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Lancet Infectious Diseases, 9.12.2022
Tilføjet 9.12.2022
Zoonotic diseases are at the nexus of climate change, changes in ecosystems, and human health. Zoonotic diseases, or zoonoses, are classically defined as diseases and infections that are naturally transmitted between vertebrate animals and humans. This editorial refers to zoonoses in a broad way and includes both the classical definition of it, and to pathogens that originated in animals that subsequently adapted to transmit between humans with or without vectors. Zoonoses derived from spillover from wildlife, such as Ebola virus disease have been emerging at an alarming rate due to deforestation and the change in ecosystems, such as land shifts, habitat alterations, global warming, and changes in the biological characteristics of pathogens and vectors, such as survival, virulence, and reproduction.
Læs mere Tjek på PubMedClinical Microbiology and Infection, 9.12.2022
Tilføjet 9.12.2022
To investigate immunogenicity and safety of BNT162b2 booster vaccination with and without a tetravalent influenza vaccine.
Læs mere Tjek på PubMedClinical Microbiology and Infection, 9.12.2022
Tilføjet 9.12.2022
COVID-19 and antimicrobial resistance (AMR) are two intersecting global public health crises.
Læs mere Tjek på PubMedClinical Microbiology and Infection, 9.12.2022
Tilføjet 9.12.2022
We report a patient case with pseudomembranous colitis associated with a mono-toxin producing Clostridioides difficile belonging to the very rarely diagnosed PCR ribotype (RT) 151. In order to understand why this isolate was not identified using a routine commercial test, we performed a genomic analysis of RT151. .
Læs mere Tjek på PubMedClinical Microbiology and Infection, 8.12.2022
Tilføjet 9.12.2022
Solid organ transplant (SOT) recipients have increased morbidity and mortality risk from coronavirus disease 2019 (COVID-19).
Læs mere Tjek på PubMedClinical Microbiology and Infection, 8.12.2022
Tilføjet 9.12.2022
Monkeypox, a zoonotic orthopoxvirus, has spread to many countries in recent months, involving mostly men who have sex with men (MSM) with multiple partners. Clinical presentation includes skin lesions, systemic signs, and less frequently skin superinfections, or ano-rectal and ophthalmic involvements. We aim to detail cases of myocarditis attributable to monkeypox, an entity that has been poorly described.
Læs mere Tjek på PubMedClinical Microbiology and Infection, 8.12.2022
Tilføjet 9.12.2022
To determine the epidemiological cut-off values (ECVs) of ten antifungal agents in a wide range of yeasts and Aspergillus spp. using gradient concentration strips (GCS).
Læs mere Tjek på PubMedLancet, 10.12.2022
Tilføjet 9.12.2022
Diagnoses are growing and experts fear that infection is moving from key populations to the public at large. Udani Samarasekera reports.
Læs mere Tjek på PubMedLancet, 10.12.2022
Tilføjet 9.12.2022
Before our interview, Ntobeko Ntusi, Chair and Head of the Department of Medicine at the University of Cape Town (UCT) and Groote Schuur Hospital, South Africa, had been doing a bedside tutorial with students. He highlighted the different way they had presented the Black and White patients. “I asked the students why it is important to clarify the HIV status of Black patients when you present them when it has no bearing on their clinical presentation. And you can see the dumbfounded faces because it's not something they do consciously, but these biases are so in-built, even at this young age”, he says.
Læs mere Tjek på PubMedLancet, 10.12.2022
Tilføjet 9.12.2022
Microbiologist Senjuti Saha is the Director of the non-profit Child Health Research Foundation (CHRF), in Dhaka, Bangladesh, and a strong advocate for equity in global health research. When she received a grant in 2018 to set up a sequencing facility at CHRF and got the non-governmental organisation's first sequencing machine, she says, “I wanted to show the world that you could be anywhere in the world and be able to sequence. You don’t have to ship samples out to the US or UK. You can sequence wherever you are and everybody's capable.
Læs mere Tjek på PubMedBMJ Open, 8.12.2022
Tilføjet 8.12.2022
ObjectivesTo establish the implications of frailty as a predictor of outcome in patients with head and neck cancer requiring flap repair.DesignRetrospective cohort.Data sourceWe captured data from patients above 60 years old undergoing head and neck tumour resection and free flap reconstruction surgery between June 2019 and June 2020 at the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. The data contain all treatment information.Outcome variablesSurgery repeated in 30 days, postoperative complications, hospital length of stay, postoperative main biochemical standards.Exposure variablesAge, sex, smoking history, alcoholism history, American Society of Anesthesiologists score, National Nosocomial Infection Surveillance score and Clinical T staging were exposure variables. The frailty index is the main variable.ResultA total of 254 patients were included in this study. Among them, 124 patients were classified as frail, while 130 patients were classified as non-frail. We found that frail patients stayed in the hospital longer than non-frail patients after surgery (p=0.018). According to the data of 26 frail patients who directly entered the intensive care unit (ICU), we found that these patients had a lower leucocyte count (p=0.005).ConclusionsFrailty is a useful predictor of outcomes in patients undergoing head and neck cancer surgery with flap reconstruction. Frailty can be a clinical tool used to identify high-risk patients and guide perioperative care to optimise patient outcomes. Frail patients have better outcomes if they directly enter the ICU.
Læs mere Tjek på PubMedBMJ Open, 8.12.2022
Tilføjet 8.12.2022
IntroductionThere is a high burden of hypertension (HTN) among HIV-infected people in Uganda. However, capacity to prevent, diagnose and treat HTN is suboptimal. This study seeks to leverage the existing HIV-related infrastructure in primary care health facilities (HFs) using the integrated HIV/HTN care model to improve health outcomes of patients with HIV and HTN.Methods and analysisIntegrated HIV/HTN study a type-1 effectiveness/implementation cluster randomised trial, will evaluate the effectiveness of a multicomponent model intervention in 13 districts randomised to the intervention arm compared with 13 districts randomised to control. Two randomly selected HFs per district and their patients will be eligible to participate. The intervention will comprise training of primary healthcare (PHC) providers followed by regular supervision, integration of HTN care into HIV clinics, improvement of the health management information system, IT-based messaging to improve communication among frontline PHCs and district-level managers. HTN care guidelines, sphygmomanometers, patient registers and a buffer stock of essential drugs will be provided to HFs in both study arms. We will perform cross-sectional surveys at baseline, 12 and 24 months, on a random sample of patients attending HFs to measure effectiveness of the integrated care model between 2021 and 2024. We will perform in-depth interviews of providers, patients and healthcare managers to assess barriers and facilitators of integrated care. We will measure the cost of the intervention through microcosting and time-and-motion studies. The outcomes will be analysed taking the clustered structure of the data set into account.Ethics and disseminationEthics approval has been obtained from the Research Ethics Committees at London School of Hygiene and Tropical Medicine, and Makerere University School of Medicine. All participants will provide informed consent prior to study inclusion. Strict confidentiality will be applied throughout. Findings will be disseminated to public through meetings, and publications.Trial registration numberNCT04624061
Læs mere Tjek på PubMedBMJ Open, 8.12.2022
Tilføjet 8.12.2022
ObjectivesTo describe child and parent weight change during the pandemic, overall and by income precarity.DesignA cross-sectional online survey was conducted.SettingCaregivers of children 0–17 years of age living in Ontario, Canada, during the COVID-19 pandemic from May 2021 to July 2021.ParticipantsA convenience sample of parents (n=9099) with children (n=9667) living in Ontario were identified through crowdsourcing.Primary outcome measureParents recalled, for themselves and their child, whether they lost weight, gained weight or remained the same over the past year. OR and 95% CI were estimated using multinomial logistic regression for the association between income precarity variables and weight loss or gain, adjusted for age, gender and ethnicity.ResultsOverall, 5.5% of children lost weight and 20.2% gained weight. Among adolescents, 11.1% lost weight and 27.1% gained weight. For parents, 17.1% reported weight loss and 57.7% reported weight gain. Parent weight change was strongly associated with child weight change. Income precarity measures, including job loss by both parents (OR=7.81, 95% CI 5.16 to 11.83) and disruption to household food supply (OR=6.05, 95% CI 4.77 to 7.68), were strongly associated with child weight loss. Similarly, job loss by both parents (OR=2.03, 95% CI 1.37 to 3.03) and disruption to household food supply (OR=2.99, 95% CI 2.52 to 3.54) were associated with child weight gain.ConclusionsWeight changes during the COVID-19 pandemic were widespread and income precarity was strongly associated with weight loss and weight gain in children and parents. Further research is needed to investigate the health outcomes related to weight change during the pandemic, especially for youth, and the impacts of income precarity.
Læs mere Tjek på PubMedBMJ Open, 8.12.2022
Tilføjet 8.12.2022
IntroductionRegular intramuscular benzathine penicillin G injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. As the pharmacological correlate of protection remains unknown, it is difficult to recommend changes to this established regimen. Determining the minimum effective penicillin exposure required to prevent Streptococcus pyogenes infection will accelerate development of new long-acting penicillins for RHD prevention as well as inform opportunities to improve existing regimens. The CHIPS trial will address this knowledge gap by directly testing protection afforded by different steady state plasma concentrations of penicillin in an established model of experimental human S. pyogenes pharyngitis.Methods and analysisThis is a double-blinded, placebo-controlled, randomised experimental human infection study. Sixty healthy adult volunteers aged 18–40 years will be recruited and randomised 1:1:1:1:1 to continuous intravenous penicillin infusions targeting five different steady state plasma concentrations of 0 (placebo), 3, 6, 12 and 20 ng/mL via a midline catheter. Each participant’s penicillin pharmacokinetic parameters will be established prior to the challenge, to ensure accurate dosing for the continuous infusion. Following the challenge with a well-characterised strain of S. pyogenes, participants will be observed for up to 6 days for the development of pharyngitis and treated with antibiotics prior to discharge. The primary objective is to determine the minimum effective steady-state plasma penicillin concentration required to prevent experimental pharyngitis. Secondary objectives will explore systemic and mucosal immunoinflammatory responses during pharyngitis, bacterial colonisation dynamics, environmental contamination and qualitative evaluation of the participant experience.Ethics and disseminationEthical approval has been obtained (Bellberry Human Research Ethics Committee). Findings will be reported in peer-reviewed publications and presented at national/international stakeholder forums.Trial registration numberACTRN12621000751875.
Læs mere Tjek på PubMedBMJ Open, 8.12.2022
Tilføjet 8.12.2022
IntroductionCo-designing healthcare research and health services is becoming increasingly prominent. Co-design invites people with disability to leverage their lived experience knowledge to improve service provision, as well as ensuring meaningful and relevant research. Given the emerging nature of the use of co-design with adults with neurological disability, well-defined guidelines on best practice are yet to be developed. The aim of this scoping review is to synthesise available peer-reviewed literature which investigates the use of co-design in research and/or service development with adults who have an acquired neurological disability and live within the community. The findings of this review will help to guide future co-design practice, ensuring people with acquired neurological disability are best supported and engaged in the process.Methods and analysisThis review will follow methodology proposed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews. Systematic electronic database searches will be conducted between the years 2000 and 2022, via MEDLINE, CINAHL, PsycINFO, Scopus and Embase. Article screening and selection will follow the five-stage framework of Arksey and O’Malley, using Covidence software to support review of each retrieved article by two independent reviewers. Final selected qualitative and/or mixed-methods studies that meet the inclusion criteria will be charted, data collated, summarised and reported. Thematic synthesis will be applied to the qualitative data extracted from these studies.Ethics and disseminationEthics approval will not be required to conduct this scoping review. It is the authors’ intention for the findings of this scoping review to be made available to relevant stakeholders through open-access peer-reviewed publication and disseminated with other healthcare and research networks via translation pieces, including the development of short video summaries and practice resources.
Læs mere Tjek på PubMedBMJ Open, 8.12.2022
Tilføjet 8.12.2022
ObjectivesThe existing literature regarding the mental health consequences of COVID-19 among healthcare workers revolves predominantly around specialised hospital settings, while neglecting primary healthcare workers (PHCW) who are the first point of contact for patients. In view of negligible evidence, this study explored the mental health impact of COVID-19 and health system response, and sought suggestions and recommendations from the PHCWs to address their mental health needs during the pandemic crisis.DesignWe employed a qualitative exploratory design.SettingA total of 42 primary healthcare facilities across 15 districts in Sindh and Punjab provinces of Pakistan.ParticipantsWe telephonically conducted 47 in-depth interviews with health service providers and hospital managers. A combination of inductive and deductive approach was used for data analyses using NVivo V.11.0.ResultsThere was immense fear, stress and anxiety among PHCWs being infected and infecting their families at the beginning of this outbreak and its peak which tapered off over time. It was triggered by lack of information about the virus and its management, false rumours, media hype, lack of personal protective measures (personal protective equipment, PPE) and non-cooperation from patients and community people. Trainings on awareness raising and the PPEs provided by the healthcare system, with emotional support from coworkers and supervisors, were instrumental in addressing their mental health needs. Additionally, they recommended appreciation and recognition, and provision of psychosocial support from mental health professionals.ConclusionPrimary healthcare system should be prepared to provide timely informational (eg, continuous updates in training and guidelines), instrumental (eg, provision of PPE, appreciation and recognition), organisational (eg, safe and conducive working environment) and emotional and psychosocial support (eg, frequent or needs-based session from mental health professionals) to PHCWs in order to mitigate the mental health impact of pandemic crisis.
Læs mere Tjek på PubMedClinical & Experimental Immunology, 8.12.2022
Tilføjet 8.12.2022
SummaryThe importance of antibodies, particularly neutralising antibodies, has been known for decades. When examining the immune responses against a pathogen after a vaccination or infection it is easier to measure the levels of antigen specific antibodies than the T-cell response, but it does not give the whole picture. The levels of neutralising antibodies is harder to determine but gives a better indication of the quality of the antibody response. The induction of long-lived antibody secreting plasma cells are crucial for a persistent humoral immune response, which has been shown for example after vaccination with the vaccinia vaccine, where antibody levels have been shown to persist for decades.With the SARS-CoV-2 pandemic ravaging the world for the past years and the monumental effort in designing and releasing novel vaccines against the virus, much effort has been put in analysing the quantity, quality and persistence of antibody responses.The current review will focus on the plasma cells and discuss how long-lasting immune responses are induced, the importance of antigen availability and retention in evoking a long-lasting persisting antibody response.Since SARS-CoV-2 is a novel disease and many different vaccination strategies have been generated, focus will be put on persisting antibody responses against these different types of vaccines, which will give an insight into the generation of immunological memory and the persistence of antibody responses.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 8.12.2022
Tilføjet 8.12.2022
AbstractBackgroundMen who have sex with men (MSM) on antiretroviral therapy (ART) are at risk for multimorbidity as life expectancy increases. Simulation models can project population sizes and age distributions to assist with health policy planning.MethodsWe populated the CEPAC-US model with CDC data to project the HIV epidemic among MSM in the US. The PEARL model was predominantly informed by NA-ACCORD data (2009-2017). We compared projected population sizes and age distributions of MSM receiving ART (2021-2031) and investigated how parameters and assumptions affected results.ResultsWe projected an aging and increasing population of MSM on ART: CEPAC-US: mean ± SD age, 48.6 ± 13.7y [2021] vs. 53.9 ± 15.0y [2031]; PEARL: 46.7 ± 13.2y vs. 49.2 ± 14.6y. We projected 548,800 MSM on ART (147,020 ≥ 65y) in 2031 (CEPAC-US) and 599,410 (113,400 ≥ 65y) (PEARL). Compared with PEARL, CEPAC-US projected a smaller population of MSM on ART by 2031 and a slower increase in population size, driven by higher estimates of disengagement in care and mortality.ConclusionFindings from two structurally distinct microsimulation models suggest that the MSM population receiving ART in the US will increase and age over the next decade. Subgroup-specific data regarding engagement in care and mortality can improve projections and inform health care policy planning.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 8.12.2022
Tilføjet 8.12.2022
Journal of Infectious Diseases, 8.12.2022
Tilføjet 8.12.2022
AbstractThe lack of a long-term in vitro culture method has severely restricted the study of Plasmodium vivax, in part because it limits genetic manipulation and reverse genetics. We used the recently optimized P. cynomolgi Berok in vitro culture model to investigate the putative P. vivax drug resistance marker MDR1 Y976F. Introduction of this mutation using CRISPR-Cas9 increased sensitivity to mefloquine, but had no significant effect on sensitivity to chloroquine, amodiaquine, piperaquine and artesunate. To our knowledge, this is the first reported use of CRISPR-Cas9 in P. cynomolgi, and the first reported integrative genetic manipulation of this species.
Læs mere Tjek på PubMedTrends in Parasitology, 7.12.2022
Tilføjet 8.12.2022
In recent years, with the development of microbial research technologies, microbiota research has received widespread attention. The parasitoid wasp genus Nasonia is a good model organism for studying insect behavior, development, evolutionary genetics, speciation, and symbiosis. This review describes key advances and progress in the field of the Nasonia microbiome interactions. We provide an overview of the advantages of Nasonia as a model organism for microbiome studies, list research methods to study the Nasonia microbiome, and discuss recent discoveries in Nasonia microbiome research.
Læs mere Tjek på PubMedJournal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
Journal of Medical Virology, 7.12.2022
Tilføjet 8.12.2022
BMC Infectious Diseases, 8.12.2022
Tilføjet 8.12.2022
Abstract Introduction Antimicrobial stewardship programs are intended to improve patient outcomes, reduce side effects, bacterial resistance, and costs. Thus, it is important to assess their impact on an ongoing basis. We aimed to assess the impact of the antimicrobial stewardship program in two different hospitals which used different program approaches. Methodology This is a retrospective observational study in two private hospitals [4088 patient records] in Amman- Jordan. Antibiotic susceptibility using antibiogram results, consumption of antibiotics using Defined Daily Dose, and the incidence of Multi-Drug Resistance were recorded using patients’ records during 2018, 2019, and 2020. Results Antimicrobial stewardship program outcomes varied between the two hospitals. Bacterial susceptibility to antibiotics were improved in both hospitals. Moreover, the defined daily dose in Hospital “A” showed no significant change in Fluoroquinolones, Carbapenems, and Piperacillin- Tazobactam, Cephalosporins, and Colistin, while a significant change was observed among Anti-MRSA antibiotics. Finally, the incidence of Extended Spectrum Beta-lactamase [ESBL] E. coli, ESBL Klebsiella, and Vancomycin Resistant Enterococci [VRE] have decreased numerically over the study period, while Methicillin-Resistant Staphylococcus aureus [MRSA] showed an increase in incidence during the second year of the study. Conclusion The study emphasizes the positive impact of the AMS program throughout the three years of the study. Plus, the need to enhance the program through recruiting extra staff and applying extra regulations like implementing educational programs for the hospital staff, designing local guidelines for common ID diseases, and monitoring the program’s outcomes which would eventually be more efficient, cost-effective, and safe.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.12.2022
Tilføjet 8.12.2022
Abstract Background Both disseminated intravascular coagulation and thrombotic microangiopathy are complications of sepsis as Salmonella septicemia, respectively. They are related and have similar clinical characteristics as thrombopenia and organ dysfunctions. They rarely co-occur in some specific cases, which requires a clear distinction. Case presentation A 22-year-old woman had just undergone intracranial surgery and suffered from Salmonella derby septicemia with multiorgan involvement in the hospital. Laboratory workup demonstrated coagulation disorder, hemolytic anemia, thrombocytopenia, and acute kidney injury, leading to the co-occurrence of disseminated intravascular coagulation and secondary thrombotic microangiopathy. She received antibiotics, plasma exchange therapy, dialysis, mechanical ventilation, fluids, and vasopressors and gained full recovery without complications. Conclusion Disseminated intravascular coagulation and secondary thrombotic microangiopathy can co-occur in Salmonella derby septicemia. They should be treated cautiously in diagnosis and differential diagnosis. Thrombotic microangiopathy should not be missed just because of the diagnosis of disseminated intravascular coagulation. Proper and timely identification of thrombotic microangiopathy with a diagnostic algorithm is essential for appropriate treatment and better outcomes.
Læs mere Tjek på PubMedBMC Infectious Diseases, 8.12.2022
Tilføjet 8.12.2022
Abstract Background Several methodological tests are available to detect SARS-CoV-2 antibody. Tests are mostly used in the aid of diagnosis or for serological assessment. No tests are fully confirmatory and have variable level of diagnostic ability. We aimed at assessing agreement with three serological tests: quantitative anti receptor binding domain ELISA (Q-RBD), qualitative ELISA (WANTAI SARS-CoV-2 Ab) and qualitative chemiluminescence assay (CLIA). Methods This study was a part of a large population based sero-epidemiological cohort study. Participants aged 1 year or older were included from 25 randomly selected clusters each in Delhi urban (urban resettlement colony of South Delhi district) and Delhi rural (villages in Faridabad district, Haryana). Three type of tests were applied to all the baseline blood samples. Result of the three tests were evaluated by estimating the total agreement and kappa value. Results Total 3491 blood samples collected from March to September, 2021, out of which 1700 (48.7%) from urban and 1791 (51.3%) from rural. Overall 44.1% of participants were male. The proportion of sero-positivity were 78.1%, 75.2% and 31.8% by Wantai, QRBD and CLIA tests respectively. The total agreement between Wantai and QRBD was 94.5%, 53.1% between Wantai and CLIA, and 56.8% between QRBD and CLIA. The kappa value between these three tests were 0.84 (95% CI 0.80–0.87), 0.22 (95% CI 0.19–0.24) and 0.26 (95% CI 0.23–0.28). Conclusions There was strong concordance between Wantai and QRBD test. Agreement between CLIA with other two tests was low. Wantai and QRBD tests measuring the antibody to same S protein can be used with high agreement based on the relevant scenario.
Læs mere Tjek på PubMedTropical Medicine & International Health, 7.12.2022
Tilføjet 8.12.2022
New England Journal of Medicine, 7.12.2022
Tilføjet 8.12.2022
New England Journal of Medicine, 7.12.2022
Tilføjet 8.12.2022
New England Journal of Medicine, 7.12.2022
Tilføjet 8.12.2022