub-lineage which consists of E1-226A wildtype or reverted strains that are circulating in the Indian subcontinent before spreading to neighboring Thailand during 2018–2019 outbreak. Method In this study, samples received mostly from the Tangkak, Johor were analyzed. A total 56 CHIKV positive serum samples received in 2021 by Institute of Medical Research Malaysia (IMR), were collected based on sample selection criteria. Selected samples were subjected to total RNA extraction, whole-genome sequencing as well as bioinformatic analysis such as phylogenetic, variant and mutation analysis. Results Based on the genomic and phylogenetic analysis, the CHIKV samples from 2021 outbreak were of ECSA-IOL genotype. Genome similarity analysis also revealed that these CHIKVs were highly similar to 2018–2019 outbreak strain from Thailand. In comparison to the 2008 outbreak CHIKV isolate, the current CHIKVs lacked the E1-A226V mutation and harbored the new E1-K211E/E2-V264A sub-linage mutation. Since the E1-K211E/E2-V264A mutation facilitates adaptation to Ae. aegypti as opposed to the E1-A226V mutation which improves adaptation to Ae. albopictus, the emergence 2021 CHIKV outbreak in Malaysia can be postulated due to vector shift. Interestingly, a novel nsP3-T441A/V mutation detected in this study, may also play a role in virus transmission, pathogenicity, fitness and vector adaptation. Conclusion In summary, the current CHIKV outbreak are strains originated from the Indian subcontinent through Thailand which may have capitalized on vector shifting by adapting to Ae. aegypti. The presence of novel nsP3-T441A/V mutation may also contribute to the spread of this virus across peninsular Malaysia.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.10.2024
Tilføjet 25.10.2024
Abstract Background Micrococcus antarcticus (M. antarcticus) is an aerobic Gram-positive spherical actinobacterium that was initially isolated from Chinese Great-Wall station in Antarctica in 2000. M. antarcticus was considered to be of low pathogenicity, no previous cases of human infection by this organism have been reported. Here we describe the first report with community-acquired pneumonia (CAP) caused by M. antarcticus. Case presentation An 87-year-old female was presented to the Central Hospital of Wuhan in November 2023 with a chief complaint of cough, sputum production, and chest tightness for 2 weeks. Microbial culture of the patient’s bronchoalveolar lavage fluid (BALF) and identification of the isolates using Matrix-assisted laser desorption ionization/time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing revealed M. antarcticus infection. Combined with clinical symptoms, laboratory and imaging examination, the patient was diagnosed with CAP. Then cefoperazone/sulbactam and levofloxacin was administrated, the patient’s condition was improved and she was discharged after a week after admission, no abnormalities were detected during a 5-month follow-up. Conclusions This case highlights that M. antarcticus, first identified from a patient with CAP, is an extremely rare pathogenic microorganism. Clinicians should be aware of its potential as a pathogen in the diagnosis and treatment of CAP.
Læs mere Tjek på PubMedNazer, Lama H.; Awad, Wedad; Thawabieh, Hadeel; Abusara, Aseel; Abdelrahman, Deema; Addassi, Awad; Abuatta, Osama; Sughayer, Maher; Shehabi, Yahya
Critical Care Explorations, 25.10.2024
Tilføjet 25.10.2024
OBJECTIVES: To evaluate the effect of procalcitonin-guided management on the duration of antibiotic therapy in critically ill cancer patients with sepsis. DESIGN: Randomized, controlled, single-blinded trial. SETTING: A comprehensive multidisciplinary cancer hospital in Jordan. PATIENTS: Adults with cancer treated in the ICU who were started on antibiotics for suspected infection, met the SEPSIS-3 criteria, and were expected to stay in the ICU greater than or equal to 48 hours. INTERVENTIONS: Patients were randomized to the procalcitonin-guided or standard care (SC) arms. All patients had procalcitonin measured daily, up to 5 days or until ICU discharge or death. For the procalcitonin arm, a procalcitonin-guided algorithm was provided to guide antibiotic management, but clinicians were allowed to override the algorithm, if clinically indicated. In the SC arm, ICU clinicians were blinded to the procalcitonin levels. MEASUREMENTS AND MAIN RESULTS: Primary outcome was time to antibiotic cessation. We also evaluated the number of antibiotic-free days at 28 days, hospital discharge, or death, whichever came first, and antibiotic defined daily doses (DDDs). We enrolled 77 patients in the procalcitonin arm and 76 in the SC arm. Mean age was 58 ± 14 (sd) years, 67% were males, 74% had solid tumors, and 13% were neutropenic. Median (interquartile range [IQR]) Sequential Organ Failure Assessment scores were 7 (6–10) and 7 (5–9) and procalcitonin concentrations (ng/mL) at baseline were 3.4 (0.8–16) and 3.4 (0.5–26), in the procalcitonin and SC arms, respectively. There was no difference in the median (IQR) time to antibiotic cessation in the procalcitonin and SC arms, 8 (4–11) and 8 (5–13), respectively (p = 0.463). Median (IQR) number of antibiotic-free days were 20 (17–24) and 20 (16–23), (p = 0.484) and total DDDs were 1541.4 and 2050.4 in the procalcitonin and SC arms, respectively. CONCLUSIONS: In critically ill cancer patients with sepsis, procalcitonin-guided management did not reduce the duration of antibiotic treatment.
Læs mere Tjek på PubMedMayer, Kirby P.; Ismaeel, Ahmed; Kalema, Anna G.; Montgomery-Yates, Ashley A.; Soper, Melissa K.; Kern, Philip A.; Starck, Jonathan D.; Slone, Stacey A.; Morris, Peter E.; Dupont-Versteegden, Esther E.; Kosmac, Kate
Critical Care Explorations, 25.10.2024
Tilføjet 25.10.2024
OBJECTIVES: Persistent skeletal muscle dysfunction in survivors of critical illness due to acute respiratory failure is common, but biological data elucidating underlying mechanisms are limited. The objective of this study was to elucidate the prevalence of skeletal muscle weakness and fatigue in survivors of critical illness due to COVID-19 and determine if cellular changes associate with persistent skeletal muscle dysfunction. DESIGN: A prospective observational study in two phases: 1) survivors of critical COVID-19 participating in physical outcome measures while attending an ICU Recovery Clinic at short-term follow-up and 2) a nested cohort of patients performed comprehensive muscle and physical function assessments with a muscle biopsy; data were compared with non-COVID controls. SETTING: ICU Recovery Clinic and clinical laboratory. PATIENTS/SUBJECTS: Survivors of critical COVID-19 and non-COVID controls. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One hundred twenty patients with a median of 56 years old (interquartile range [IQR], 42–65 yr old), 43% female, and 33% individuals of underrepresented race attended follow-up 44 ± 17 days after discharge. Patients had a median Acute Physiology and Chronic Health Evaluation-II score of 24.0 (IQR, 16–29) and 98 patients (82%) required mechanical ventilation with a median duration of 14 days (IQR, 9–21 d). At short-term follow-up significant physical dysfunction was observed with 93% of patients reporting generalized fatigue and performing mean 218 ± 151 meters on 6-minute walk test (45% ± 30% of predicted). Eleven patients from this group agreed to participate in long-term assessment and muscle biopsy occurring a mean 267 ± 98 days after discharge. Muscle tissue from COVID exhibited a greater abundance of M2-like macrophages and satellite cells and lower activity of mitochondrial complex II and complex IV compared with controls. CONCLUSIONS: Our findings suggest that aberrant repair and altered mitochondrial activity in skeletal muscle associates with long-term impairments in patients surviving an ICU admission for COVID-19.
Læs mere Tjek på PubMedJiawu WanCaiqian WangZongmei WangLingli WangHaoran WangMing ZhouZhen F. FuLing ZhaoaNational Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan 430070, ChinabHubei Hongshan Laboratory, Wuhan 430070, ChinacFrontiers Science Center for Animal Breeding and Sustainable Production, Wuhan 430070, ChinadKey Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 25.10.2024
Tilføjet 25.10.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 44, October 2024.
Læs mere Tjek på PubMedJiye Cheng, Siddarth Venkatesh, Ke Ke, Michael J. Barratt, Jeffrey I. Gordon
Science, 25.10.2024
Tilføjet 25.10.2024
Nathália Mariana Santos Sansone, Luiz Felipe Azevedo Marques, and Fernando Augusto Lima Marson
Science, 25.10.2024
Tilføjet 25.10.2024
Vipul Jairath, Maria Laura Acosta Felquer, Raymond Jaihyun Cho
Lancet, 25.10.2024
Tilføjet 25.10.2024
Biological monoclonal antibody drugs inhibit overactive cytokine signalling that drives chronic inflammatory disease in different organ systems. In the last 10 years, interleukin (IL)-23 inhibitors have attained an important position in the treatment of psoriatic skin and joint disease as well as inflammatory bowel diseases. Addressing an upstream pathological mechanism shared between these disorders, this drug class has high efficacy rates and a durable response that extends dosing intervals up to 3 months.
Læs mere Tjek på PubMedClinical Infectious Diseases, 25.10.2024
Tilføjet 25.10.2024
Remdesivir is the only antiviral approved for treatment of persons hospitalized for COVID-19. This supplement presents new information from real-world cohort studies reporting reduced mortality in at-risk populations and reductions in re-admission for COVID-19 in the Omicron era.
Læs mere Tjek på PubMedMeng-Rui Lee Li-Ta Keng Ming-Chia Lee Jin-Hua Chen Chih-Hsin Lee Jann-Yuan Wang a Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwanb Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwanc Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwand School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwane Department of Nursing, Cardinal Tien College of Healthcare and Management, Taipei, Taiwanf Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwang Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwanh Department of Medical Education and Research, Wanfang Hospital, Taipei Medical University, Taipei, Taiwani Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwanj Pulmonary Research Center, Division of Pulmonary Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Emerg Microbes Infect, 25.10.2024
Tilføjet 25.10.2024
Aussara Panya, Methi Wathikthinnakon, Chutamas Thepmalee, Chutipa Chiawpanit, Suthida Panwong, Yupanun Wutti-in, Preeyanat Vongchan, Phennapha Klangsinsirikul, Pachara Sattayawat, Jeeraporn Pekkoh
PLoS One Infectious Diseases, 25.10.2024
Tilføjet 25.10.2024
by Aussara Panya, Methi Wathikthinnakon, Chutamas Thepmalee, Chutipa Chiawpanit, Suthida Panwong, Yupanun Wutti-in, Preeyanat Vongchan, Phennapha Klangsinsirikul, Pachara Sattayawat, Jeeraporn Pekkoh Cyanobacteria and algae serving as promising food supplements have recently garnered attention for their emerging potential in anti-cancer activity. Cholangiocarcinoma (CCA) or bile duct cancer is one of the top-leading cancers affecting people, particularly in Asian continent. With patients exhibiting no or minimal symptoms in the early stages, advanced CCA is often diagnosed, and primary treatments such as surgery may not be suitable. Discovery of natural bioactive compounds for cancer treatments have, thus, attracted attention as one of the effective means to combat CCA or to supplement primary treatments. In this work, ethanolic and polysaccharide extracts of cyanobacteria and algae were tested for their cytotoxicity against 2 CCA cell lines (KKU055 and KKU213A). The ethanolic extracts from Leptolyngbya sp. and Chlorella sp. demonstrated growth inhibition of both CCA cell lines, with IC50 values of 0.658 mg/mL and 0.687 mg/mL for KKU055, and 0.656 mg/mL and 0.450 mg/mL for KKU213A. In contrast, only the polysaccharide extracts from Sargassum spp. exhibited a remarkable cytotoxic effect, while the polysaccharide extract from Spirulina sp. showed slight effect only at a higher concentration (2 mg/mL). All tested extracts were further investigated for improving immune cell killing ability and showed that Spirulina sp. polysaccharide extract was able to improve the immune cell killing ability. This extract was then investigated for its effects on the immune cell population, which demonstrated to have positive impact on NK cell population. To further explore the potential use, synergistic effect of Spirulina sp. polysaccharide extract with an already-in-use chemotherapeutic drug, gemcitabine, on immune cell cytotoxicity was investigated. The results showed that the immune cell cytotoxicity was enhanced in the co-treatment compared to the use of each treatment separately. The most apparent difference was observed in KKU055 cells where % living cells were reduced from 78.96% (immune cell alone) to 20.93% when the combined gemcitabine and Spirulina sp. extracts were used.
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