Nyt fra tidsskrifterne

by Seyyed-Reza Sadat-Ebrahimi, Aysa Rezabakhsh, Naser Aslanabadi, Milad Asadi, Venus Zafari, Dariush Shanebandi, Habib Zarredar, Elgar Enamzadeh, Hamed Taghizadeh, Reza Badalzadeh

Background A number of circulating micro-ribonucleic acids (miRNAs) have been introduced as convincing predictive determinants in a variety of cardiovascular diseases. This study aimed to evaluate some miRNAs’ diagnostic and prognostic value in patients with acute heart failure (AHF). Method Forty-four AHF patients were randomly selected from a tertiary heart center, and 44 healthy participants were included in the control group. Plasma levels of assessed miRNAs, including miR -1, -21, -23, and -423-5-p were measured in both groups. The patients were followed for one year, and several clinical outcomes, including in-hospital mortality, one-year mortality, and the number of readmissions, were recorded. Results An overall 88 plasma samples were evaluated. There was no significant difference in terms of demographic characteristics between the AHF and healthy groups. Our findings revealed that mean levels of miR-1, -21, -23, and -423-5-p in AHF patients were significantly higher than in the control group. Although all assessed miRNAs demonstrated high diagnostic potential, the highest sensitivity (77.2%) and specificity (97.7%) is related to miR-1 for the values above 1.22 (p = 0.001, AUC = 0.841; 95%CI, 0.751 to 946). Besides, the levels of miR-21 and -23 were significantly lower in patients with ischemia-induced HF. However, the follow-up data demonstrated no significant association between miRNAs and prognostic outcomes including in-hospital mortality, one-year mortality, and the number of readmissions. Conclusion The result of our study demonstrated that miR-1, -21, -23, and -423-5-p can be taken into account as diagnostic aids for AHF. Nevertheless, there was no evidence supporting the efficacy of these miRNAs as prognostic factors in our study.…

Science Advances, Volume 8, Issue 38, September 2022. …

Science Advances, Volume 8, Issue 38, September 2022. …

Abstract

Background

Coagulopathy is still a serious pattern of coronavirus-19 disease. We aimed to evaluate COVID-19-associated coagulopathy and multiple hemostatic markers in Egyptian patients. In addition, to assess coagulation acute phase reactants and its effect on the outcome.

Methods

The study included 106 COVID-19 patients, and 51 controls. All patients were positive for COVID-19 infection by nasopharyngeal swab for detection of viral RNA by real-time PCR. In addition to baseline data and radiological findings, the coagulation profile was done with special attention to Fibrinogen, d-dimer, Factor VIII, von Willebrand factor (VWF), Protein C, Protein S, Antithrombin III (ATIII) and Lupus anticoagulant (LA)-1 and 2.

Results

The results showed significantly higher VWF, d-dimer, and LA1 (screening) and LA2 (confirmation) in patients than a control group. Significantly higher d-dimer FVIII, VWF and LA1-2 were detected in the severe group. ATIII had high diagnostic accuracy in severity prediction. We found a significantly higher international randomized ratio (INR) and VWF among patients with thrombotic events. For prediction of thrombosis; VWF at cutoff > 257.7 has 83.3% sensitivity and 83.3% specificity.

Conclusion

Patients with COVID-19 infection are vulnerable to different forms of coagulopathy. This could be associated with poor outcomes. d-Dimer is a chief tool in diagnosis, severity evaluation but not thrombosis prediction. Early screening for this complication and its proper management would improve the outcome.

…

Abstract

Background

In persons living with HIV (PLWH), the burden of non-communicable chronic diseases increased over time, because of aging associated with chronic inflammation, systemic immune activation, and long-term exposure to the combination antiretroviral therapy (ART).

Methods

To explore the association of chronological age, age at first ART, and exposure to ART with non-communicable chronic diseases, we performed a cross-sectional analysis to evaluate the prevalence of comorbidities in patients enrolled in the SCOLTA Project, stratified by groups of chronological age (50–59 and 60–69 years) and by years of antiretroviral treatment (ART, ≤ 3 or > 3 years).

Results

In 1394 subjects (23.8% women), mean age at enrollment was 57.4 (SD 6.5) years, and at first ART 45.3 (SD 10.7). Men were older than women both at enrollment (57.6 vs 56.8, p = 0.06) and at first ART (45.8 vs 43.6, p = 0.0009). ART duration was longer in women (13.1 vs 11.7 years, p = 0.01). The age- and sex-adjusted rate ratios (aRRs, and 95% confidence interval, CI) showed that longer ART exposure was associated with dyslipidemia (aRR 1.35, 95% CI 1.20–1.52), hypertension (aRR 1.52, 95% CI 1.22–1.89), liver disease (aRR 1.78, 95% CI 1.32–2.41), osteopenia/osteoporosis (aRR 2.88, 95% CI 1.65–5.03) and multimorbidity (aRR 1.36, 95% CI 1.21–1.54). These findings were confirmed in strata of age, adjusting for sex.

Conclusions

Our data suggest that longer ART exposure was associated with increased risk of dyslipidemia, hypertension, and osteopenia/osteoporosis, hence the presence of multimorbidity, possibly due to the exposition to more toxic antiretrovirals. We observed different comorbidities, according to ART exposure and age.

…

Tropical Medicine &International Health, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

After the legalisation of abortion in the USA in 1973, the risk of infectious morbidity and mortality from this procedure notably decreased. With increasingly restrictive legislation targeting access to safe abortion services, reviewing infectious complications of unsafe pregnancy termination is crucial, particularly the diagnosis and management of life-threatening clostridial (and related anaerobic bacterial) infections that can complicate unsafe abortion. This Review deals with two especially devastating infections that are well-documented causes of septic abortion: the anaerobic, spore-forming pathogens Clostridium perfringens and Paeniclostridium sordellii.

Ebola Virus Disease (EVD) is a dangerous condition with potential to cause epidemics. Several rapid diagnostic tests (RDTs) have been developed to diagnose EVD. These RDTs promise to be quicker and easier to use than the current gold standard diagnostic test, PCR.

Bloodstream infection (BSI) is a leading cause of morbidity and mortality worldwide [1]. Timely diagnosis of BSI is essential to improve clinical and antimicrobial management [2]. The consequences of missing a BSI diagnosis are grave given the high risk of complications. On the other hand, obtaining unnecessary blood cultures increases the cost of healthcare. Occasional growth of skin contaminants in blood cultures and the physiologic phenomenon of transient bacteremia due to viridans group streptococci may often complicate clinical management.

Since April 2022, increasing numbers of monkeypox (MPX) cases are reported outside endemic areas as part of an international outbreak. Our study shows aspects of clinical manifestations as well as epidemiological and virological features impacting transmission, for which only scarce data are available so far.

Merkel cell carcinoma, a life-threatening but radiosensitive cancer, accounts for less than 1% of all cutaneous malignancies.1 It is found predominantly in White populations and risk factors include older age (ie, age 65 years and older), ultraviolet exposure, male sex, immunosuppression, and Merkel cell polyomavirus infection.1…

When a cluster of respiratory viral infections occurs, early recognition by clinicians linked to a global network is essential for rapid identification of the causal pathogen and subsequent risk assessment and public health response. Crucial to this process are sentinel physician and hospital networks where samples are collected from patients with febrile respiratory infections; trained laboratory staff to identify the causative pathogen; and epidemiologists and public health staff to collect data and evaluate pathogen spread and disease severity in susceptible populations.

Sophie Seang and colleagues’ description of human-to-dog transmission of monkeypox virus1 raised concerns about the role of pets in monkeypox virus transmission, reinforcing recommendations from public health authorities that infected people should avoid contact with animals, isolate exposed pets, and consider removing exposed pets from the homes of immunocompromised people.2 For example, the US Centers for Disease Control and Prevention now notes that human-to-dog transmission of monkeypox virus has occurred and that signs in dogs include development of a rash, “which to-date have been located on the abdomen and anus”.

By Aug 10, 2022, 3 497 208 of the estimated 4·4 million adults living in Scotland had received three doses of a COVID-19 vaccine. However, a proportion of the adult population remains unvaccinated (defined as no record of any vaccine being administered) and susceptible to severe COVID-19 outcomes. Characterising this population can help to understand gaps in vaccine coverage and determinants of vaccine hesitancy and could support targeted public health messaging. Unlike the vaccinated population, on whom information is gathered at the point of vaccination, current estimates of the unvaccinated population are calculated using general practitioner (GP) records.

An 80-year-old man with a 1-week history of a red, swollen, and painful right leg presented to our emergency department. Additionally, he had reported long-term fatigue. A deep vein thrombosis was excluded after an ultrasound of his leg and he was found to have an infected ulcer caused by chronic venous insufficiency and an iron deficiency anaemia. The patient was referred to our clinic for further exploration of his anaemia and painful leg.

: To compare mRNA-based (mRNA) and adenovirus-vectored vaccines (ADVV) with inactivated virus vaccines (IVV) using real-world aggregate data.

by Małgorzata Pięta, Marcin Rzeszutek

Objective Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) are considered two sides of growth after trauma. Nevertheless, previous studies pointed out that in trauma living with a life-threatening illness, they may be experienced as two independently and share distinct predictors. In our study we aimed to find the different trajectories of PTG and PTD among a sample of people living with HIV (PLWH) and to investigate its predictors out of psychological resilience, and gain and loss of resources from the conservation of resources theory (COR). Methods We designed a longitudinal study that consisted of three measurements at 6-month intervals, and we recruited, respectively, 87, 85 and 71 PLWH. Each time participants filled out the following questionnaires: the expanded version of the PTG and PTD Inventory (PTGDI-X), the Brief Resilience Scale (BRS), the Conservation of Resources Evaluation (COR-E), and a survey on sociodemographic and medical data. Results We observed two separate trajectories of PTG and PTD within participants and found that each of the trajectories were related to different predictors from the studied variables. More specifically, we found a positive relationship between resilience and a descending PTD trajectory that stabilized over time. Gain of resources generally predicted a PTG trajectory, while loss of resources predicted the dynamics of PTD. Conclusions Including two parallel constructs, i.e., PTG and PTD, confirmed the independence of their mechanisms in growth processes among PLWH. The initial insight concerning the role of resilience and resources in PTG/PTD processes may inspire more effective planning for psychological help for PLWH, and it may stimulate studies on growth after trauma to further examine the two sides of this phenomenon.…

by Cecile F. Frampas, Katie Longman, Matt Spick, Holly-May Lewis, Catia D. S. Costa, Alex Stewart, Deborah Dunn-Walters, Danni Greener, George Evetts, Debra J. Skene, Drupad Trivedi, Andy Pitt, Katherine Hollywood, Perdita Barran, Melanie J. Bailey

Background The COVID-19 pandemic is likely to represent an ongoing global health issue given the potential for new variants, vaccine escape and the low likelihood of eliminating all reservoirs of the disease. Whilst diagnostic testing has progressed at a fast pace, the metabolic drivers of outcomes–and whether markers can be found in different biofluids–are not well understood. Recent research has shown that serum metabolomics has potential for prognosis of disease progression. In a hospital setting, collection of saliva samples is more convenient for both staff and patients, and therefore offers an alternative sampling matrix to serum. Methods Saliva samples were collected from hospitalised patients with clinical suspicion of COVID-19, alongside clinical metadata. COVID-19 diagnosis was confirmed using RT-PCR testing, and COVID-19 severity was classified using clinical descriptors (respiratory rate, peripheral oxygen saturation score and C-reactive protein levels). Metabolites were extracted and analysed using high resolution liquid chromatography-mass spectrometry, and the resulting peak area matrix was analysed using multivariate techniques. Results Positive percent agreement of 1.00 between a partial least squares–discriminant analysis metabolomics model employing a panel of 6 features (5 of which were amino acids, one that could be identified by formula only) and the clinical diagnosis of COVID-19 severity was achieved. The negative percent agreement with the clinical severity diagnosis was also 1.00, leading to an area under receiver operating characteristics curve of 1.00 for the panel of features identified. Conclusions In this exploratory work, we found that saliva metabolomics and in particular amino acids can be capable of separating high severity COVID-19 patients from low severity COVID-19 patients. This expands the atlas of COVID-19 metabolic dysregulation and could in future offer the basis of a quick and non-invasive means of sampling patients, intended to supplement existing clinical tests, with the goal of offering timely treatment to patients with potentially poor outcomes.…

by Saifur Rahman Chowdhury, Humayun Kabir, Sinthia Mazumder, Nahida Akter, Mahmudur Rahman Chowdhury, Ahmed Hossain

Background Depression is one of the most serious yet understudied issues among Bangladeshi nurses, bringing health dangers to this workforce. This study aimed to investigate how workplace violence (WPV), bullying, burnout, and job satisfaction are correlated with depression and identify the factors associated with depression among Bangladeshi nurses. Methods For this cross-sectional study, data were collected between February 26, 2021, and July 10, 2021 from the Bangladeshi registered nurses. The Workplace Violence Scale (WPVS), the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), the Short Index of Job Satisfaction (SIJS-5), and the Patient Health Questionnaire (PHQ-9) were used to measure WPV, bullying, burnout, job satisfaction, and depression, respectively. Inferential statistics include Pearson’s correlation test, t-test, one-way ANOVA test, multiple linear regression, and multiple hierarchal regression analyses were performed. Results The study investigated 1,264 nurses (70.02% female) with an average age of 28.41 years (SD = 5.54). Depression was positively correlated with WPV, bullying, and burnout and negatively correlated with job satisfaction (p 48 hours) had a significantly higher depression score (β = 1.490, 95% CI = 0.511 to 2.470) than those who worked ≤ 36 hours. Depression was found to be significantly higher among those who did not receive a timely salary (β = 2.136, 95% CI = 1.138 to 3.134), rewards for good works (β = 1.862, 95% CI = 1.117 to 2.607), and who had no training on WPV (β = 0.895, 95% CI = 0.092 to 1.698). Conclusions Controlling burnout, bullying, and workplace violence, as well as improving the work environment for nurses and increasing job satisfaction, are the essential indicators of reducing depression. This can be accomplished with integrative support from hospital executives, policymakers, and government officials.…

by Gwen Weeldenburg, Lars Borghouts, Tim van de Laak, Teun Remmers, Menno Slingerland, Steven Vos

The aim of the present study was to explore the impact of TARGET-based teaching strategies on students’ motivation in a Dutch secondary school PE context. We examined to what extent mastery climate teaching strategies perceived by students (independently or interactively) explain variability in students’ motivation towards PE. In total 3,150 students (48.2% girls; 51.8% boys) with a mean age of 13.91 years (SD = 1.40) completed the Behavioural Regulations in Physical Education Questionnaire (BRPEQ), measuring students’ autonomous motivation, controlled motivation and amotivation, and the Mastery Teaching Perception Questionnaire (MTP-Q), measuring student-perceived application of mastery TARGET teaching strategies. Hierarchical regression analyses indicated that after controlling for gender, age, and educational type, the predictive effects of the perceived mastery climate teaching strategies differed by motivational outcome. Overall, students who reported higher levels of perceived application of mastery TARGET teaching strategies showed more autonomous motivation and less amotivation. Specifically, the teaching strategies within the task structure were the strongest predictors for students’ autonomous motivation and amotivation. No meaningful statistically significant two-way interaction effects between any of the TARGET variables were found, supporting the proposition of an additive relationship between the TARGET teaching strategies.

by Mariane Daou, Hussein Kannout, Mariam Khalili, Mohamed Almarei, Mohamed Alhashami, Zainab Alhalwachi, Fatima Alshamsi, Mohammad Tahseen Al Bataineh, Mohd Azzam Kayasseh, Abdulmajeed Al Khajeh, Shadi W. Hasan, Guan K. Tay, Samuel F. Feng, Dymitr Ruta, Ahmed F. Yousef, Habiba S. Alsafar, on behalf of the UAE COVID-19 Collaborative Partnership

Coronavirus disease 2019 (COVID-19) was first identified in respiratory samples and was found to commonly cause cough and pneumonia. However, non-respiratory symptoms including gastrointestinal disorders are also present and a big proportion of patients test positive for the virus in stools for a prolonged period. In this cross-sectional study, we investigated viral load trends in stools and nasopharyngeal swabs and their correlation with multiple demographic and clinical factors. The study included 211 laboratory-confirmed cases suffering from a mild form of the disease and completing their isolation period at a non-hospital center in the United Arab Emirates. Demographic and clinical information was collected by standardized questionnaire and from the medical records of the patient. Of the 211 participants, 25% tested negative in both sample types at the time of this study and 53% of the remaining patients had detectable viral RNA in their stools. A positive fecal viral test was associated with male gender, diarrhea as a symptom, and hospitalization during infection. A positive correlation was also observed between a delayed onset of symptoms and a positive stool test. Viral load in stools positively correlated with, being overweight, exercising, taking antibiotics in the last 3 months and blood type O. The viral load in nasopharyngeal swabs, on the other hand, was higher for blood type A, and rhesus positive (Rh factor). Regression analysis showed no correlation between the viral loads measured in stool and nasopharyngeal samples in any given patient. The results of this work highlight the factors associated with a higher viral count in each sample. It also shows the importance of stool sample analysis for the follow-up and diagnosis of recovering COVID-19 patients.