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Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Emerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Carvalho, I. d. S., Mendes, R. C. M. G., Melo, P. d. O. C., Simoes, C. F., Leal, L. P., Guedes, T. G., Ormeno, G. I. R., Linhares, F. M. P.
BMJ Open, 15.04.2021
Tilføjet 15.04.2021
Introduction
Prisons are places with high vulnerability and high risk for the development of sexually transmitted infections. World Health Agencies recommend establishing intervention measures, such as information and education, on the prevention of diseases. Thus, technologies as tools for health education have been used to reduce sexually transmitted infections. However, no systematic review has investigated the effectiveness of these interventions. Therefore, this review’s objective is to examine the effect of educational technologies used for preventing sexually transmitted infections in incarcerated women.
Methods and analysis
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be strictly followed. The following electronic databases will be searched: Scopus; Cumulative Index of Nursing and Allied Health, Education Resources Information Center, Embase, PsycINFO, PubMed/Medline, Web of Science and Google Scholar. Randomised clinical trials of interventions that used educational technologies to prevent sexually transmitted infections in incarcerated women will be searched in the databases from the beginning of 2020 until December by two researchers independently. A narrative synthesis will be constructed for all included studies, and if there are sufficient data, a meta-analysis will be performed using the Review Manager software (V.5.3). Continuous results will be presented as the weighted mean difference or the standardised mean difference with 95% CIs. Under the heterogeneity of the included studies, a random-effects or fixed-effects model will be used. The studies’ heterogeneity will be assessed by the I2 method. The sensitivity analysis will be carried out to examine the magnitude of each study’s influence on the general results. A significance level of p≤0.05 will be adopted.
Ethics and disclosure
Ethical approval is not required because no primary data will be collected. The results will be published in journals reviewed by peers.
PROSPERO registration number
CRD42020163820.
Læs mere Tjek på PubMedMisra, R., Kesarwani, V., Nath, A.
BMJ Open, 15.04.2021
Tilføjet 15.04.2021
Objectives
We aim to define the burden of rifampicin monoresistant tuberculosis (TB) at a tertiary care centre in northern India as well as determine the second-line drug susceptibilities (SL-DST) in a subset of patients.
Methods
A total of 3045 pulmonary (n=1883) and extrapulmonary (n=1162) samples from likely patients with TB were subjected to microscopy, culture and the Xpert MTB/RIF assay from March 2017 to June 2019. SL-DST testing by line probe assay version 2 for fluoroquinolones (FQs) and second-line injectable drugs were performed on 62 samples.
Results
Out of 3045 samples processed in our laboratory during the study period, 36.1% (1101/3045) were positive for Mycobacterium tuberculosis complex (MTBC) and 21.6% were rifampicin monoresistant (223/1032). The rate of rifampicin resistance in pulmonary samples was 23.5% (166/706) and in extrapulmonary cases, it was 17.4% (57/326). Out of 62 cases included for second-line testing, 48 were resistant to FQs (77.4%) while 11 were extensively drug resistant.
Conclusions
India urgently needs to arrest an emerging multidrug-resistant TB epidemic with associated resistance to FQs. A robust surveillance system is needed to execute the National Strategic Plan for 2017–2025.
Læs mere Tjek på PubMedPorter, C., Favara, M., Hittmeyer, A., Scott, D., Sanchez Jimenez, A., Ellanki, R., Woldehanna, T., Duc, L. T., Craske, M. G., Stein, A.
BMJ Open, 15.04.2021
Tilføjet 15.04.2021
Objective
To provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low/middle-income countries (LMICs).
Design
A phone survey administered between August and October 2020 to participants of a population-based longitudinal cohort study established in 2002 comprising two cohorts born in 1994–1995 and 2001–2002 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We use logistic regressions to examine associations between mental health and pandemic-related stressors, structural factors (gender, age), and lifelong protective/risk factors (parent and peer relationship, wealth, long-term health problems, past emotional problems, subjective well-being) measured at younger ages.
Setting
A geographically diverse, poverty-focused sample, also reaching those without mobile phones or internet access.
Participants
10 496 individuals were approached; 9730 participated. Overall, 8988 individuals were included in this study; 4610 (51%) men and 4378 (49%) women. Non-inclusion was due to non-location or missing data.
Main outcome measures
Symptoms consistent with at least mild anxiety or depression were measured by Generalized Anxiety Disorder-7 (≥5) or Patient Health Questionnaire-8 (≥5).
Results
Rates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) (95% CI 38.63% to 43.12%; (29.49–33.74)), and lowest in Vietnam at 9% (9%) (95% CI 8.16% to 10.58%; (8.33–10.77)), mirroring COVID-19 mortality rates. Women were most affected in all countries except Ethiopia. Pandemic-related stressors such as health risks/expenses, economic adversity, food insecurity, and educational or employment disruption were risk factors for anxiety and depression, though showed varying levels of importance across countries. Prior parent/peer relationships were protective factors, while long-term health or emotional problems were risk factors.
Conclusion
Pandemic-related health, economic and social stress present significant risks to the mental health of young people in LMICs where mental health support is limited, but urgently needed to prevent long-term consequences.
Læs mere Tjek på PubMedZhongjie Li, Fengfeng Liu, Jinzhao Cui, Zhibin Peng, Zhaorui Chang, Shengjie Lai, Qiulan Chen, Liping Wang, George F. Gao, Zijian Feng
Nature, 15.04.2021
Tilføjet 15.04.2021
Nature Medicine, Published online: 15 April 2021; doi:10.1038/s41591-021-01308-7
Comprehensive large-scale nucleic acid-testing strategies support China™s sustained containment of COVID-19
Læs mere Tjek på PubMedThi H.O. Nguyen, Louise C. Rowntree, Jan Petersen, Brendon Y. Chua, Luca Hensen, Lukasz Kedzierski, Carolien E. van de Sandt, Priyanka Chaurasia, Hyon-Xhi Tan, Jennifer R. Habel, Wuji Zhang, Lily Allen, Linda Earnest, Kai Yan Mak, Jennifer A. Juno, Kathleen Wragg, Francesca L. Mordant, Fatima Amanat, Florian Krammer, Nicole A. Mifsud, Denise L. Doolan, Katie L. Flanagan, Sabrina Sonda, Jasveen Kaur, Linda M. Wakim, Glen P. Westall, Fiona James, Effie Mouhtouris, Claire L. Gordon, Natasha E. Holmes, Olivia C. Smibert, Jason A. Trubiano, Allen C. Cheng, Peter Harcourt, Patrick Clifton, Jeremy Chase Crawford, Paul G. Thomas, Adam K. Wheatley, Stephen J. Kent, Jamie Rossjohn, Joseph Torresi, Katherine Kedzierska
Immunity, 15.04.2021
Tilføjet 15.04.2021
Examining unmanipulated SARS-CoV-2-specific T cells is important for understanding primary and recall responses during COVID-19. Nguyen et al. analyze ex vivo CD8+ T cells specific for SARS-CoV-2 epitopes and find that immunodominant B7/N105-specific CD8+ T cells are present at high frequencies in blood samples from unexposed, acute COVID-19, and convalescence individuals, which is underpinned by diverse TCR repertoires.
Læs mere Tjek på PubMedShadnaz Asgari, Jelena Trajkovic, Mehran Rahmani, Wenlu Zhang, Roger C. Lo, Antonella Sciortino
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Shadnaz Asgari, Jelena Trajkovic, Mehran Rahmani, Wenlu Zhang, Roger C. Lo, Antonella Sciortino
The COVID-19 pandemic compelled the global and abrupt conversion of conventional face-to-face instruction to the online format in many educational institutions. Urgent and careful planning is needed to mitigate negative effects of pandemic on engineering education that has been traditionally content-centered, hands-on and design-oriented. To enhance engineering online education during the pandemic, we conducted an observational study at California State University, Long Beach (one of the largest and most diverse four-year university in the U.S.). A total of 110 faculty members and 627 students from six engineering departments participated in surveys and answered quantitative and qualitative questions to highlight the challenges they experienced during the online instruction in Spring 2020. Our results identified various issues that negatively influenced the online engineering education including logistical/technical problems, learning/teaching challenges, privacy and security concerns and lack of sufficient hands-on training. For example, more than half of the students indicated lack of engagement in class, difficulty in maintaining their focus and Zoom fatigue after attending multiple online sessions. A correlation analysis showed that while semi-online asynchronous exams were associated with an increase in the perceived cheating by the instructors, a fully online or open-book/open-note exams had an association with a decrease in instructor™s perception of cheating. To address various identified challenges, we recommended strategies for educational stakeholders (students, faculty and administration) to fill the tools and technology gap and improve online engineering education. These recommendations are practical approaches for many similar institutions around the world and would help improve the learning outcomes of online educations in various engineering subfields. As the pandemic continues, sharing the results of this study with other educators can help with more effective planning and choice of best practices to enhance the efficacy of online engineering education during COVID-19 and post-pandemic.
Læs mere Tjek på PubMedJohn Njuma Libwea, Mark A. Fletcher, Paul Koki Ndombo, Angeline Boula, Nadesh Taku Ashukem, Madeleine Ngo Baleba, Rachel Sandrine Kingue Bebey, Eric Gaston Nkolo Mviena, Jean Tageube, Marie Kobela Mbollo, Sinata Koulla-Shiro, Shabir Madhi, Berthe-Marie Njanpop-Lafourcade, Ali Mohammad, Elizabeth Begier, Joanna Southern, Rohini Beavon, Bradford Gessner
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by John Njuma Libwea, Mark A. Fletcher, Paul Koki Ndombo, Angeline Boula, Nadesh Taku Ashukem, Madeleine Ngo Baleba, Rachel Sandrine Kingue Bebey, Eric Gaston Nkolo Mviena, Jean Tageube, Marie Kobela Mbollo, Sinata Koulla-Shiro, Shabir Madhi, Berthe-Marie Njanpop-Lafourcade, Ali Mohammad, Elizabeth Begier, Joanna Southern, Rohini Beavon, Bradford Gessner
Background The 13-valent pneumococcal conjugate vaccine (PCV13) entered Cameroon™s childhood national immunization programme (NIP) in July 2011 under a 3-dose schedule (6, 10, 14 weeks of age) without any catch-up. We described the impact of PCV13 onserotype distribution among pneumococcal meningitis cases over time.
Methods We used laboratory-based sentinel surveillance data to identify meningitis cases among 2- to 59-month-old children with clinically-suspected bacterial meningitis (CSBM) admitted to hospitals in Yaoundé (August 2011-December 2018). Purulent meningitis cases had a cerebrospinal fluid (CSF) white blood cell (WBC) count ≥20 per mm3. Pneumococcal meningitis cases had S. pneumoniae identified from CSF, with serotyping by polymerase chain reaction. Years 2011-2014 were described as early PCV13 era (EPE) and years 2015-2018 as late PCV13 era (LPE) impact periods.
Results Among children hospitalized with CSBM who had a lumbar puncture obtained, there was no significant change from the EPE versus the LPE in the percentage identified with purulent meningitis: 7.5% (112/1486) versus 9.4% (154/1645), p = 0.0846. The percentage of pneumococcal meningitis cases due to PCV13 vaccine-serotype (VST) decreased from 62.0% (31/50) during the EPE to 35.8% (19/53) in the LPE, p = 0.0081. The most frequent pneumococcal meningitis VSTs during the EPE were 6A/6B (30%) and 5 (6%), and during the LPE were 14 (13.2%), 3 (7.6%), 4 (5.6%) and 18C (5.6%).
Conclusion Four to seven years after PCV13 introduction, the proportion of pneumococcal meningitis due to vaccine serotypes has declined, mainly due to reductions of serotypes 6A/6B, 1, 19A, and 23F; nevertheless, PCV13 VSTs remain common. Because the analyzed surveillance system was not consistent or population based, we could not estimate incidence or overall impact; this emphasizes the need for improved surveillance to document further the utility of PCV13 immunization in Cameroon.
Læs mere Tjek på PubMedAvishek Chatterjee, Guangyao Wu, Sergey Primakov, Cary Oberije, Henry Woodruff, Pieter Kubben, Ronald Henry, Marcel J. H. Aries, Martijn Beudel, Peter G. Noordzij, Tom Dormans, Niels C. Gritters van den Oever, Joop P. van den Bergh, Caroline E. Wyers, Suat Simsek, Renée Douma, Auke C. Reidinga, Martijn D. de Kruif, Julien Guiot, Anne-Noelle Frix, Renaud Louis, Michel Moutschen, Pierre Lovinfosse, Philippe Lambin
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Avishek Chatterjee, Guangyao Wu, Sergey Primakov, Cary Oberije, Henry Woodruff, Pieter Kubben, Ronald Henry, Marcel J. H. Aries, Martijn Beudel, Peter G. Noordzij, Tom Dormans, Niels C. Gritters van den Oever, Joop P. van den Bergh, Caroline E. Wyers, Suat Simsek, Renée Douma, Auke C. Reidinga, Martijn D. de Kruif, Julien Guiot, Anne-Noelle Frix, Renaud Louis, Michel Moutschen, Pierre Lovinfosse, Philippe Lambin
Objective To establish whether one can build a mortality prediction model for COVID-19 patients based solely on demographics and comorbidity data that outperforms age alone. Such a model could be a precursor to implementing smart lockdowns and vaccine distribution strategies.
Methods The training cohort comprised 2337 COVID-19 inpatients from nine hospitals in The Netherlands. The clinical outcome was death within 21 days of being discharged. The features were derived from electronic health records collected during admission. Three feature selection methods were used: LASSO, univariate using a novel metric, and pairwise (age being half of each pair). 478 patients from Belgium were used to test the model. All modeling attempts were compared against an age-only model.
Results In the training cohort, the mortality group™s median age was 77 years (interquartile range = 70-83), higher than the non-mortality group (median = 65, IQR = 55-75). The incidence of former/active smokers, male gender, hypertension, diabetes, dementia, cancer, chronic obstructive pulmonary disease, chronic cardiac disease, chronic neurological disease, and chronic kidney disease was higher in the mortality group. All stated differences were statistically significant after Bonferroni correction. LASSO selected eight features, novel univariate chose five, and pairwise chose none. No model was able to surpass an age-only model in the external validation set, where age had an AUC of 0.85 and a balanced accuracy of 0.77.
Conclusion When applied to an external validation set, we found that an age-only mortality model outperformed all modeling attempts (curated on www.covid19risk.ai) using three feature selection methods on 22 demographic and comorbid features.
Læs mere Tjek på PubMedOlivia L. McGovern, Mark Stenger, Sara E. Oliver, Tara C. Anderson, Cheryl Isenhour, Matthew R. Mauldin, Nia Williams, Eric Griggs, Tonny Bogere, Chris Edens, Aaron T. Curns, Joana Y. Lively, Yingtao Zhou, Songli Xu, Maureen H. Diaz, Jessica L. Waller, Kevin R. Clarke, Mary E. Evans, Elisabeth M. Hesse, Sapna Bamrah Morris, Robert P. McClung, Laura A. Cooley, Naeemah Logan, Andrew T. Boyd, Allan W. Taylor, Kristina L. Bajema, Stephen Lindstrom, Christopher A. Elkins, Christopher Jones, Aron J. Hall, Samuel Graitcer, Alexandra M. Oster, Alicia M. Fry, Marc Fischer, Laura Conklin, Runa H. Gokhale
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Olivia L. McGovern, Mark Stenger, Sara E. Oliver, Tara C. Anderson, Cheryl Isenhour, Matthew R. Mauldin, Nia Williams, Eric Griggs, Tonny Bogere, Chris Edens, Aaron T. Curns, Joana Y. Lively, Yingtao Zhou, Songli Xu, Maureen H. Diaz, Jessica L. Waller, Kevin R. Clarke, Mary E. Evans, Elisabeth M. Hesse, Sapna Bamrah Morris, Robert P. McClung, Laura A. Cooley, Naeemah Logan, Andrew T. Boyd, Allan W. Taylor, Kristina L. Bajema, Stephen Lindstrom, Christopher A. Elkins, Christopher Jones, Aron J. Hall, Samuel Graitcer, Alexandra M. Oster, Alicia M. Fry, Marc Fischer, Laura Conklin, Runa H. Gokhale
Background The Coronavirus Disease 2019 (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), evolved rapidly in the United States. This report describes the demographic, clinical, and epidemiologic characteristics of 544 U.S. persons under investigation (PUI) for COVID-19 with complete SARS-CoV-2 testing in the beginning stages of the pandemic from January 17 through February 29, 2020.
Methods In this surveillance cohort, the U.S. Centers for Disease Control and Prevention (CDC) provided consultation to public health and healthcare professionals to identify PUI for SARS-CoV-2 testing by quantitative real-time reverse-transcription PCR. Demographic, clinical, and epidemiologic characteristics of PUI were reported by public health and healthcare professionals during consultation with on-call CDC clinicians and subsequent submission of a CDC PUI Report Form. Characteristics of laboratory-negative and laboratory-positive persons were summarized as proportions for the period of January 17−February 29, and characteristics of all PUI were compared before and after February 12 using prevalence ratios.
Results A total of 36 PUI tested positive for SARS-CoV-2 and were classified as confirmed cases. Confirmed cases and PUI testing negative for SARS-CoV-2 had similar demographic, clinical, and epidemiologic characteristics. Consistent with changes in PUI evaluation criteria, 88% (13/15) of confirmed cases detected before February 12, 2020, reported travel from China. After February 12, 57% (12/21) of confirmed cases reported no known travel- or contact-related exposures.
Conclusions These findings can inform preparedness for future pandemics, including capacity for rapid expansion of novel diagnostic tests to accommodate broad surveillance strategies to assess community transmission, including potential contributions from asymptomatic and presymptomatic infections.
Læs mere Tjek på PubMedSebastien Kenmoe, Arnol Bowo-Ngandji, Cyprien Kengne-Nde, Jean Thierry Ebogo-Belobo, Donatien Serge Mbaga, Gadji Mahamat, Cynthia Paola Demeni Emoh, Richard Njouom
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Sebastien Kenmoe, Arnol Bowo-Ngandji, Cyprien Kengne-Nde, Jean Thierry Ebogo-Belobo, Donatien Serge Mbaga, Gadji Mahamat, Cynthia Paola Demeni Emoh, Richard Njouom
Introduction Consideration of confounding factors about the association between Lower Respiratory Tract Infections (LRTI) in childhood and the development of subsequent wheezing has been incompletely described. We determined the association between viral LRTI at ≤ 5 years of age and the development of wheezing in adolescence or adulthood by a meta-analysis and a sensitivity analysis including comparable studies for major confounding factors.
Methods We performed searches through Pubmed and Global Index Medicus databases. We selected cohort studies comparing the frequency of subsequent wheezing in children with and without LRTI in childhood regardless of the associated virus. We extracted the publication data, clinical and socio-demographic characteristics of the children, and confounding factors. We analyzed data using random effect model.
Results The meta-analysis included 18 publications (22 studies) that met the inclusion criteria. These studies showed that viral LRTI in children ≤ 3 years was associated with an increased risk of subsequent development of wheezing (OR = 3.1, 95% CI = 2.4-3.9). The risk of developing subsequent wheezing was conserved when considering studies with comparable groups for socio-demographic and clinical confounders.
Conclusions When considering studies with comparable groups for most confounding factors, our results provided strong evidence for the association between neonatal viral LRTI and the subsequent wheezing development. Further studies, particularly from lower-middle income countries, are needed to investigate the role of non-bronchiolitis and non-HRSV LRTI in the association between viral LRTI in childhood and the wheezing development later. In addition, more studies are needed to investigate the causal effect between childhood viral LRTI and the wheezing development later.
Trial registration Review registration: PROSPERO, CRD42018116955; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018116955.
Læs mere Tjek på PubMedKevin Guedj, Mathieu Uzzan, Damien Soudan, Catherine Trichet, Antonino Nicoletti, Emmanuel Weiss, Hana Manceau, Alexandre Nuzzo, Olivier Corcos, Xavier Treton, Katell Peoc™h
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Kevin Guedj, Mathieu Uzzan, Damien Soudan, Catherine Trichet, Antonino Nicoletti, Emmanuel Weiss, Hana Manceau, Alexandre Nuzzo, Olivier Corcos, Xavier Treton, Katell Peoc™h
Background Severe acute respiratory syndrome caused by the novel coronavirus (SARS-CoV-2) is frequently associated with gastrointestinal manifestations. Herein we evaluated the interest in measuring the intestinal fatty acid-binding protein (I-FABP), a biomarker of intestinal injury, in COVID-19 patients.
Methods Serum I-FABP was analyzed in 28 consecutive patients hospitalized for a PCR-confirmed COVID-19, in 24 hospitalized patients with non-COVID-19 pulmonary diseases, and 79 patients admitted to the emergency room for abdominal pain.
Results I-FABP serum concentrations were significantly lower in patients with COVID-19, as compared to patients with non-COVID-19 pulmonary diseases [70.3 pg/mL (47-167.9) vs. 161.1 pg/mL (88.98-305.2), respectively, p = 0.008]. I-FABP concentrations in these two populations were significantly lower than in patients with abdominal pain without COVID-19 [344.8 pg/mL (268.9-579.6)]. I-FABP was neither associated with severity nor the duration of symptoms. I-FABP was correlated with polymorphonuclear cell counts.
Conclusions In this pilot study, we observed a low I-FABP concentration in COVID-19 patients either with or without gastrointestinal symptoms, of which the pathophysiological mechanisms and clinical impact remain to be established. Further explorations on a larger cohort of patients will be needed to unravel the molecular mechanism of such observation, including the effects of malabsorption and/or abnormal lipid metabolism.
Læs mere Tjek på PubMedKatherine Klise, Walt Beyeler, Patrick Finley, Monear Makvandi
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Katherine Klise, Walt Beyeler, Patrick Finley, Monear Makvandi
As social distancing policies and recommendations went into effect in response to COVID-19, people made rapid changes to the places they visit. These changes are clearly seen in mobility data, which records foot traffic using location trackers in cell phones. While mobility data is often used to extract the number of customers that visit a particular business or business type, it is the frequency and duration of concurrent occupancy at those sites that governs transmission. Understanding the way people interact at different locations can help target policies and inform contact tracing and prevention strategies. This paper outlines methods to extract interactions from mobility data and build networks that can be used in epidemiological models. Several measures of interaction are extracted: interactions between people, the cumulative interactions for a single person, and cumulative interactions that occur at particular businesses. Network metrics are computed to identify structural trends which show clear changes based on the timing of stay-at-home orders. Measures of interaction and structural trends in the resulting networks can be used to better understand potential spreading events, the percent of interactions that can be classified as close contacts, and the impact of policy choices to control transmission.
Læs mere Tjek på PubMedAriane Cristina Barboza Zanetti, Bruna Moreno Dias, Andrea Bernardes, Helaine Carneiro Capucho, Alexandre Pazetto Balsanelli, André Almeida de Moura, Rodrigo Soato, Carmen Silvia Gabriel
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Ariane Cristina Barboza Zanetti, Bruna Moreno Dias, Andrea Bernardes, Helaine Carneiro Capucho, Alexandre Pazetto Balsanelli, André Almeida de Moura, Rodrigo Soato, Carmen Silvia Gabriel
Objective To analyze the incidence and preventability of adverse events related to health care in adult patients admitted to a Brazilian teaching hospital.
Methods A retrospective cohort study, in which the incidence and preventability of adverse events related to health care were based on a two-stage retrospective review of 368 medical records (nurses and pharmacist review of medical records, followed by physicians review of triggered medical records) of adult patients whose hospitalizations occurred during 2015 in a high-complexity public teaching hospital located in Brazil. Data were collected from February 2018 to February 2019.
Results A total of 266 adverse events were observed in 124 patients. The incidence of adverse events related to health care was 33.7% (95% CI 0.29-0.39), and the incidence density was 4.97 adverse events per 100 patient-days. Adverse events were responsible for 701 additional days of hospitalization, and the estimated length of additional hospital stay attributable to them was, on average, 6.8 days per event. The most common types of events were related to general care (60; 22.6%), medications (50; 18.8%), nosocomial infection (35; 13.2%), any other type (11; 4.1%), and diagnoses (2; 0.8%). Regarding the severity of adverse events, it was found that 168 (63.2%) were mild, 55 (20.7%) were moderate, and 43 (16.2%) were severe. In addition, it was estimated that 155 (58.3%) events were preventable. The length of a patient™s hospital stay was identified as a risk factor for the occurrence of adverse events (RR 1.20; 95% CI 1.04-1.39).
Conclusions Through knowledge of the incidence, nature, severity, preventability, and risk factors for the occurrence of adverse events, it is possible to create the opportunities to prioritize the implementation of strategies for mitigating specific events based on reliable data and concrete information.
Læs mere Tjek på PubMedBenjamin R. Bates, Adriana Tami, Ana Carvajal, Mario J. Grijalva
PLoS One Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
by Benjamin R. Bates, Adriana Tami, Ana Carvajal, Mario J. Grijalva
Background COVID-19 threatens health systems worldwide, but Venezuela™s system is particularly vulnerable. To prevent the spread of COVID-19, individuals must adopt preventive behaviors. However, to encourage behavior change, we must first understand current knowledge, attitudes, and practices (KAPs) that inform response to this health threat.
Methods We explored KAPs among Venezuelans using a cross-sectional, internet-based questionnaire. The questionnaire explored individuals™ knowledge about COVID-19; their attitudes toward the world™s and the Venezuelan authorities™ abilities to control it; and their self-reported practices. We also collected demographic data. Binomial logistic regression analyses were used to predict the adoption of preventive behaviors based on demographic variables, individual knowledge level, and individual attitudes.
Results 3122 individuals completed the questionnaire. Participants had a high level of knowledge about COVID-19. They expressed high levels of optimism that the world would eventually control COVID-19, but they were very pessimistic about the public authorities in Venezuela. Most participants adopted preventive practices. Binomial regression suggests younger people, less educated people, and manual laborers hold lower levels of knowledge, and these groups, as well as men, were less likely to adopt preventive practices. Knowledge, by itself, had no association with optimism and little association with self-reported practices.
Conclusions As other KAP studies in Latin America found, knowledge is not sufficient to prompt behavior change. Venezuelans™ pessimism about their own country™s ability should be explored in greater depth. Health promotion in Venezuela may wish to target the most at risk groups: men, younger people, less educated people, and manual laborers.
Læs mere Tjek på PubMedInfection, 15.04.2021
Tilføjet 15.04.2021
Abstract
In patients who develop sepsis, whether due to primary, secondary or metastatic lesions, the skin is frequently affected. However, there are unresolved aspects regarding the general clinical manifestations in the skin or the prognosis and/or therapeutic implications. The main challenge in the approach to sepsis is its early diagnosis and management. In this review, we address the sepsis-skin relationship and the potential impact of early dermatological intervention on the septic patient through ten basic questions. We found little evidence of the participation of the dermatologist in sepsis alert programs. There are early skin changes that may alert clinicians on a possible sepsis, such as skin mottling or variations in acral skin temperature. In addition, the skin is an accessible and highly cost-effective tissue for etiological studies of some forms of sepsis (e.g., meningococcal purpura) and its involvement defines the prognosis of certain patients (e.g., infective endocarditis).
Læs mere Tjek på PubMedNeven Stevic, Emeric Chatelain, Auguste Dargent, Laurent Argaud, Martin Cour, Claude Guérin
American Journal of Respiratory and Critical Care Medicine , 15.04.2021
Tilføjet 15.04.2021
American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 8, Page 1025-1027, April 15, 2021.
Læs mere Tjek på PubMedElisa Ramos-Sevillano, Giuseppe Ercoli, Philip Felgner, Rafael Ramiro de Assis, Rie Nakajima, David Goldblatt, Robert S. Heyderman, Stephen B. Gordon, Daniela M. Ferreira, Jeremy S. Brown
American Journal of Respiratory and Critical Care Medicine , 15.04.2021
Tilføjet 15.04.2021
American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 8, Page 1037-1041, April 15, 2021.
Læs mere Tjek på PubMedKeir E. J. Philip, Adam Lewis, Sara C. Buttery, Colm McCabe, Daisy Fancourt, Christopher M. Orton, Michael I. Polkey, Nicholas S. Hopkinson
American Journal of Respiratory and Critical Care Medicine , 15.04.2021
Tilføjet 15.04.2021
American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 8, Page 1041-1042, April 15, 2021.
Læs mere Tjek på PubMedMatthias Echternach, Caroline Westphalen, Marie Christine Köberlein, Sophia Gantner, Gregor Peters, Tobias Benthaus, Bernhard Jakubaß, Liudmila Kuranova, Michael Döllinger, Stefan Kniesburges
American Journal of Respiratory and Critical Care Medicine , 15.04.2021
Tilføjet 15.04.2021
American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 8, Page 1042-1043, April 15, 2021.
Læs mere Tjek på PubMedAmerican Journal of Respiratory and Critical Care Medicine , 15.04.2021
Tilføjet 15.04.2021
American Journal of Respiratory and Critical Care Medicine, Volume 203, Issue 8, Page 1045-1045, April 15, 2021.
Læs mere Tjek på PubMedBMC Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Abstract
Background
The primary objective of the study is to describe the cellular characteristics of bronchoalveolar lavage fluid (BALF) of COVID-19 patients requiring invasive mechanical ventilation; the secondary outcome is to describe BALF findings between survivors vs non-survivors.
Materials and methods
Patients positive for SARS-CoV-2 RT PCR, admitted to ICU between March and April 2020 were enrolled. At ICU admission, BALF were analyzed by flow cytometry. Univariate, multivariate and Spearman correlation analyses were performed.
Results
Sixty-four patients were enrolled, median age of 64‰years (IQR 58-69). The majority cells in the BALF were neutrophils (70%, IQR 37.5-90.5) and macrophages (27%, IQR 7-49) while a minority were lymphocytes, 1%, TCD3+‰92% (IQR 82-95). The ICU mortality was 32.8%. Non-survivors had a significantly older age (p‰=‰0.033) and peripheral lymphocytes (p‰=‰0.012) were lower compared to the survivors. At multivariate analysis the percentage of macrophages in the BALF correlated with poor outcome (OR 1.336, CI95% 1.014-1.759, p‰=‰0.039).
Conclusions
In critically ill patients, BALF cellularity is mainly composed of neutrophils and macrophages. The macrophages percentage in the BALF at ICU admittance correlated with higher ICU mortality. The lack of lymphocytes in BALF could partly explain a reduced anti-viral response.
Læs mere Tjek på PubMedLuyi Tian, Sara Tomei, Jaring Schreuder, Tom S. Weber, Daniela Amann-Zalcenstein, Dawn S. Lin, Jessica Tran, Cindy Audiger, Mathew Chu, Andrew Jarratt, Tracy Willson, Adrienne Hilton, Ee Shan Pang, Timothy Patton, Madison Kelly, Shian Su, Quentin Gouil, Peter Diakumis, Melanie Bahlo, Toby Sargeant, Lev M. Kats, Philip D. Hodgkin, Meredith O™Keeffe, Ashley P. Ng, Matthew E. Ritchie, Shalin H. Naik
Immunity, 15.04.2021
Tilføjet 15.04.2021
In the absence of a time machine, a single cell cannot be tested more than once in a destructive assay. Tian et al. instead develop clonal multi-omics to bypass this challenge and identify Bcor as a regulator of dendritic cell fate.
Læs mere Tjek på PubMedEmerging Infectious Diseases, 15.04.2021
Tilføjet 15.04.2021
Malaria Journal, 10.04.2021
Tilføjet 15.04.2021
Abstract
Background
Volunteer infection studies have become a standard model for evaluating drug efficacy against Plasmodium infections. Molecular techniques such as qPCR are used in these studies due to their ability to provide robust and accurate estimates of parasitaemia at increased sensitivity compared to microscopy. The validity and reliability of assays need to be ensured when used to evaluate the efficacy of candidate drugs in clinical trials.
Methods
A previously described 18S rRNA gene qPCR assay for quantifying Plasmodium falciparum in blood samples was evaluated. Assay performance characteristics including analytical sensitivity, reportable range, precision, accuracy and specificity were assessed using experimental data and data compiled from phase 1 volunteer infection studies conducted between 2013 and 2019. Guidelines for validation of laboratory-developed molecular assays were followed.
Results
The reportable range was 1.50 to 6.50 log10 parasites/mL with a limit of detection of 2.045 log10 parasites/mL of whole blood based on a parasite diluted standard series over this range. The assay was highly reproducible with minimal intra-assay (SD‰=‰0.456 quantification cycle (Cq) units [0.137 log10 parasites/mL] over 21 replicates) and inter-assay (SD‰=‰0.604 Cq units [0.182 log10 parasites/mL] over 786 qPCR runs) variability. Through an external quality assurance program, the QIMR assay was shown to generate accurate results (quantitative bias‰+‰0.019 log10 parasites/mL against nominal values). Specificity was 100% after assessing 164 parasite-free human blood samples.
Conclusions
The 18S rRNA gene qPCR assay is specific and highly reproducible and can provide reliable and accurate parasite quantification. The assay is considered fit for use in evaluating drug efficacy in malaria clinical trials.
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