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Azhar S. Sindi, Ali S. Cheema, Michelle L. Trevenen, Donna T. Geddes, Matthew S. Payne, Lisa F. Stinson
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Azhar S. Sindi, Ali S. Cheema, Michelle L. Trevenen, Donna T. Geddes, Matthew S. Payne, Lisa F. StinsonHuman milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.
Læs mere Tjek på PubMedManjusha Vaidya, Jonhoi Smith, Melvin Field, Kiminobu Sugaya
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Manjusha Vaidya, Jonhoi Smith, Melvin Field, Kiminobu SugayaExosomes participate in intercellular communication by transporting functionally active molecules. Such cargo from the original cells comprising proteins, micro-RNA, mRNA, single-stranded (ssDNA) and double-stranded DNA (dsDNA) molecules pleiotropically transforms the target cells. Although cancer cells secrete exosomes carrying a significant level of DNA capable of modulating oncogene expression in a recipient cell, the regulatory mechanism is unknown. We have previously reported that cancer cells produce exosomes containing NANOGP8 DNA. NANOGP8 is an oncogenic paralog of embryonic stem cell transcription factor NANOG and does not express in cells since it is a pseudogene. However, in this study, we evaluated NANOGP8 expression in glioblastoma multiforme (GBM) tissue from a surgically removed brain tumor of a patient. Significantly higher NANOGP8 transcription was observed in GBM cancer stem cells (CSCs) than in GBM cancer cells or neural stem cells (NSCs), despite identical sequences of NANOGP8-upstream genomic region in all the cell lines. This finding suggests that upstream genomic sequences of NANOGP8 may have environment-dependent promoter activity. We also found that the regulatory sequences upstream of exosomal NANOGP8 GBM DNA contain multiple core promoter elements, transcription factor binding sites, and segments of human viruses known for their oncogenic role. The exosomal sequence of NANOGP8-upstream GBM DNA is different from corresponding genomic sequences in CSCs, cancer cells, and NSCs as well as from the sequences reported by NCBI. These sequence dissimilarities suggest that exosomal NANOGP8 GBM DNA may not be a part of the genomic DNA. Exosomes possibly acquire this DNA from other sources where it is synthesized by an unknown mechanism. The significance of exosome-bestowed regulatory elements in the transcription of promoter-less retrogene such as NANOGP8 remains to be determined.
Læs mere Tjek på PubMedGeorgina Drago, Francisco Javier Pérez-Sádaba, Susana Aceituno, Carla Gari, Juan Luis López-Belmonte
PLoS One Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
by Georgina Drago, Francisco Javier Pérez-Sádaba, Susana Aceituno, Carla Gari, Juan Luis López-BelmonteObjectives Describe healthcare resource use and costs per hospitalized coronavirus disease-2019 (COVID-19) patient during the three main outbreak waves. Methods A retrospective observational study. COVID-19 patient data were collected from a dataset from 17 hospitals in the HM Hospitals Group. Mean total costs per hospitalized patient and per day were estimated in each wave, as defined by the Spanish National Health System perspective. In addition, costs were estimated for both patients admitted and those not admitted to the intensive care unit (ICU) and were stratified by age groups. Results A total of 3756 COVID-19 patients were included: 2279 (60.7%) for the first, 740 (19.7%) for the second, and 737 (19.6%) for the and third wave. Most (around 90%) did not require ICU treatment. For those patients, mean ± SD cost per patient ranged from €10 196.1 ± €7237.2 (mean length of stay [LOS] ± SD: 9.7 ± 6.2 days) for the second wave to €9364.5 ± €6321.1 for the third wave (mean 9.0 ± 5.7 days). Mean costs were around €1000 per day for all the waves. For patients admitted to the ICU, cost per patient ranged from €81 332.5 ± €63 725.8 (mean 31.0 ± 26.3 days) for the second wave to €36 952.1 ± €24 809.2 (mean 15.7 ± 8.2 days) for the third wave. Mean costs per day were around €3000 for all the waves. When estimated by age, mean LOS and costs were greater in patients over 80 when not admitted to the ICU and for patients aged 60 to 79 when admitted to the ICU. Conclusions LOS was longer for patients admitted to the ICU (especially in the first two waves) and for older patients in our study cohort; these populations incurred the highest hospitalization costs.
Læs mere Tjek på PubMedInfection, 25.01.2023
Tilføjet 25.01.2023
Abstract Purpose Sepsis in critically ill patients with injury bears a high morbidity and mortality. Extensive phenotypic monitoring of leucocyte subsets in critically ill patients at ICU admission and during sepsis development is still scarce. The main objective of this study was to identify early changes in leukocyte phenotype which would correlate with later development of sepsis. Methods Patients who were admitted in a tertiary ICU for organ support after severe injury (elective cardiac surgery, trauma, necessity of prolonged ventilation or stroke) were sampled on admission (T1) and 48–72 h later (T2) for phenotyping of leukocyte subsets by flow cytometry and cytokines measurements. Those who developed secondary sepsis or septic shock were sampled again on the day of sepsis diagnosis (Tx). Results Ninety-nine patients were included in the final analysis. Nineteen (19.2%) patients developed secondary sepsis or septic shock. They presented significantly higher absolute monocyte counts and CRP at T1 compared to non-septic patients (1030/µl versus 550/µl, p = 0.013 and 5.1 mg/ml versus 2.5 mg/ml, p = 0.046, respectively). They also presented elevated levels of monocytes with low expression of L-selectin (CD62Lneg monocytes) (OR[95%CI] 4.5 (1.4–14.5), p = 0.01) and higher SOFA score (p < 0.0001) at T1 and low mHLA-DR at T2 (OR[95%CI] 0.003 (0.00–0.17), p = 0.049). Stepwise logistic regression analysis showed that both monocyte markers and high SOFA score (> 8) were independently associated with nosocomial sepsis occurrence. No other leucocyte count or surface marker nor any cytokine measurement correlated with sepsis occurrence. Conclusion Monocyte counts and change of phenotype are associated with secondary sepsis occurrence in critically ill patients with injury.
Læs mere Tjek på PubMedInfection, 25.01.2023
Tilføjet 25.01.2023
Abstract Purpose To evaluate the impact of an optimal and reproducible cutoff value set according to a predefined lymphopenia scale as an early predictor of in-hospital mortality and other outcomes in patients hospitalized with pneumococcal pneumonia and positive urinary antigen at admission to the emergency department. Methods An observational cohort study was conducted based on analysis of a prospective registry of consecutive immunocompetent adults hospitalized for pneumococcal pneumonia in two tertiary hospitals. Generalized additive models were constructed to assess the smooth relationship between in-hospital mortality and lymphopenia. Results We included 1173 patients. Lymphopenia on admission was documented in 686 (58.4%). No significant differences were observed between groups regarding the presence of comorbidities. Overall, 299 (25.5%) patients were admitted to intensive care and 90 (7.6%) required invasive mechanical ventilation. Fifty-nine (5%) patients died, among them 23 (38.9%) in the first 72 h after admission. A lymphocyte count < 500/μL, documented in 282 (24%) patients, was the predefined cutoff point that best predicted in-hospital mortality. After adjustment, these patients had higher rates of intensive care admission (OR 2.9; 95% CI 1.9–4.3), invasive mechanical ventilation (OR 2.2; 95% CI 1.2–3.9), septic shock (OR 1.8; 95% CI 1.1–2.9), treatment failure (OR 2.1; 95% CI 1.2–3.5), and in-hospital mortality (OR 2.2; 95% 1.1–4.9). Severe lymphopenia outperformed PSI score in predicting early and 30-day mortality in patients classified in the higher-risk classes. Conclusion Lymphocyte count < 500/μL could be used as a reproducible predictor of complicated clinical course in patients with an early diagnosis of pneumococcal pneumonia.
Læs mere Tjek på PubMedTrends in Parasitology, 25.01.2023
Tilføjet 25.01.2023
Human height reflects a combination of an individual’s genotype (see Glossary) and environmental factors which influence phenotypic expression of that genotype. An estimated 149.2 million children under the age of 5 were physically stunted in 2020, defined as falling at least –2 standard deviations below the height-for-age World Health Organization (WHO) Child Growth Standards median [1]. Stunting is a visible indicator of a deficient environment, the consequences of which include child morbidity, including an increased risk of long-term chronic diseases, and in severe cases even mortality (Box 1) [2].
Læs mere Tjek på PubMedJournal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Journal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Journal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Journal of Medical Virology, 24.01.2023
Tilføjet 25.01.2023
Infection and Immunity, 25.01.2023
Tilføjet 25.01.2023
Infection and Immunity, 25.01.2023
Tilføjet 25.01.2023
International Journal of Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
On 29 January 2020, the first SARS-CoV-2 case was notified in Italy [1,2] and, by 21 February 2022, almost 12 million confirmed cases and 150,000 deaths from COVID-19 had been recorded in the country [3].
Læs mere Tjek på PubMedClinical Microbiology and Infection, 24.01.2023
Tilføjet 25.01.2023
The COVID-19 pandemic has highlighted the high diagnostic accuracy of the nasopharyngeal swab (including in intensive care unit (ICU) patients. This study aimed to compare nasopharyngeal swab and bronchoalveolar lavage (BAL) results for non-SARS-CoV-2 viruses in patients with suspected pneumonia.
Læs mere Tjek på PubMedScience Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Science Advances, 25.01.2023
Tilføjet 25.01.2023
Clinical Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
Clinical Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
AbstractBackgroundCurrent understanding of severe RSV infections in adults is limited by clinical under-recognition. We compared the prevalence, clinical characteristics, and outcomes of RSV infections vs influenza in adults hospitalized with acute respiratory illnesses in a prospective national surveillance network.MethodsHospitalized adults who met a standardized ARI case definition were prospectively enrolled across three respiratory seasons from hospitals participating across all sites of the U.S. Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN, 2016-2019). All participants were tested for RSV and influenza by RT-PCR. Multivariable logistic regression was used to test associations between laboratory-confirmed infection and characteristics and clinical outcomes.ResultsAmong 10,311 hospitalized adults, 6% tested positive for RSV (n=622), 18.8% positive for influenza (n=1,940), and 75.1% negative for RSV and influenza (n=7,749). Congestive Heart Failure (CHF) or Chronic Obstructive Pulmonary Disease (COPD) was more frequent among adults with RSV than influenza (CHF: 37.3% vs. 28.8%, p<0.0001; COPD: 47.6% vs. 35.8%, p<0.0001). Patients with RSV more frequently had longer admissions [OR=1.38 (95% CI: 1.06-1.80) for stays >one week] and mechanical ventilation [OR=1.45 (95% CI: 1.09-1.93)] compared with influenza, but not compared to the influenza negative group [OR=1.03 (95% CI: 0.82-1.28); OR=1.17 (0.91-1.49), respectively.]ConclusionsThe prevalence of RSV across three recent respiratory illness seasons was considerable. Our findings suggest those with RSV might incur worse outcomes than influenza in hospitalized adults and frequently have pre-existing cardiopulmonary conditions. This study informs future vaccination strategies and underscores a need for RSV surveillance among adults experiencing severe ARI.
Læs mere Tjek på PubMedClinical Infectious Diseases, 25.01.2023
Tilføjet 25.01.2023
AbstractBackgroundWith the advent of efficacious oral Direct-acting antivirals (DAAs) for hepatitis C virus(HCV), identification of characteristics associated with adherence is critical to treatment success. We examined correlates of sub-optimal adherence to HCV therapy in a single-arm, multinational, clinical trial.MethodsACTG A5360 enrolled HCV treatment-naïve persons without decompensated cirrhosis from 5 countries. All participants received a 12-weeks course of sofosbuvir/velpatasvir at entry. In-person visits occurred at initiation and week 24, sustained virologic response (SVR) assessment. Adherence at week 4 was collected remotely and was dichotomized optimal (100%, no missed doses) versus sub-optimal (<100%). Correlates of sub-optimal adherence were explored using logistic regression.Results400 participants enrolled; 399 initiated treatment; 395/397 (99%) reported completing at week 24.. Median age was 47 years with 35% female. Among the 368 reporting optimal adherence at week 4 SVR was 96.5% (95% CI [94.1%, 97.9%]) vs. 77.8% (95% CI [59.2%, 89.4%]) p-value < 0.001. In the multivariate model age < 30 years and being a US participant were independently associated with early sub-optimal adherence. Participants < 30 years were 7.1 times more likely to have early sub-optimal adherence compared to their older counterparts.ConclusionSelf-reported optimal adherence at week 4 was associated with SVR. Early self-reported adherence could be used to identify those at higher risk of treatment failure and may benefit from additional support. Younger individuals < 30 years may also be prioritized for additional adherence support.
Læs mere Tjek på PubMedAntimicrobial Agents And Chemotherapy, 24.01.2023
Tilføjet 25.01.2023
Immunity, 25.01.2023
Tilføjet 25.01.2023
Publication date: Available online 23 January 2023Source: ImmunityAuthor(s): Yingjiao Cao, Yu Li, Xiangyang Wang, Shaorui Liu, Yongmei Zhang, Gaoyu Liu, Shusen Ye, Yuhao Zheng, Jiacong Zhao, Xiaodong Zhu, Yingying Chen, Haixu Xu, Dingyun Feng, Dubo Chen, Ling Chen, Wangkai Liu, Wenjie Zhou, Zhi Zhang, Pan Zhou, Kai Deng
Læs mere Tjek på PubMedMicrobiology and Molecular Biology Reviews, 24.01.2023
Tilføjet 25.01.2023
Romana Haneef, Myriam Fayad, Anne Fouillet, Cécile Sommen, Christophe Bonaldi, Grant M. A. Wyper, Sara Monteiro Pires, Brecht Devleesschauwer, Antoine Rachas, Panayotis Constantinou, Daniel Levy-Bruhl, Nathalie Beltzer, Anne Gallay
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Romana Haneef, Myriam Fayad, Anne Fouillet, Cécile Sommen, Christophe Bonaldi, Grant M. A. Wyper, Sara Monteiro Pires, Brecht Devleesschauwer, Antoine Rachas, Panayotis Constantinou, Daniel Levy-Bruhl, Nathalie Beltzer, Anne GallayBackground The World Health Organization declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on March 11, 2020. The standardized approach of disability-adjusted life years (DALYs) allows for quantifying the combined impact of morbidity and mortality of diseases and injuries. The main objective of this study was to estimate the direct impact of COVID-19 in France in 2020, using DALYs to combine the population health impact of infection fatalities, acute symptomatic infections and their post-acute consequences, in 28 days (baseline) up to 140 days, following the initial infection. Methods National mortality, COVID-19 screening, and hospital admission data were used to calculate DALYs based on the European Burden of Disease Network consensus disease model. Scenario analyses were performed by varying the number of symptomatic cases and duration of symptoms up to a maximum of 140 days, defining COVID-19 deaths using the underlying, and associated, cause of death. Results In 2020, the estimated DALYs due to COVID-19 in France were 990 710 (1472 per 100 000), with 99% of burden due to mortality (982 531 years of life lost, YLL) and 1% due to morbidity (8179 years lived with disability, YLD), following the initial infection. The contribution of YLD reached 375%, assuming the duration of 140 days of post-acute consequences of COVID-19. Post-acute consequences contributed to 49% of the total morbidity burden. The contribution of YLD due to acute symptomatic infections among people younger than 70 years was higher (67%) than among people aged 70 years and above (33%). YLL among people aged 70 years and above, contributed to 74% of the total YLL. Conclusions COVID-19 had a substantial impact on population health in France in 2020. The majority of population health loss was due to mortality. Men had higher population health loss due to COVID-19 than women. Post-acute consequences of COVID-19 had a large contribution to the YLD component of the disease burden, even when we assume the shortest duration of 28 days, long COVID burden is large. Further research is recommended to assess the impact of health inequalities associated with these estimates.
Læs mere Tjek på PubMedMeng Hua, Lin Wang
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Meng Hua, Lin WangThe effectiveness of the blended teaching model in improving university students’ English learning achievement has been frequently reported in China in the post-pandemic era. However, such research has seldom explored the students’ entire EFL (English as a foreign language) learning process and mechanism from the perspective of learners within this model. This study therefore used the 3P (presage, process and product) teaching and learning theory to explore the mediating role of learning methods (i.e., learning engagement and academic procrastination) in the relationship between learning preparation (i.e., academic self-concept and course experience) and learning achievement within the Chinese EFL blended teaching context from the perspective of learners. In this study, 942 Chinese university students (male: N = 447; female: N = 495) participated in a survey and completed electronic questionnaires on EFL-related academic self-concept, learning engagement, academic procrastination, and learning achievement. The data were analyzed using AMOS software and a structural equation modeling (SEM) technique. The results showed that both students’ academic self-concept and course experience directly and positively predicted their English learning achievement. Moreover, students’ academic self-concept of learning achievement was partially mediated by learning engagement and academic procrastination, whereas the effect of course experience on learning achievement was fully mediated by learning engagement and academic procrastination. After discussing these findings, suggestions as well as limitations for future studies will be given.
Læs mere Tjek på PubMedPerica Davitkov, Kyle Hoffman, Yngve Falck-Ytter, Brigid Wilson, Gjorgje Stojadinovikj, Donald D. Anthony, Stanley Martin Cohen, Gregory Cooper
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Perica Davitkov, Kyle Hoffman, Yngve Falck-Ytter, Brigid Wilson, Gjorgje Stojadinovikj, Donald D. Anthony, Stanley Martin Cohen, Gregory CooperBackground & aims Both non-alcoholic fatty liver disease (NAFLD) and hepatitis C virus (HCV) infection commonly result in hepatic fibrosis and may lead to cirrhosis. This study aims to determine the incidence of HCC in patients with HCV or NAFLD complicated by advanced fibrosis, inferred from measurements of liver stiffness. Methods Using Veterans Affairs (VA) Informatics and Computing Infrastructure (VINCI), we identified a nationwide cohort of patients with an existing diagnosis of HCV or NAFLD with liver transient elastography (TE) testing from 2015 to 2019. HCC cases, along with a random sample of non-HCC patients, were identified and validated, leading to calculation of incidence rates for HCC after adjustment for confounders. Results 26,161 patients carried a diagnosis of HCV and 13,629 were diagnosed with NAFLD at the time of testing. In those with HCV, rates of HCC increased with liver stiffness with incidences of 0.28 (95% CI 0.24, 0.34), 0.93 (95% CI 0.72, 1.17), 1.28 (95% CI 0.89, 1.79), and 2.79 (95% CI 2.47, 3.14)/100,000 person years for TE score ranges 14.5 kPa, respectively, after a median follow-up of 2.3 years. HCC incidence also increased with higher TE liver stiffness measures in NAFLD after a median follow-up of 1.1 years. Conclusion In this retrospective cohort, the incidence of HCC in HCV and NAFLD increases with higher TE liver stiffness measures, confirming that advanced fibrosis portends risk in viral and non-viral fibrotic liver diseases. Additional comparative studies are needed to determine the optimal cut point of TE liver stiffness to inform HCC screening guidelines and approaches.
Læs mere Tjek på PubMedApichaya Sriwarom, Direkrit Chiewchengchol, Supichcha Saithong, Navaporn Worasilchai, Ariya Chindamporn
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Apichaya Sriwarom, Direkrit Chiewchengchol, Supichcha Saithong, Navaporn Worasilchai, Ariya ChindampornNeutrophils are innate immune cells that play crucial roles in response to extracellular pathogens, including bacteria and fungi. Pythium insidiosum (P insidiosum) is a fungus-like pathogen that causes 'pythiosis' in mammals. This study investigated in vitro function of human neutrophils against P. insidiosum. We demonstrated the killing mechanism of neutrophils when incubated with P. insidiosum zoospores (infective stage), such as phagocytosis and neutrophil extracellular traps (NETs). Healthy human neutrophils significantly reduced six strains of live zoospores isolated from different sources compared to the condition without neutrophils (p < 0.001), observed by colony count and trypan blue staining. As our results showed the killing ability of neutrophils, we further investigated the neutrophil killing mechanism when incubating with zoospores. Our study found that only two strains of heat-killed zoospores significantly induced phagocytosis (p < 0.01). Co-culture of heat-killed zoospores and neutrophils demonstrated NET formation, which was detected by immunofluorescence staining using DAPI, anti-myeloperoxidase, and anti-neutrophil elastase and quantitated under the fluorescence microscope. In addition, the level of cell-free DNA released from neutrophils (as a marker of NET production) after incubation with zoospores showed significantly increased levels when compared with unstimulated neutrophils (p < 0.001). Our findings demonstrate that neutrophils revealed the NET formation in response to P. insidiosum zoospores. This study is the first observation of the neutrophil mechanism against P. insidiosum, which could provide a better understanding of some parts of the innate immune response during pythiosis.
Læs mere Tjek på PubMedKarina Dahl Steffensen, Dorte Gilså Hansen, Kurt Espersen, Susanne Lauth, Peter Fosgrau, Anders Meinert Pedersen, Peter Sigerseth Groen, Christian Sauvr, Karina Olling
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Karina Dahl Steffensen, Dorte Gilså Hansen, Kurt Espersen, Susanne Lauth, Peter Fosgrau, Anders Meinert Pedersen, Peter Sigerseth Groen, Christian Sauvr, Karina OllingBackground Shared decision making (SDM) is a core element in the meeting between patient and healthcare professionals, but has proved difficult to implement and sustain in routine clinical practice. One of five Danish regions set out to succeed and to develop a model that ensures lasting SDM based on learnings from large-scale real-world implementation initiatives that go beyond the ’barriers’ and ’facilitators’ research approach. This paper describes this process and development of a generic implementation model, SDM:HOSP. Methods This project was carried out in the Region of Southern Denmark with five major hospital units. Based on existing theory of SDM, SDM implementation, implementation science and improvement methodology, a process of four phases were described; development of conceptual elements, field-testing, evaluation, and development of the final implementation model. The conceptual elements developed aimed to prepare leaders, train SDM teachers, teach clinicians to perform SDM, support development of patient decision aids, and support systematic planning, execution and follow-up. Field testing was done including continuous participant evaluations and an overall evaluation after one year. Results Data from field testing and learnings from the implementation process, illustrated the need for a dynamic and easy adjustable model. The final SDM:HOSP model included four themes; i)Training of Leaders, ii) Training of Teachers and Clinicians, iii) Decision Helper, and iv) ‘Process’, each with details in three levels, 1) shared elements, 2) recommendations, and 3) local adaption. Conclusions A feasible and acceptable model for implementation of SDM across hospitals and departments that accounts for different organizations and cultures was developed. The overall design can easily be adapted to other organizations and can be adjusted to fit the specific organization and culture. The results from the ongoing and overall evaluation suggest promising avenues for future work in further testing and research of the usability of the model.
Læs mere Tjek på PubMedMaika Takahashi, Kaori Saito, Tomohiko Ai, Shuko Nojiri, Abdullah Khasawneh, Faith Jessica Paran, Yuki Horiuchi, Satomi Takei, Takamasa Yamamoto, Mitsuru Wakita, Makoto Hiki, Takashi Miida, Toshio Naito, Kazuhisa Takahashi, Yoko Tabe
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Maika Takahashi, Kaori Saito, Tomohiko Ai, Shuko Nojiri, Abdullah Khasawneh, Faith Jessica Paran, Yuki Horiuchi, Satomi Takei, Takamasa Yamamoto, Mitsuru Wakita, Makoto Hiki, Takashi Miida, Toshio Naito, Kazuhisa Takahashi, Yoko TabeBackground Despite the worldwide campaigns of COVID-19 vaccinations, the pandemic is still a major medical and social problem. The Ortho VITROS SARS-CoV-2 spike-specific quantitative IgG (VITROS S-IgG) assay has been developed to assess neutralizing antibody (NT antibody) against SARS-CoV-2 spike (S) antibodies. However, it has not been evaluated in Japan, where the total cases and death toll are lower than the rest of the world. Methods The clinical performance of VITROS S-IgG was evaluated by comparing with the NT antibody levels measured by the surrogate virus neutralizing antibody test (sVNT). A total of 332 serum samples from 188 individuals were used. Of these, 219 samples were from 75 COVID-19 patients: 96 samples from 20 severe/critical cases (Group S), and 123 samples from 55 mild/moderate cases (Group M). The remaining 113 samples were from 113 healthcare workers who had received 2 doses of the BNT162b2 vaccine. Results VITROS S-IgG showed good correlation with the cPass sVNT assay (Spearman rho = 0.91). Both VITROS S-IgG and cPass sVNT showed significantly higher plateau levels of antibodies in Group S compared to Group M. Regarding the humoral immune responses after BNT162b2 vaccination, individuals who were negative for SARS-CoV-2 nucleocapsid (N)-specific antibodies had statistically lower titers of both S-IgG and sVNT compared to individuals with a history of COVID-19 and individuals who were positive for N-specific antibodies without history of COVID-19. In individuals who were positive for N-specific antibodies, S-IgG and sVNT titers were similar to individuals with a history of COVID-19. Conclusions Although the automated quantitative immunoassay VITROS S-IgG showed a reasonable correlation with sVNT antibodies, there is some discrepancy between Vitros S-IgG and cPass sVNT in milder cases. Thus, VITROS S-IgG can be a useful diagnostic tool in assessing the immune responses to vaccination and herd immunity. However, careful analysis is necessary to interpret the results.
Læs mere Tjek på PubMedCalixte Ida Penda, Patricia Épée Eboumbou, Grace Ngondi, Jean Baptiste Hzounda Fokou, Christelle Véronique Pfoum, Ritha Mbono Betoko, Charlotte Eposse, Laurent-Mireille Endale, Francine Same Bebey, Carole Else Eboumbou Moukoko
PLoS One Infectious Diseases, 24.01.2023
Tilføjet 25.01.2023
by Calixte Ida Penda, Patricia Épée Eboumbou, Grace Ngondi, Jean Baptiste Hzounda Fokou, Christelle Véronique Pfoum, Ritha Mbono Betoko, Charlotte Eposse, Laurent-Mireille Endale, Francine Same Bebey, Carole Else Eboumbou MoukokoAcute fever in the majority of children in resource-limited countries is attributable to malaria and often treated without laboratory evidence. The aim of the study was to characterize acute pediatric infectious fevers (APIF) in the pediatric department of the Douala Laquintinie Hospital. A cross-sectional study was conducted among children aged 2 months to 15 years who were admitted with an acute fever (anal temperature ≥ 37.5°C less than 5 days in infants and 7 days in adolescents). 200 children were included and followed up during their hospitalization. The mean age was 3.7 (IQ25-75: 1–4.6) years. More than 3 out of 5 patients (62.5%) came from another health facility and anemia accounted for 29% of the reasons for consultation associated with fever. The main symptoms were vomiting (28%), cough (26%), convulsions (21%) and diarrhea (20%). Skin-mucosal pallor (43.0%) and hepatosplenomegaly (26.0%) were the most common physical signs encountered. Among febrile children, 116/200 (58%) were infected with at least 1 pathogen, and 1/200 (0.5%) had a fever of unknown etiology. Malaria (53% vs 80.5% presumptive) associated with anemia (95.3% of cases) was the most common pathology associated with APIF, followed by pneumonia (19.5%), meningitis (11.5%) and urinary tract infections (10% vs 54.5% presumptive). Malaria was over-diagnosed on admission and over-treated as well as urinary tract infection. A better understanding of common pathogens carriage, a better capacity for improved diagnosis and a better applied clinical algorithm for febrile illnesses in children are needed.
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