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32 emner vises.
Lorena G. Barberia, Silvia Figueiredo Costa, Ester C. Sabino
Nature, 21.06.2021
Tilføjet 21.06.2021
Nature Medicine, Published online: 21 June 2021; doi:10.1038/s41591-021-01423-5
Brazil needs a coordinated and cooperative approach to tackle COVID-19
Læs mere Tjek på PubMedRoberto Burioni, Eric J. Topol
Nature, 21.06.2021
Tilføjet 21.06.2021
Nature Medicine, Published online: 21 June 2021; doi:10.1038/s41591-021-01421-7
Has SARS-CoV-2 reached peak fitness?
Læs mere Tjek på PubMedNoritomi, D. T., Ranzani, O. T., Ferraz, L. J. R., dos Santos, M. C., Cordioli, E., Albaladejo, R., Serpa Neto, A., Correa, T. D., Berwanger, O., de Morais, L. C., Schettino, G., Cavalcanti, A. B., Rosa, R. G., Biondi, R. S., Salluh, J. I., Azevedo, L. C. P., Pereira, A. J., On behalf of the TELESCOPE Trial Investigators, Pereira, Noritomi, Ranzani, Santos, Cavalcanti, Neto, Cordioli, Gatti, Salluh, Ferraz, Caus, Azevedo, Santos, Berwanger, Rosa, Albaladejo, Biondi, Correa
BMJ Open, 21.06.2021
Tilføjet 21.06.2021
Introduction
Daily multidisciplinary rounds (DMRs) consist of systematic patient-centred discussions aiming to establish joint therapeutic goals for the next 24 hours of intensive care unit (ICU) care. The aim of the present study protocol is to evaluate whether an intervention consisting of guided DMRs, supported by a remote specialist and audit/feedback on care performance will reduce ICU length of stay compared with a control group.
Methods and analysis
A multicentre, controlled, cluster-randomised superiority trial including 30 ICUs in Brazil (15 intervention and 15 control), from August 2019 to June 2021. In a parallel assignment, ICUs are randomised to a complex-intervention composed by daily rounds carried out through Tele-ICU by a remote ICU physician; development of local quality indicators dashboards coupled with monthly meetings with local leadership; and dissemination of evidence-based clinical protocols versus usual care. Primary outcome is ICU length of stay. Secondary outcomes include classification of the unit according to the profiles defined by the standardised resource use and the standardised mortality rate, hospital mortality, incidence of healthcare-associated infections, ventilator-free days at 28 days, patient-days receiving oral or enteral feeding, patient-days under light sedation or alert and calm, rate of patients under normoxaemia. All adult patients admitted after the beginning of the study in each participant ICU will be enrolled. Inclusion criteria (clusters): public Brazilian ICUs with a minimum of 8 ICU beds interested/committed to participating in the study. Exclusion criteria (clusters): units with fully established DMRs by an intensivist, specialised or step-down units.
Ethics and dissemination
The study protocol was approved by the institutional review board (IRB) of the coordinator centre, and by IRBs of each enrolled hospital/ICU. Statistical analysis protocol is being prepared for submission before the end of patient’s enrolment. Results will be disseminated through conferences, peer-reviewed journals and to each participating unit.
Trial registration number
NCT03920501; Pre-results.
Læs mere Tjek på PubMedGogishvili, M., Costa, S. A., Florez, K., Huang, T. T.
BMJ Open, 21.06.2021
Tilføjet 21.06.2021
Background
In 2012, the Government of Spain enacted Royal Decree-Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 excluding undocumented immigrants from publicly funded healthcare services. We conducted a policy implementation analysis to describe and evaluate the legal and regulatory actions taken at the autonomous community (AC) level after enactment of 2012 RDL and RD and their impact on access to general healthcare and HIV services among undocumented immigrants.
Methods
We reviewed documents published by the governments of seven ACs (Andalucía, Aragón, Euskadi (Basque Country), Castilla-La Mancha, Galicia, Madrid, Valencia) from April 2012 to July 2018, describing circumstances under which undocumented immigrants would be able to access free healthcare services. We developed indicators according to the main systemic barriers presented in official documents to analyse access to free healthcare across the participating ACs. ACs were grouped under five access categories: high, medium-high, medium, medium-low and low.
Results
Andalucía provided the highest access to free healthcare for undocumented immigrants in both general care and HIV treatment. Medium-high access was provided by Euskadi and medium access by Aragón, Madrid and Valencia. Castilla-La Mancha provided medium-low access. Galicia had low access. Only Madrid and Galicia provided different and higher level of access to undocumented migrants in HIV care compared with general healthcare.
Conclusions
Implementation of 2012 RDL and RD across the ACs varied significantly, in part due to the decentralisation of the Spanish healthcare system. The challenge of healthcare access among undocumented immigrants included persistent systemic restrictions, frequent and unclear rule changes, and the need to navigate differences across ACs of Spain.
Læs mere Tjek på PubMedWalker, J. L., Rentsch, C. T., McDonald, H. I., Bak, J., Minassian, C., Amirthalingam, G., Edelstein, M., Thomas, S.
BMJ Open, 21.06.2021
Tilføjet 21.06.2021
Objective
To examine the social determinants of influenza and pertussis vaccine uptake among pregnant women in England.
Design
Nationwide population-based cohort study.
Setting
The study used anonymised primary care data from the Clinical Practice Research Datalink and linked Hospital Episode Statistics secondary care data.
Participants
Pregnant women eligible for pertussis (2012–2015, n=68 090) or influenza (2010/2011–2015/2016, n=152 132) vaccination in England.
Main outcome measures
Influenza and pertussis vaccine uptake.
Results
Vaccine uptake was 67.3% for pertussis and 39.1% for influenza. Uptake of both vaccines varied by region, with the lowest uptakes in London and the North East. Lower vaccine uptake was associated with greater deprivation: almost 10% lower in the most deprived quintiles compared with the least deprived for influenza (34.5% vs 44.0%), and almost 20% lower for pertussis (57.7% vs 76.0%). Lower uptake for both vaccines was also associated with non-white ethnicity (lowest among women of black ethnicity), maternal age under 20 years and a greater number of children in the household. The associations between all social factors and vaccine uptake were broadly unchanged in fully adjusted models, suggesting the social determinants of uptake were largely independent of one another. Among 3111 women vaccinated against pertussis in their first eligible pregnancy and pregnant again, 1234 (40%) were not vaccinated in their second eligible pregnancy.
Conclusions
Targeting promotional campaigns to pregnant women who are younger, of non-white ethnicity, with more children, living in areas of greater deprivation or the London or North East regions, has potential to reduce vaccine-preventable disease among infants and pregnant women, and to reduce health inequalities. Vaccination promotion needs to be sustained across successive pregnancies. Further research is needed into whether the effectiveness of vaccine promotion strategies may vary according to social factors.
Læs mere Tjek på PubMedXian, Z., Saxena, A., Javed, Z., Jordan, J. E., Alkarawi, S., Khan, S. U., Shah, K., Vahidy, F. S., Nasir, K., Dubey, P.
BMJ Open, 21.06.2021
Tilføjet 21.06.2021
Objective
To evaluate COVID-19 infection and mortality disparities in ethnic and racial subgroups in a state-wise manner across the USA.
Methods
Publicly available data from The COVID Tracking Project at The Atlantic were accessed between 9 September 2020 and 14 September 2020. For each state and the District of Columbia, % infection, % death, and % population proportion for subgroups of race (African American/black (AA/black), Asian, American Indian or Alaska Native (AI/AN), and white) and ethnicity (Hispanic/Latino, non-Hispanic) were recorded. Crude and normalised disparity estimates were generated for COVID-19 infection (CDI and NDI) and mortality (CDM and NDM), computed as absolute and relative difference between % infection or % mortality and % population proportion per state. Choropleth map display was created as thematic representation proportionate to CDI, NDI, CDM and NDM.
Results
The Hispanic population had a median of 158% higher COVID-19 infection relative to their % population proportion (median 158%, IQR 100%–200%). This was followed by AA, with 50% higher COVID-19 infection relative to their % population proportion (median 50%, IQR 25%–100%). The AA population had the most disproportionate mortality, with a median of 46% higher mortality than the % population proportion (median 46%, IQR 18%–66%). Disproportionate impact of COVID-19 was also seen in AI/AN and Asian populations, with 100% excess infections than the % population proportion seen in nine states for AI/AN and seven states for Asian populations. There was no disproportionate impact in the white population in any state.
Conclusions
There are racial/ethnic disparities in COVID-19 infection/mortality, with distinct state-wise patterns across the USA based on racial/ethnic composition. There were missing and inconsistently reported racial/ethnic data in many states. This underscores the need for standardised reporting, attention to specific regional patterns, adequate resource allocation and addressing the underlying social determinants of health adversely affecting chronically marginalised groups.
Læs mere Tjek på PubMedTemsah, M.-H., Barry, M., Aljamaan, F., Alhuzaimi, A., Al-Eyadhy, A., Saddik, B., Alrabiaah, A., Alsohime, F., Alhaboob, A., Alhasan, K., Alaraj, A., Halwani, R., Alamro, N. M., Al-Shahrani, F. S., Jamal, A., Alsubaie, S., Memish, Z. A., Al-Tawfiq, J. A.
BMJ Open, 21.06.2021
Tilføjet 21.06.2021
Objectives
The aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience.
Design
National cross-sectional, pilot-validated questionnaire.
Setting
Online, self-administered questionnaire among HCWs.
Participants
A total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis.
Intervention
Data were collected through an online survey sent to HCWs during 1–15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale.
Results
Among the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine’s efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine’s manufacturing country (28.6%).
Conclusions
Awareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers.
Læs mere Tjek på PubMedHaynes, N. A., Saint-Joy, V., Swain, J., Ezekwesili, A., Vernet, F. V., Dawson, C., Laneau, D., Tierney, A., Shea, J. A., Ambrose, M. S.
BMJ Open, 21.06.2021
Tilføjet 21.06.2021
Background
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, conferring a disparate burden on low-income and middle-income countries (LMICs). Haiti represents a resource-constrained setting, limited by a paucity of resources and trained cardiovascular professionals equipped to address the increasing burden of CVD.
Objective
Here, we describe the creation of a comprehensive cardiology curriculum delivered through a virtual classroom. The curriculum was created to augment cardiovascular education in LMICs such as Haiti.
Methods
Over one academic year (May 2019–2020), International Cardiology Curriculum Accessible by Remote Distance Learning-Haiti consisted of biweekly, live-streamed, synchronous didactic lectures, seminars and case presentations broadcasted to 16 internal medicine (IM) residents at Hôpital Universitaire de Mirebalais, one of only four IM training programmes in Haiti. The virtual classroom was created using commercially available videoconferencing and data-sharing platforms. Prelecture and postlecture surveys and an end of the year survey were administered to assess the impact of the curriculum.
Results
Participant performance analysis revealed that 80% of the curriculum demonstrated a positive trend in knowledge acquisition postintervention. Based on the end of the year evaluation, 94% of participants reported that the curriculum was educational and relevant to medical practice in Haiti and 100% reported that the curriculum was good to excellent. Additionally, the curriculum was cited as an effective means of maintaining trainee education during the COVID-19 pandemic.
Conclusion
This international medical education pilot study demonstrates the feasibility of augmenting cardiology education in LMICs by creating a virtual curriculum made possible by local partnerships, internet access and technology.
Læs mere Tjek på PubMedKazuomi Takahashi, Shotaro Okachi, Hirotoshi Yasui, Shunichi Taki, Takayasu Ito, Noriaki Fukatsu, Kazuhide Sato
International Journal of Infectious Diseases, 21.06.2021
Tilføjet 21.06.2021
Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading worldwide and has become a threat to humankind. Respiratory infectious viruses such as SARS-CoV-2 are transmitted via contact and droplets and have a high secondary attack rate ranging from 3.0–11.2% in households (Wiersinga et al., 2020). Diagnosis of respiratory infectious virus is performed by collecting specimens from the surface of the respiratory mucosa using nasopharyngeal swabs (Föh et al., 2020; Marty et al., 2020).
Læs mere Tjek på PubMedAlfredo Bruno, Domenica de Mora, Byron Freire-Paspuel, Angel S. Rodriguez, Maria Belen Paredes-Espinosa, Maritza Olmedo, Martha Sanchez, Jennifer Romero, Michelle Paez, Manuel Gonzalez, Alberto Orlando, Miguel Angel Garcia-Bereguiain
International Journal of Infectious Diseases, 21.06.2021
Tilføjet 21.06.2021
The Humanity is facing the biggest public health crisis since the "Spanish flu" in 1918. The Coronaviruses Disease 2019 (COVID-19) pandemic, caused by an infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has challenged public health systems worldwide since the initial outbreak in the Chinese city of Wuhan in December 2019. By January 31st 2021, SARS-CoV-2 had caused more than 100 million infections and 2.2 million deaths worldwide (https://coronavirus.jhu.edu/map.html).
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.06.2021
Tilføjet 21.06.2021
Abstract
Background
Previous studies have indicated that host genetic factors play an essential role in immunity to human immunodeficiency virus (HIV) infection. We aimed to investigate the association between the toll-interacting protein (TOLLIP) and mannose-binding lectin 2 (MBL2) genes and HIV infection susceptibility among Chinese Han patients.
Methods
This is a case-control study. A total of 435 HIV-infected patients and 1013 seronegative healthy individuals were recruited. DNA was extracted from whole blood. Two SNPs in the MBL2 gene (rs7096206 and rs1800450) and three SNPs in the TOLLIP gene (rs5743899, rs3750920, and rs5743867) were selected and genotyped using a SNPscan Kit (Cat#: G0104, Genesky Biotechnologies Inc., Shanghai, China). Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using unconditional binary logistic regression.
Results
A significant association between the minor alleles rs5743899 (C allele) and rs5743867 (G allele) in the TOLLIP gene and susceptibility to HIV infection was found in this study after adjusting for age and sex (Pa = 0.011 and < 0.001, respectively). The rs5743867 in the TOLLIP gene was significantly associated with the risk of HIV infection in dominant, recessive, and additive models when adjusted for age and sex (Pa < 0.05). No significant association was found between MBL2 gene polymorphisms and HIV infection.
Conclusion
Our study found a statistically significant association between the two SNPs (rs5743867 and rs5743899) in the TOLLIP gene and susceptibility to HIV infection in a Chinese Han population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.06.2021
Tilføjet 21.06.2021
Abstract
Background
Bloodstream infections due to Staphylococcus aureus cause significant patient morbidity and mortality worldwide. Of major concern is the emergence and spread of methicillin-resistant S. aureus (MRSA) in bloodstream infections, which are associated with therapeutic failure and increased mortality.
Methods
We generated high quality draft genomes from 323 S. aureus blood culture isolates from patients diagnosed with bloodstream infection at the Dartmouth-Hitchcock Medical Center, New Hampshire, USA in 2010–2018.
Results
In silico detection of antimicrobial resistance genes revealed that 133/323 isolates (41.18%) carry horizontally acquired genes conferring resistance to at least three antimicrobial classes, with resistance determinants for aminoglycosides, beta-lactams and macrolides being the most prevalent. The most common resistance genes were blaZ and mecA, which were found in 262/323 (81.11%) and 104/323 (32.20%) isolates, respectively. Majority of the MRSA (102/105 isolates or 97.14%) identified using in vitro screening were related to two clonal complexes (CC) 5 and 8. The two CCs emerged in the New Hampshire population at separate times. We estimated that the time to the most recent common ancestor of CC5 was 1973 (95% highest posterior density (HPD) intervals: 1966–1979) and 1946 for CC8 (95% HPD intervals: 1924–1959). The effective population size of CC8 increased until the late 1960s when it started to level off until late 2000s. The levelling off of CC8 in 1968 coincided with the acquisition of SCCmec Type IV in majority of the strains. The plateau in CC8 also coincided with the acceleration in the population growth of CC5 carrying SCCmec Type II in the early 1970s, which eventually leveled off in the early 1990s. Lastly, we found evidence for frequent recombination in the two clones during their recent clonal expansion, which has likely contributed to their success in the population.
Conclusions
We conclude that the S. aureus population was shaped mainly by the clonal expansion, recombination and co-dominance of two major MRSA clones in the last five decades in New Hampshire, USA. These results have important implications on the development of effective and robust strategies for intervention, control and treatment of life-threatening bloodstream infections.
Læs mere Tjek på PubMedMarco Aurelio Safadi, Margarita Riera-Montes, Lulu Bravo, Auchara Tangsathapornpong, Rosanna Lagos, Usa Thisyakorn, Alexandre C. Linhares, Rose Capeding, Olarn Prommalikit, Thomas Verstraeten, Miguel O'Ryan
International Journal of Infectious Diseases, 20.06.2021
Tilføjet 21.06.2021
Acute gastroenteritis (AGE) is one of the leading causes of death in children under 5-years of age worldwide. Mortality due to AGE has decreased in the past decades, thanks to improved hygiene conditions and rotavirus (RV) vaccination among other interventions (GBD 2017 Diarrhoeal Disease Collaborators, 2020). However, AGE is responsible for significant morbidity and burden on health services and societies worldwide, including deaths in resource deprived countries (GBD 2017 Diarrhoeal Disease Collaborators, 2020) .
Læs mere Tjek på PubMedNa Li
Frontiers in Immunology, 26.10.2022
Tilføjet 21.06.2021
Post-ischemic acute kidney injury and disease (AKI/AKD) involve acute tubular necrosis and irreversible nephron loss. Mononuclear phagocytes including conventional dendritic cells (cDCs) are present during different phases of injury and repair, but the functional contribution of this subset remains controversial. Transcription factor interferon regulatory factor 8 (IRF8) is required for the development of type I conventional dendritic cells (cDC1s) lineage and helps to define distinct cDC1 subsets. We identified one distinct subset among mononuclear phagocyte subsets according to the expression patterns of CD11b and CD11c in healthy kidney and lymphoid organs, of which IRF8 was significantly expressed in the CD11blowCD11chigh subset that mainly comprised cDC1s. Next, we applied a Irf8-deficient mouse line (Irf8fl/flClec9acre mice) to specifically target Clec9a-expressing cDC1s in vivo. During post-ischemic AKI/AKD, these mice lacked cDC1s in the kidney without affecting cDC2s. The absence of cDC1s mildly aggravated the loss of living primary tubule and decline of kidney function, which was associated with decreased anti-inflammatory Tregs-related immune responses, but increased T helper type 1 (TH1)-related and pro-inflammatory cytokines, infiltrating neutrophils and acute tubular cell death, while we also observed a reduced number of cytotoxic CD8+ T cells in the kidney when cDC1s were absent. Together, our data show that IRF8 is indispensable for kidney cDC1s. Kidney cDC1s mildly protect against post-ischemic AKI/AKD, probably via suppressing tissue inflammation and damage, which implies an immunoregulatory role for cDC1s.
Læs mere Tjek på PubMedLynn S. Zijenah, Tsitsi Bandason, Wilbert Bara, Maria Mary Chipiti, David Allan Katzenstein
International Journal of Infectious Diseases, 20.06.2021
Tilføjet 20.06.2021
Mother-to-child transmission of HIV-1 (MTCT) can occur intrauterine (IU), or intrapartum (IP) or postpartum (PP) mainly via breastfeeding. Characterizing the three modes of HIV-1 transmission is important as different risk factors may influence transmission during each period (Zijenah et al; 2004) and thus different modalities may be required for their prevention Furthermore, characterizing the timing of MTCT may lead to better understanding of the biological mechanisms of HIV-1 transmission as well as the epidemiology and pathogenesis of HIV infection which may be utilized in designing and evaluating interventions to reduce MTCT.
Læs mere Tjek på PubMedRachel S Cooper, Aleksandra Kowalczuk, Gwen Wilkie, Mark A. Vickers, Marc L. Turner, John D.M. Campbell, Alasdair R Fraser
Clinical & Experimental Immunology, 19.06.2021
Tilføjet 20.06.2021
Achala Kamaladasa, Banuri Gunasekara, Chandima Jeewandara, Deshni Jayathilaka, Ananda Wijewickrama, Dinuka Guruge, Ruwan Wijayamuni, Tan T.K, Graham S. Ogg, Alain Townsend, Gathsaurie Neelika Malavige
International Journal of Infectious Diseases, 20.06.2021
Tilføjet 20.06.2021
There are many antibody assays currently in use to determine IgG, IgM and IgA specific to the SARS-CoV-2(Algaissi et al., 2020, Sun et al., 2020, Vogelzang et al., 2020). While some of these assays measure total antibodies to mainly the spike protein receptor binding domain (RBD), some measure IgM or IgG responses to S1, S2 or the nucleocapsid protein(Sun et al., 2020, Vogelzang et al., 2020). While these assays are sometimes used in conjunction with the PCR assays, some are used to detect those who have had asymptomatic infection and in sero-surveillance studies(Galipeau et al., 2020).Even though the RT-PCR is the gold standard in identifying those who are acutely infected with SARS-CoV-2, serological tests can contribute by providing more accurate estimates of past SARS-CoV-2 infections and immune status of the population (Ghaffari et al., 2020).
Læs mere Tjek på PubMedDe Matos Andreia, Brandão Lopes Sara, Serra José Eduardo, Ferreira Eugénia, Saraiva da Cunha, José
International Journal of Infectious Diseases, 19.06.2021
Tilføjet 20.06.2021
According to World Health Organization (WHO), early HIV diagnosis and combination antiretroviral therapy (cART) accessibility led to an increased overall survival in people living with human-immunodeficiency-virus (PLWHIV) and Acquired Immunodeficiency Syndrome (AIDS). In 2000, according to National Health Institute Doutor Ricardo Jorge (INSA), 60% of deaths occurred in the first year of diagnosis. Mortality due to HIV continuously decreased and, nowadays, in Portugal, most of the deaths occur after more than one decade of HIV diagnosis (INSA, 2019).
Læs mere Tjek på PubMedZaid A Alhinai, Nagi Elsidig
International Journal of Infectious Diseases, 19.06.2021
Tilføjet 20.06.2021
With the race to vaccinate the world against SARS-CoV-2 well on its way, many countries have already achieved impressive vaccination rates, and are quickly reaping the benefits. Yet not all highly-vaccinated populations are seeing the same results. A striking example of such divergent outcomes is currently being seen in the neighboring states of Qatar and Bahrain. In an impressive feat, both nations have vaccinated more than 50% of their population. And while in Qatar infection rates have decreased in a reassuring manner, infection rates have surprisingly sky-rocketed to unprecedented and alarming levels in Bahrain (Figure 1).
Læs mere Tjek på PubMedYaprak Ozakman, Ioannis Eleftherianos
Trends in Parasitology, 19.06.2021
Tilføjet 20.06.2021
The entomopathogenic nematodes Heterorhabditis and Steinernema form mutualistic complexes with Gram-negative bacteria. These insect parasites have emerged as excellent research tools for studying nematode pathogenicity and elucidating the features that allow them to persist and multiply within the host. A better understanding of the molecular mechanisms of nematode infection and host antinematode processes will lead to the development of novel means for parasitic nematode control. Recent work has demonstrated the power of using the Drosophila infection model to identify novel parasitic nematode infection factors and elucidate the genetic and functional bases of host antinematode defense.
Læs mere Tjek på PubMedDavid Bass, Sonja Rueckert, Rowena Stern, Alison C. Cleary, Joe D. Taylor, Georgia M. Ward, Rony Huys
Trends in Parasitology, 19.06.2021
Tilføjet 20.06.2021
There is a large diversity of eukaryotic symbionts of copepods, dominated by epizootic protists such as ciliates, and metazoan parasites. Eukaryotic endoparasites, copepod-associated bacteria, and viruses are less well known, partly due to technical limitations. However, new molecular techniques, combined with a range of other approaches, provide a complementary toolkit for understanding the complete symbiome of copepods and how the symbiome relates to their ecological roles, relationships with other biota, and responses to environmental change.
Læs mere Tjek på PubMedMary Grace B Dacuma, Judeline C Dimalibot, Joselito A Baril, Fatima Allian, Dayang Karna Bahidjan, Virgilio Mori, Sukarno Asri, Federico Yadao, Walter Notario, Ernesto Bona, Jose Barroquillo, Mary Oguike, Chris Drakeley, Rachel Hallett, Colin J Sutherland
International Journal of Infectious Diseases, 19.06.2021
Tilføjet 19.06.2021
To achieve the goal of malaria elimination by 2030, the Department of Health (DOH) in the Philippines is following a devolved malaria elimination strategy in all endemic provinces [1]. The Philippines scaled up vector control and has deployed artemether-lumefantrine (AL) with primaquine (PQ) as the first line treatment for Plasmodium falciparum since 2009. Chloroquine (CQ) and primaquine remained the approved regimen for treating Plasmodium vivax malaria. These measures resulted in 80% reduction in malaria cases with 27 provinces declared malaria-free in 2013 [2, 3].
Læs mere Tjek på PubMedKimberly Cipko, Alice Kizny Gordon, Suman Adhikari, Pamela Konecny
International Journal of Infectious Diseases, 19.06.2021
Tilføjet 19.06.2021
Limited treatment options exist for extensively drug-resistant Acinetobacter baumannii (XDRAB) (Theuretzbacher et al., 2020). Cefiderocol is a novel siderophore cephalosporin able to utilise bacterial iron transport mechanisms, in addition to porin channels, to enter cells and inhibit cell wall synthesis (Wu et al., 2020). It is a poor efflux pump substrate and demonstrates enhanced stability against hydrolysis by amp-C beta-lactamases, extended-spectrum beta-lactamases (ESBL) and most carbapenemases (Wu et al., 2020), resulting in activity against carbapenem-resistant Enterobacterales (CRE) and multi-drug resistant (MDR) Pseudomonas and Acinetobacter species.
Læs mere Tjek på PubMedHamilton FW, Lee TC, Arnold DT, Lilford R, Hemming K
International Journal of Infectious Diseases, 19.06.2021
Tilføjet 19.06.2021
Convalescent plasma (CP) – blood components from patients recovered from an infection - has been used for more than a century to treat infections, with widespread use in the 1920’s and 30’s for pneumococcal infections and scarlet fever, before falling out of favour with the development of antibiotics.1 The principle is that of ‘passive immunisation’ – passing antibodies from those recovered from infection to those naïve to it, thereby providing a degree of protection from that specific agent.2 It is therefore unsurprising that interest in the use of CP to prevent and treat COVID-19 has been widespread.
Læs mere Tjek på PubMedSimon Lea, Rosemary Gaskell, Simon Hall, Barbara Maschera, Edith Hessel, Dave Singh
Clinical & Experimental Immunology, 18.06.2021
Tilføjet 19.06.2021
Pantazis, Nikos; Rosinska, Magdalena; VAN Sighem, Ard; Quinten, Chantal; Noori, Teymur; Burns, Fiona; Cortes Martins, Helena; Kirwan, Peter D; O’donnell, Kate; Paraskevis, Dimitrios; Sommen, Cécile; Zenner, Dominik; Pharris, Anastasia
Journal of Acquired Immune Deficiency Syndromes, 15.06.2021
Tilføjet 19.06.2021
Background:
Migrant populations are overrepresented among persons diagnosed with HIV in the European Union (EU) and the European Economic Area (EEA). Understanding the timing of HIV acquisition (pre- or post-migration) is crucial for developing public health interventions and for producing reliable estimates of HIV incidence and the number of people living with undiagnosed HIV infection. We summarize a recently proposed method for determining timing of HIV acquisition and apply it to both real and simulated data.
Methods:
The considered method combines estimates from a mixed model, applied to data from a large seroconverters cohort, with biomarker measurements and individual characteristics to derive probabilities of pre-migration HIV acquisition within a Bayesian framework. The method is applied to a subset of data from The European Surveillance System (TESSy) and simulated data.
Findings:
Simulation study results showed good performance with the probabilities of correctly classifying a pre-migration or a post-migration case being 87.4% and 80.4%, respectively. Applying the method to TESSy data, we estimated the proportions of migrants who acquired HIV in the destination country were 31.9%, 37.1%, 45.3% and 45.2% for those originating from Africa, Europe, Asia and other regions, respectively.
Conclusions:
Although the considered method was initially developed for cases with multiple biomarkers’ measurements, its performance when applied to data where only one CD4 count per individual is available, remains satisfactory. Application of the method to TESSy data, estimated that a substantial proportion of HIV acquisition among migrants occurs in destination countries, having important implications for public health policy and programmes.
Correspondence and requests for reprints to: Nikos Pantazis, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, 75 Mikras Asias,115 27 Athens, Greece, email: npantaz@med.uoa.gr
The authors report no conflicts of interest related to this work.
Funding: This work was supported by the European Centre for Disease Prevention and Control (Framework Contract ECDC/2018/014).
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedGiacomelli, Andrea; Cozzi-Lepri, Alessandro; Cingolani, Antonella; Tavelli, Alessandro; Mazzotta, Valentina; Tesoro, Daniele; Bassetti, Matteo; Castagna, Antonella; Di Biagio, Antonio; Lichter, Miriam; Monforte, Antonella d’Arminio; Rusconi, Stefano; on behalf of the ICONA Foundation Study Group
Journal of Acquired Immune Deficiency Syndromes, 15.06.2021
Tilføjet 19.06.2021
Background:
To assess the impact of syphilis infection on the risk of HIV-RNA elevation in people living with HIV (PLWH) with current HIV-RNA ≤50 copies/mL.
Setting:
The Italian Cohort Naïve Antiretrovirals (ICONA).
Methods:
All PLWH (2009-2020) under antiretroviral treatment with at least 2 consecutive HIV-RNA values ≤50 copies/mL before the date of syphilis diagnosis and at least one HIV-RNA determination after the syphilis event were enrolled. A control group of PLWH without syphilis was matched for mode of HIV transmission. Outcomes were defined using the first HIV-RNA measure in the time window ranging between -2 and +6 months of the diagnosis/index date. The primary outcome used a single value>200 copies/mL to define HIV-RNA elevation associated with risk of transmission. The association between syphilis infection and the protocol defined outcome was evaluated using logistic regression analysis.
Results:
Nine hundred and twenty-six PLWH with a syphilis event were enrolled and matched with a random sample of 1370 PLWH without syphilis. Eighteen of the 926 (1.9%) with syphilis had ≥1 HIV-RNA>200 copies/mL in the window vs. 29/1370 (2.1%) of the not exposed (p=0.77). In the multivariable analysis adjusted for age, year of diagnosis/index date and clinical site, syphilis infection was not associated with the risk of HIV-RNA >200 copies/mL [adjusted Odds Ratio 0.81; 95% confidence interval 0.43-1.52, p=0.508].
Conclusions:
We did not find any evidence for an association between syphilis infection and viral elevation >200 copies/mL.
Corresponding author: Andrea Giacomelli, MD, Luigi Sacco DIBIC, Università degli Studi di Milano, III Infectious Diseases Unit, L. Sacco Hospital, Via G.B. Grassi 74, 20157 Milano, Italy, Tel. +39.02.50319761; Fax +39.02.50319758; E-mail andrea.giacomelli@unimi.it, ORCID ID: 0000-0003-3685-4289
* current address: UOC Malattie Infettive, ASST Ovest Milanese, Ospedale di Legnano, Italy.
Conflicts of Interest and Source of Funding: None related to the present manuscript.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChawana, Tariro Dianah; Nhachi, Charles Fungai Brian; Nathoo, Kusum; Ngara, Bernard; Okochi, Hideaki; Louie, Alexander; Kuncze, Karen; Katzenstein, David; Metcalfe, John; Gandhi, Monica; Adolescent Treatment Failure (ATF) study team
Journal of Acquired Immune Deficiency Syndromes, 15.06.2021
Tilføjet 19.06.2021
Background:
Sub-optimal adherence to antiretroviral therapy (ART) is responsible for most virologic failure among adolescents with HIV. Methods for objectively measuring adherence to ART are limited. This study assessed the association between ritonavir concentrations in hair, self-reported adherence and modified directly administered antiretroviral therapy on virologic outcomes among HIV-infected adolescents who were virologically failing second-line ART in Harare, Zimbabwe.
Methods:
HIV-infected adolescents on atazanavir/ritonavir-based second-line treatment for >6 months with viral load ≥1,000 copies/mL were randomized to either modified directly administered antiretroviral therapy (mDAART) plus standard-of-care (intervention) or standard-of-care alone (control). Questionnaires were administered; viral load and hair samples were collected at baseline and after 90 days. Virological suppression was defined as
Læs mere Tjek på PubMedSilhol, Romain; Coupland, Helen; Baggaley, Rebecca F.; Miller, Lori; Staadegaard, Lisa; Gottlieb, Sami L.; Stannah, James; Turner, Katherine M. E.; Vickerman, Peter; Hayes, Richard; Mayaud, Philippe; Looker, Katharine J.; Boily, Marie-Claude
Journal of Acquired Immune Deficiency Syndromes, 15.06.2021
Tilføjet 19.06.2021
Background:
Biological and epidemiological evidence suggest that herpes simplex virus type 2 (HSV-2) elevates HIV acquisition and transmission risk. We improved previous estimates of the contribution of HSV-2 to HIV infections by using a dynamic-transmission model.
Setting:
WHO regions.
Methods:
We developed a mathematical model of HSV-2/HIV transmission among 15-49-year-old heterosexual, non-drug-injecting populations, calibrated using region-specific demographic and HSV-2/HIV epidemiological data. We derived global and regional estimates of the contribution of HSV-2 to HIV infection over ten years (the transmission population-attributable fraction, tPAF) under three additive scenarios, assuming: (1) HSV-2 only increases HIV acquisition (“conservative”); (2) HSV-2 also increases HIV transmission (“liberal”); (3) HIV/ART (antiretroviral therapy) also modifies HSV-2 transmission and HSV-2 decreases ART effect on HIV transmission ("fully liberal”).
Results:
Under the conservative scenario, the predicted tPAF was 37.3% (95% uncertainty interval 33.4-43.2%) and an estimated 5.6 (4.5-7.0) million incident heterosexual HIV infections were due to HSV-2 globally over 2009-2018. The contribution of HSV-2 to HIV infections was largest for the African region (tPAF=42.6% (38.0-51.2%)), and lowest for the European region (tPAF=11.2% (7.9-13.8%)). The tPAF was higher among female sex-workers, their clients, and older populations, reflecting their higher HSV-2 prevalence. The tPAF was ∼50% and 1.3-2.4-fold higher for the liberal/fully liberal than the conservative scenario across regions.
Conclusion:
HSV-2 may have contributed to at least 37% of incident HIV infections in the last decade worldwide, and even more in Africa, and may continue to do so despite increased ART access unless future improved HSV-2 control measures, such as vaccines, become available.
Correspondence to Romain Silhol, PhD, MRC Centre for Global Infectious Disease, Analysis, Department of Infectious Disease Epidemiology, Imperial College London, St, Mary’s Hospital, 2 Norfolk Place, W2 1PG London, United Kingdom (email: r.silhol@imperial.ac.uk , phone: +44207594 3290, fax: +442074023927)
The authors report no conflicts of interest related to this work.
* These authors have contributed equally to the work.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedFlynn, Patricia M.; Taha, Taha E; Cababasay, Mae; Butler, Kevin; Fowler, Mary Glenn; Mofenson, Lynne M.; Owor, Maxensia; Fiscus, Susan; Stranix-Chibanda, Lynda; Coutsoudis, Anna; Gnanashanmugam, Devasena; Chakhtoura, Nahida; McCarthy, Katie; Frenkel, Lisa; Beck, Ingrid; Mukuzunga, Cornelius; Makanani, Bonus; Moodley, Dhayendre; Nematadzira, Teacler; Kusakara, Bangani; Patil, Sandesh; Vhembo, Tichaona; Bobat, Raziya; Mmbaga, Blandina T; Masenya, Maysseb; Nyati, Mandisa; Theron, Gerhard; Mulenga, Helen; Shapiro, David E.; and the PROMISE Study Team
Journal of Acquired Immune Deficiency Syndromes, 15.06.2021
Tilføjet 19.06.2021
Background:
Breastfeeding mothers with HIV infection not qualifying for antiretroviral therapy (ART) based on country-specific guidelines at the time of the PROMISE trial and their uninfected neonates were randomized to maternal ART (mART) or infant nevirapine prophylaxis (iNVP) postpartum. HIV transmission proportions were similar (< 1%) in the two arms. We assessed whether maternal viral load (MVL) or CD4 cell counts were associated with breastfeeding HIV transmission.
Methods:
MVL was collected at entry (7-14 days postpartum) and weeks 6, 14, 26, and 50 postpartum. CD4 cell counts were collected at entry and weeks 14, 26, 38, and 50 postpartum. Infant HIV-1 nucleic acid tests (NAT) were obtained at weeks 1, 6, every 4 weeks until week 26, then every 12 weeks. The associations of baseline and time-varying MVL and CD4 with transmission risk were assessed using time-to-event analyses by randomized treatment arm.
Results:
2431 mother-infant pairs enrolled. Baseline MVL (p= 0.11) and CD4 (p=0.51) were not significantly associated with infant HIV-1 infection. Time-varying MVL was significantly associated with infant HIV-1 infection (hazard ratio (95% CI): 13.96 (3.12, 62.45)) in the mART arm but not in the iNVP arm (hazard ratio (95% CI): 1.04 (.20, 5.39)). Time-varying CD4 cell counts were also significantly associated with infant HIV-1 infection in the mART arm but not in the iNVP arm (hazard ratio, 95% CI: 0.18 (0.03, 0.93) in mART arm and 0.38 (0.08, 1.77) in iNVP arm).
Conclusions:
In women receiving mART, increased MVL and decreased CD4 count during breastfeeding were associated with increased risk of infant HIV-1 infection.
Correspondence to: Patricia M. Flynn, MD, 262 Danny Thomas Place, Memphis, TN 38105, E-mail: pat.flynn@stjude.org, Phone: 901-595-4662, Fax: 901-595-8600
Conflict of Interest: Dr. Flynn is a consultant for Merck. No other authors declare conflict of interest.
Funding: Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) with co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Mental Health (NIMH), all components of the National Institutes of Health (NIH), under Award Numbers UM1AI068632 (IMPAACT LOC), UM1AI068616 (IMPAACT SDMC) and UM1AI106716 (IMPAACT LC), and by NICHD contract number HHSN275201800001I. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Study drugs were provided by AbbVie, Boehringer-Ingelheim, Gilead Sciences, and ViiV/GlaxoSmithKline.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedIrfan Ullah, Wardah Hassan, Muhammad Junaid Tahir, Ali Ahmed
Journal of Medical Virology, 18.06.2021
Tilføjet 19.06.2021
BMC Infectious Diseases, 19.06.2021
Tilføjet 19.06.2021
Abstract
Background
Coronavirus disease 2019 (COVID-19) has been shown to cause serious health problems among them is the Acute Respiratory Distress syndrome (ARDS). Vitamin D receptor (VDR) signaling possibly partakes in the pathophysiology of this devastating complication.
Methods
In the current project, we have appraised expression levels of VDR, CYP27B1 and a number of associated lncRNAs in the circulation of COVID-19 patients versus healthy subjects using real-time PCR method.
Results
Expression of SNHG6 was considerably lower in COVID-19 patients compared with control subjects (Ratio of mean expression (RME) = 0.22, P value = 7.04E-05) and in both female and male COVID-19 patients compared with sex-matched unaffected individuals (RME = 0.32, P value = 0.04 and RME = 0.16, P value = 0.000679683, respectively). However, its expression was similar among ICU-hospitalized and non-ICU patients. Similarly, expression of SNHG16 was lower in in COVID-19 patients compared with controls (RME = 0.20, P value = 5.94E-05) and in both female and male patients compared with sex-matched controls (RME = 0.32, P value = 0.04 and RME = 0.14, P value = 0.000496435, respectively) with no significant difference among ICU-hospitalized and non-ICU hospitalized patients. Expression of VDR was lower in COVID-19 patients compared with controls (RME = 0.42, P value = 0.04) and in male patients compared with male controls (RME = 0.27, P value = 0.02). Yet, expression of VDR was statistically similar between female subgroups and between ICU-hospitalized and non-ICU hospitalized patients. Expression levels CYP27B, Linc00511 and Linc00346 were similar among COVID-19 patients and healthy subjects or between their subgroups. Significant correlations have been detected between expression levels of VDR, CYP27B and SNHG6, SNHG16, Linc00511 and Linc00346 lncRNAs both among COVID-19 patients and among healthy controls with the most significant ones being SNHG6 and SNHG16 (r = 0.74, P value = 3.26e-17 and r = 0.81, P = 1.54e-22, respectively).
Conclusion
Combination of transcript levels of VDR, CYP27B and SNHG6, SNHG16, Linc00511 and Linc00346 could differentiate patients from controls with AUC = 0.76, sensitivity = 0.62 and specificity = 0.81. The current data potentiate SNHG6, SNHG16 and VDR as possible contributors in COVID-19 infection but not in the severity of ARDS.
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