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Gonçalves VN, Amorim SS, da Costa MC, de Assis Santos D, Convey P, Rosa LH. Pathogenic potential of an environmental Aspergillus fumigatus strain recovered from soil of Pygoscelis papua (Gentoo penguins) colony in Antarctica. Braz J Microbiol 2024:10.1007/s42770-024-01326-w. [PMID: 38649623 DOI: 10.1007/s42770-024-01326-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/30/2024] [Indexed: 04/25/2024] Open
Abstract
Aspergillus fumigatus is a common opportunistic pathogen in different animals, including birds such as penguins. For the first time, a fungal strain identified as A. fumigatus was isolated from soil in the nests of gentoo penguins, Pygoscelis papua, on Livingston Island, South Shetland Islands (maritime Antarctica). This isolate (A. fumigatus UFMGCB 11829) displayed a series of potentially pathogenic characteristics in vitro. We evaluated its detailed molecular taxonomy and submitted the A. fumigatus UFMGCB 11829 Antarctic strain to in vivo pathogenic modelling. The isolate was confirmed to represent A. fumigatus morphological and phylogenetic analysis showed that it was closely related to A. fumigatus sequences reported from animals, immunosuppressed humans, storage grains, plants and soils. The strain displayed the best mycelial growth and conidia production at 37 ºC; however, it was also able to grow and produce conidia at 15º, demonstrating its capability to survive and colonize penguin nest at least in the summer season in maritime Antarctica. In pathogenicity tests, healthy mice did not showed symptoms of infection; however, 50% lethality was observed in immunosuppressed mice that were inoculated with 106 and 107 spores. Lethality increased to 100% when inoculated with 108 spores. Our data highlight the potential pathogenicity of opportunistic A. fumigatus that may be present in the Antarctic, and the risks of both their further transfer within Antarctica and outwards to other continents, risks which may be exacerbated due global climatic changes.
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Affiliation(s)
- Vívian Nicolau Gonçalves
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, P. O. Box 486, Belo Horizonte, MG, CEP 31270-901, Brazil
| | - Soraya Sander Amorim
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, P. O. Box 486, Belo Horizonte, MG, CEP 31270-901, Brazil
| | - Marliete Carvalho da Costa
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, P. O. Box 486, Belo Horizonte, MG, CEP 31270-901, Brazil
| | - Daniel de Assis Santos
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, P. O. Box 486, Belo Horizonte, MG, CEP 31270-901, Brazil
| | - Peter Convey
- British Antarctic Survey, NERC, High Cross, Madingley Road, Cambridge, CB3 0ET, UK
- Department of Zoology, University of Johannesburg, Auckland Park 2006, PO Box 524, Johannesburg, South Africa
- Biodiversity of Antarctic and Sub-Antarctic Ecosystems, Santiago, Chile
| | - Luiz Henrique Rosa
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, P. O. Box 486, Belo Horizonte, MG, CEP 31270-901, Brazil.
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Weaver AA, Ronning IN, Armstrong W, Miller AN, Kiani B, Shayn Martin R, Beavers KM, Stitzel JD. Computed tomography assessment of pelvic bone density: Associations with age and pelvic fracture in motor vehicle crashes. Accid Anal Prev 2023; 193:107291. [PMID: 37716194 PMCID: PMC10591932 DOI: 10.1016/j.aap.2023.107291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Motor vehicle crash (MVC) occupants routinely get a computed tomography (CT) scan to screen for internal injury, and this CT can be leveraged to opportunistically derive bone mineral density (BMD). This study aimed to develop and validate a method to measure pelvic BMD in CT scans without a phantom, and examine associations of pelvic BMD with age and pelvic fracture incidence in seriously injured MVC occupants from the Crash Injury Research and Engineering Network (CIREN) study. A phantom-less muscle-fat calibration technique to measure pelvic BMD was validated using 45 quantitative CT scans with a bone calibration phantom. The technique was then used to measure pelvic BMD from CT scans of 252 CIREN occupants (ages 16+) in frontal MVCs who had sustained either abdominal or pelvic injury. Pelvic BMD was analyzed in relation to age and pelvic fracture incidence. In the validation set, phantom-based calibration vs. phantom-less muscle-fat calibration yielded similar BMD values at the anterior superior iliac spine (ASIS; R2 = 0.95, p < 0.001) and iliac crest (R2 = 0.90, p < 0.001). Pelvic BMD was measured in 150 female and 102 male CIREN occupants aged 16-89, and 25% of these occupants sustained pelvic fracture. BMD at the ASIS and iliac crest declined with age (p < 0.001). For instance, iliac crest BMD decreased an average of 25 mg/cm3 per decade of age. The rate of iliac crest BMD decline was 7.6 mg/cm3 more per decade of age in occupants with pelvic fracture compared to those not sustaining pelvic fracture. Findings suggest pelvic BMD may be a contributing risk factor for pelvic fracture in MVCs.
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Affiliation(s)
- Ashley A Weaver
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States.
| | - Isaac N Ronning
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States; University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - William Armstrong
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States.
| | - Anna N Miller
- Department of Orthopaedic Surgery, Washington University School of Medicine, 600 S. Euclid Ave., St. Louis, MO 63110, United States.
| | - Bahram Kiani
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States.
| | - R Shayn Martin
- Department of Surgery, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States.
| | - Kristen M Beavers
- Department of Health and Exercise Science, Wake Forest University, Worrell Professional Center, Winston-Salem, NC 27109, United States.
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States.
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Reifferscheid L, Kiely MS, Lin MSN, Libon J, Kennedy M, MacDonald SE. Effectiveness of hospital-based strategies for improving childhood immunization coverage: A systematic review. Vaccine 2023; 41:5233-5244. [PMID: 37500415 DOI: 10.1016/j.vaccine.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Hospital settings represent an opportunity to offer and/or promote childhood vaccination. The purpose of the systematic review was to assess the effectiveness of different hospital-based strategies for improving childhood vaccination coverage. METHODS A systematic search of multiple bibliographic databases, thesis databases, and relevant websites was conducted to identify peer-reviewed articles published up to September 20, 2021. Articles were included if they evaluated the impact of a hospital (inpatient or emergency department)-based intervention on childhood vaccination coverage, were published in English or French, and were conducted in high-income countries. High quality studies were included in a narrative synthesis. RESULTS We included 25 high quality studies out of 7,845 unique citations. Studies focused on routine, outbreak, and influenza vaccines, and interventions included opportunistic vaccination (i.e. vaccination during hospital visit) (n = 7), patient education (n = 2), community connection (n = 2), patient reminders (n = 2), and opportunistic vaccination combined with patient education and/or reminders (n = 12). Opportunistic vaccination interventions were generally successful at improving vaccine coverage, though results ranged from no impact to vaccinating 71 % of eligible children with routine vaccines and 9-61 % of eligible children with influenza vaccines. Interventions that aimed to increase vaccination after hospital discharge (community connection, patient education, reminders) were less successful. CONCLUSIONS Some interventions that provide vaccination to children accessing hospitals improved vaccine coverage; however, the baseline coverage level of the population, as well as implementation strategies used impact success. There is limited evidence that interventions promoting vaccination after hospital discharge are more successful if they are tailored to the individual.
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Affiliation(s)
| | - Marilou S Kiely
- Institut National de Santé Publique du Québec, Québec City, QC, Canada; Faculty of Medicine, Department of Social and Preventive Medicine, Québec City, QC, Canada; Centre de recherche du CHU de Québec, Québec City, QC, Canada
| | | | - Jackie Libon
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Megan Kennedy
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Kiconco P, Achan B, Najjingo I, Sanya M, Okeng A, Binoga W, Musinguzi B, Bwanga F. Dimorphic Fungal Infections in HIV/AIDS Patients with non-TB Chronic Cough at Mulago Hospital, Kampala, Uganda. Res Sq 2023:rs.3.rs-3194828. [PMID: 37546749 PMCID: PMC10402261 DOI: 10.21203/rs.3.rs-3194828/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Introduction Dimorphic fungi cause infection following inhalation of spores into the pulmonary system. In the lower respiratory tract, the conidia transform into the yeast phase which are engulfed by alveolar macrophages and may be destroyed without disease manifestation. However, in some cases they may persist and cause fungal disease characterized by formation of granulomas in the infected tissues, which may mimic MTB. Objective To explore if dimorphic fungi play any role in pulmonary disease among XpertTB/RIF Negative HIV Patients with chronic cough attending ISS Clinic at Mulago hospital Uganda. Methods Sputum samples were collected from 175 consented HIV infected patients attending ISS Clinic. Upon Xpert/RIF test at ISS Clinic 21 of these tested positive, the 154 negative sputum samples were then subjected to PCR for dimorphic fungi at MBN Clinical Laboratories. Singleplex PCR using specific primers was used to detect a target sequency in the gene of each dimorphic fungi of interest, the resulting amplicons were electrophoresed on a 2% gel then visualized under UV light. Results Blastomyces dermatitidis and Tarolomyces marneffei were detected in 16.4% of the studied participants, with 9.1% and 7.1% respectively and 83.8% of the participant sample had no dimorphic fungi. Coccidiodes immitis, Paracoccidiodes brasiliensis and Histoplasma capsulatum were not detected in any of the participants. Conclusion Dimorphic fungi play a role in pulmonary disease among the HIV/AIDS with non- TB chronic in Uganda.
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Martinez V, Matabang MA, Miller D, Aggarwal R, LaFortune A. First case report on Empedobacter falsenii bacteremia. IDCases 2023; 33:e01814. [PMID: 37645528 PMCID: PMC10461116 DOI: 10.1016/j.idcr.2023.e01814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 08/31/2023] Open
Abstract
Empedobacter falsenii, formerly known as Wautersiella falsenii, was first described in 2006. It is a non-motile, non-fermenting, gram-negative rod, which grows aerobically. A handful of case reports have described its isolation from respiratory, urinary and abscess samples. Besides clinical specimens, it has also been isolated from metalworking fluids and aerosols, carpet surfaces and polluted soils. However, to our knowledge, this is the first case report that describes bacteremia from Empedobacter falsenii. We present a 56-year-old male with liver cirrhosis, congestive heart failure and substance abuse disorder, who was admitted in a community hospital in the Bronx, New York for bacteremia of the said organism. This bacterium may serve as a reservoir for resistance genes, such as ERB, tetX and aadS, posing dangers to immunocompromised or hospitalized patients, highlighting the need to study this organism further.
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Affiliation(s)
- Vince Martinez
- Department of Medicine, Lincoln Medical Center, The Bronx, New York, United States
| | | | - Dwayvania Miller
- Department of Medicine, Lincoln Medical Center, The Bronx, New York, United States
| | - Richa Aggarwal
- Department of Medicine, Lincoln Medical Center, The Bronx, New York, United States
| | - Alexander LaFortune
- Department of Medicine, Lincoln Medical Center, The Bronx, New York, United States
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Naghavi M, De Oliveira I, Mao SS, Jaberzadeh A, Montoya J, Zhang C, Atlas K, Manubolu V, Montes M, Li D, Atlas T, Reeves A, Henschke C, Yankelevitz D, Budoff M. Opportunistic AI-enabled automated bone mineral density measurements in lung cancer screening and coronary calcium scoring CT scans are equivalent. Eur J Radiol Open 2023; 10:100492. [PMID: 37214544 PMCID: PMC10196960 DOI: 10.1016/j.ejro.2023.100492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Rationale and objectives We previously reported a novel manual method for measuring bone mineral density (BMD) in coronary artery calcium (CAC) scans and validated our method against Dual X-Ray Absorptiometry (DEXA). Furthermore, we have developed and validated an artificial intelligence (AI) based automated BMD (AutoBMD) measurement as an opportunistic add-on to CAC scans that recently received FDA approval. In this report, we present evidence of equivalency between AutoBMD measurements in cardiac vs lung CT scans. Materials and methods AI models were trained using 132 cases with 7649 (3 mm) slices for CAC, and 37 cases with 21918 (0.5 mm) slices for lung scans. To validate AutoBMD against manual measurements, we used 6776 cases of BMD measured manually on CAC scans in the Multi-Ethnic Study of Atherosclerosis (MESA). We then used 165 additional cases from Harbor UCLA Lundquist Institute to compare AutoBMD in patients who underwent both cardiac and lung scans on the same day. Results Mean±SD for age was 69 ± 9.4 years with 52.4% male. AutoBMD in lung and cardiac scans, and manual BMD in cardiac scans were 153.7 ± 43.9, 155.1 ± 44.4, and 163.6 ± 45.3 g/cm3, respectively (p = 0.09). Bland-Altman agreement analysis between AutoBMD lung and cardiac scans resulted in 1.37 g/cm3 mean differences. Pearson correlation coefficient between lung and cardiac AutoBMD was R2 = 0.95 (p < 0.0001). Conclusion Opportunistic BMD measurement using AutoBMD in CAC and lung cancer screening scans is promising and yields similar results. No extra radiation plus the high prevalence of asymptomatic osteoporosis makes AutoBMD an ideal screening tool for osteopenia and osteoporosis in CT scans done for other reasons.
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Affiliation(s)
- Morteza Naghavi
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Isabel De Oliveira
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Song Shou Mao
- Lundquist Institute, Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA
| | | | - Juan Montoya
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Chenyu Zhang
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Kyle Atlas
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Venkat Manubolu
- Lundquist Institute, Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA
| | - Marlon Montes
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Dong Li
- Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA
| | - Thomas Atlas
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | | | | | | | - Matthew Budoff
- Lundquist Institute, Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA
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Messingschlager C, Ferrando CA, Chang OH. Intention matters: Success rate of bilateral salpingo-oophorectomy at the time of vaginal hysterectomy for pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 2023; 283:54-58. [PMID: 36773471 DOI: 10.1016/j.ejogrb.2023.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this study was to determine the incidence of successful bilateral salpingo-oophorectomy at the time of vaginal hysterectomy for pelvic organ prolapse and to evaluate associated factors and success rate over time. STUDY DESIGN This was a retrospective chart review of all women who underwent vaginal hysterectomy for pelvic organ prolapse who were consented for bilateral salpingo-oophorectomy "if possible" and "including extraordinary measures" between 2014 and 2019 at a tertiary medical center. Baseline demographic data along with prolapse stage, operative findings, operative time, and complications were recorded. Univariate analysis using the Pearson's chi-square test, the student's t-test or Mann Whitney U test when appropriate and multivariable logistic regression was performed to determine predictors of successful vaginal bilateral salpingo-oophorectomy. RESULTS A total of 453 eligible patients were included. 420 patients (92.7 %) were consented for bilateral salpingo-oophorectomy "if possible" and 33 patients (7.3 %) were consented for "including extraordinary measures". The success rate of vaginal bilateral salpingo-oophorectomy in all patients was 57.9 % (n = 262). Of the patients consented for extraordinary measures, the success rate was 93.9 % (n = 31), compared to a success rate of 55 % (n = 231) in the "if possible" group. A concurrent posterior repair was found to have higher odds of successful bilateral salpingo-oophorectomy (adjOR 1.75 [95 % CI = 1.17-2.61]). Successful bilateral salpingo-oophorectomy extended operative time by 14 min (154 min vs 140 min, p < 0.001). Compared to patients in the unsuccessful group, the successful group had a higher proportion of the following indications: a family history of ovarian cancer, personal breast cancer history or patient request for definitive removal. CONCLUSION When the pre-operative intention to perform bilateral salpingo-oophorectomy at the time of vaginal hysterectomy for pelvic organ prolapse is high, the success rate is nearly 40% higher when compared to an opportunistic procedure. This suggests that success is closely linked to the surgeon's determination to complete this procedure vaginally.
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Affiliation(s)
- Cory Messingschlager
- Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Cecile A Ferrando
- Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Olivia H Chang
- Division of Female Urology, Pelvic Reconstructive Surgery & Voiding Dysfunction. Department of Urology, University of California Irvine, Irvine, CA, United States.
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Abstract
Picobirnaviruses (PBVs) are small non enveloped viruses with bi-segmented ds RNA. They have been observed in a wide variety of vertebrates, including mammals and birds with or without diarrhoea, as well as in sewage samples since its discovery (1988). The source of the viruses is uncertain. True hosts of PBVs and their role as primary pathogens or secondary opportunistic agents or innocuous viruses in the gut remains alien. The mechanisms by which they play a role in pathogenicity are still unclear based on the fact that they can be found in both symptomatic and asymptomatic cases. There is a need to determine their tropism since they have not only been associated with viral gastroenteritis but also been reported in the respiratory tracts of pigs. As zoonotic agents with diverse hosts, the importance of epidemiological and surveillance studies cannot be overstated. The segmented genome of PBV might pose a serious public health issue because of the possibility of continuous genetic reassortment. Aware of the growing attention being given to emerging RNA viruses, we reviewed the current knowledge on PBVs and described the current status of PBVs in animals.
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Affiliation(s)
- Mareddy Vineetha Reddy
- Department of Veterinary Microbiology, College of Veterinary Science & Animal Husbandry, Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P India
| | - Vandana Gupta
- Department of Veterinary Microbiology, College of Veterinary Science & Animal Husbandry, Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P India
| | - Anju Nayak
- Department of Veterinary Microbiology, College of Veterinary Science & Animal Husbandry, Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P India
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Poullain F, Champsaur P, Pauly V, Knoepflin P, Le Corroller T, Creze M, Pithioux M, Bendahan D, Guenoun D. Vertebral trabecular bone texture analysis in opportunistic MRI and CT scan can distinguish patients with and without osteoporotic vertebral fracture: A preliminary study. Eur J Radiol 2023; 158:110642. [PMID: 36527774 DOI: 10.1016/j.ejrad.2022.110642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the potential of texture parameters from opportunistic MRI and CT for the detection of patients with vertebral fragility fracture, to design a decision tree and to compute a Random Forest analysis for the prediction of fracture risk. METHODS One hundred and eighty vertebrae of sixty patients with at least one (30) or without (30) a fragility fracture were retrospectively assessed. Patients had a DXA, an MRI and a CT scan from the three first lumbar vertebrae. Vertebrae texture analysis was performed in routine abdominal or lumbar CT and lumbar MRI using 1st and 2nd order texture parameters. Hounsfield Unit Bone density (HU BD) was also measured on CT-scan images. RESULTS Twelve texture parameters, Z-score and HU BD were significantly different between the two groups whereas T score and BMD were not. The inter observer reproducibility was good to excellent. Decision tree showed that age and HU BD were the most relevant factors to predict the fracture risk with a 93 % sensitivity and 56 % specificity. AUC was 0.91 in MRI and 0.92 in CT-scan using the Random Forest analysis. The corresponding sensitivity and specificity were 72 % and 93 % in MRI and 83 and 89 % in CT. CONCLUSIONS This study is the first to compare texture indices computed from opportunistic CT and MR images. Age and HU-BD together with selected texture parameters could be used to assess risk fracture. Machine learning algorithm can detect fracture risk in opportunistic CT and MR imaging and might be of high interest for the diagnosis of osteoporosis.
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Tsavdaridou AI, Almpanidou V, Mazaris AD. Novel climates in European river sub-basins pose a challenge for the persistence of freshwater fish. Sci Total Environ 2022; 830:154696. [PMID: 35318063 DOI: 10.1016/j.scitotenv.2022.154696] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/03/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
Understanding how climate change would affect biota inhabiting sensitive and highly valuable ecosystems, spanning broad regions, is essential to anticipate implications for biodiversity and humans, and to identify management and mitigation measures. Traditionally, assessments to evaluate climatic risks over broad regions and for many species implement models that allow the projection of a climate-driven redistribution of biodiversity. Still, the wealth and quality of the background information (e.g., species presence data) constrain the accuracy and representativeness of such frameworks. As an alternative, here, we developed a twofold approach to assess the vulnerability of 86 European freshwater fish. We accounted for shifts in a multidimensional climatic space of broader hydrological units that host freshwater bodies in Europe. We then linked metrics of their climatic stability with groups of species, which were generated from six intrinsic traits that shape species adaptive capacity to climate change. Our results demonstrated that the climate of all (n = 538) river sub-basins hosted in the European Union territory would change by 2100, with more than 10% of them being projected to gain completely novel climates. Sub-basins predicted to lose more than 90% of their current climatic space were mainly identified in the area around the Baltic Sea, but also in Mediterranean regions (i.e., Iberian Peninsula). Important numbers of fish species with life history strategies that are considered susceptible to climate change were identified in sub-basins that were predicted to completely lose their current climatic conditions. Clearly, the climate of valuable freshwater ecosystems is changing, affecting species and their communities in varying ways. The risk is high, and is not limited to specific regions; thus, new effective strategies and measures are needed to conserve freshwater fish and their habitats across Europe.
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Affiliation(s)
- Anastasia I Tsavdaridou
- Department of Ecology, School of Biology, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
| | - Vasiliki Almpanidou
- Department of Ecology, School of Biology, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Antonios D Mazaris
- Department of Ecology, School of Biology, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Abstract
Around 57.1% of microsporidia occupy aquatic environments, excluding a further 25.7% that utilise both terrestrial and aquatic systems. The aquatic microsporidia therefore compose the most diverse elements of the Microsporidia phylum, boasting unique structural features, variable transmission pathways, and significant ecological influence. From deep oceans to tropical rivers, these parasites are present in most aquatic environments and have been shown to infect hosts from across the Protozoa and Animalia. The consequences of infection range from mortality to intricate behavioural change, and their presence in aquatic communities often alters the overall functioning of the ecosystem.In this chapter, we explore aquatic microsporidian diversity from the perspective of aquatic animal health. Examples of microsporidian parasitism of importance to an aquacultural ('One Health') context and ecosystem context are focussed upon. These include infection of commercially important penaeid shrimp by Enterocytozoon hepatopenaei and interesting hyperparasitic microsporidians of wild host groups.Out of ~1500 suggested microsporidian species, 202 have been adequately taxonomically described using a combination of ultrastructural and genetic techniques from aquatic and semi-aquatic hosts. These species are our primary focus, and we suggest that the remaining diversity have additional genetic or morphological data collected to formalise their underlying systematics.
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Affiliation(s)
- Jamie Bojko
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
- National Horizons Centre, Teesside University, Darlington, UK.
| | - Grant D Stentiford
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, Dorset, UK
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Zink MD, Mischke KG, Keszei AP, Rummey C, Freedman B, Neumann G, Tolksdorf A, Frank F, Wienströer J, Kuth N, Schulz JB, Marx N. Screen-detected atrial fibrillation predicts mortality in elderly subjects. Europace 2021; 23:29-38. [PMID: 33020819 PMCID: PMC7842093 DOI: 10.1093/europace/euaa190] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/18/2020] [Indexed: 01/05/2023] Open
Abstract
Aims Current guidelines recommend opportunistic screening for atrial fibrillation (AF) but the prognosis of individuals is unclear. The aim of this investigation is to determine prevalence and 1-year outcome of individuals with screen-detected AF. Methods and results We performed a prospective, pharmacy-based single time point AF screening study in 7107 elderly citizens (≥65 years) using a hand-held, single-lead electrocardiogram (ECG) device. Prevalence of AF was assessed, and data on all-cause death and hospitalization for cardiovascular (CV) causes were collected over a median follow-up of 401 (372; 435) days. Mean age of participants was 74 ± 5.9 years, with 58% (N = 4130) of female sex. Automated heart rhythm analyses identified AF in 432 (6.1%) participants, with newly diagnosed AF in 3.6% of all subjects. During follow-up, 62 participants (0.9%) died and 390 (6.0%) were hospitalized for CV causes. Total mortality was 2.3% in participants with a screen-detected AF and 0.8% in subjects with a normal ECG [hazard ratio (HR) 2.94; 95% confidence interval (CI) 1.49–5.78; P = 0.002]; hospitalization for CV causes occurred in 10.6% and 5.5%, respectively (HR 2.08; 95% CI 1.52–2.84; P < 0.001). Compared with subjects without a history of AF at baseline and a normal ECG, participants with newly diagnosed or known AF had a significantly higher mortality risk with HRs of 2.64 (95% CI 1.05–6.66; P = 0.04) and 2.68 (95% CI 1.44–4.97; P = 0.002), respectively. After multivariable adjustment, screen-detected AF remained a significant predictor of death or hospitalization for CV causes. Conclusion Pharmacy-based, automated AF screening in elderly citizens identified subjects with unknown AF and an excess mortality risk over the next year.
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Affiliation(s)
- Matthias D Zink
- Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Pauwelsstraße 30, D-52074 Aachen, Germany
- Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Maastricht, the Netherlands
| | - Karl G Mischke
- Department of Internal Medicine I, Leopoldina Hospital Schweinfurt, Schweinfurt, Germany
| | - Andras P Keszei
- Center for Translational and Clinical Research, RWTH Aachen University, Aachen, Germany
| | | | - Ben Freedman
- Heart Research Institute, Charles Perkins Centre, Concord Hospital Cardiology, University of Sydney, Camperdown, Australia
| | | | - Alina Tolksdorf
- Department of General Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Friederike Frank
- Department of General Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Jan Wienströer
- Department of Medical Informatics, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Nicole Kuth
- Department of General Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, Aachen, Germany
| | - Nikolaus Marx
- Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Pauwelsstraße 30, D-52074 Aachen, Germany
- Corresponding author. Tel: +49 241 80 89300; fax: +49 241 80 82545. E-mail address:
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Ehresman J, Schilling A, Yang X, Pennington Z, Ahmed AK, Cottrill E, Lubelski D, Khan M, Moseley KF, Sciubba DM. Vertebral bone quality score predicts fragility fractures independently of bone mineral density. Spine J 2021; 21:20-27. [PMID: 32474223 DOI: 10.1016/j.spinee.2020.05.540] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Current evidence suggests that dual-energy x-ray absorptiometry (DXA) scans, the conventional method defining osteoporosis, is underutilized and, when used, may underestimate patient risk for skeletal fragility. It has recently been suggested that other imaging modalities may better estimate bone quality, such as the magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score which also may assess vertebral compression fracture risk in patients with spine metastases. PURPOSE To evaluate whether VBQ score is predictive of fragility fractures in a population with pre-existing low bone density and at high-risk for fracture. STUDY DESIGN/SETTING Retrospective single-center cohort. PATIENT SAMPLE Patients followed at a metabolic bone clinic for osteopenia and/or osteoporosis. OUTCOME MEASURES Radiographically-documented new-onset fragility fracture. METHODS Patients with a DXA and MRI scans at the time of consultation and ≥2-year follow-up were included. Details were gathered about patient demographics, health history, current medication use, and serological studies of kidney function and bone turnover. For each patient, VBQ score was calculated using T1-weighted lumbar MRI images. Univariable and multivariable analyses were used to identify the independent predictors of a new fragility fracture. To support the construct validity of VBQ, patient VBQ scores were compared to those in a cohort of 45 healthy adults. RESULTS Seventy-two (39.1%) study participants suffered fragility fractures, the occurrence of which was associated with higher VBQ score (3.50 vs. 3.01; p<.001), chronic glucocorticoid use (30.6% vs. 15.2%; p=.014), and a history of prior fragility fracture (36.1% vs. 21.4%; p=.030). Mean VBQ score across all patients in the study cohort was significantly higher than the mean VBQ score in the healthy controls (p<.001). In multivariable analysis, new-onset fracture was independently associated with history of prior fracture (OR=6.94; 95% confidence interval [2.48-19.40]; p<.001), higher VBQ score (OR=2.40 per point; [1.30-4.44]; p=.003), higher body mass index (OR=1.09 per kg/m²; [1.01-1.17]; p=.03), and chronic glucocorticoid use (OR=2.89; [1.03-8.17]; p=0.043). Notably, DXA bone mineral density (BMD) was not found to be significantly predictive of new-onset fractures in the multivariable analysis (p=.081). CONCLUSIONS Here we demonstrate the novel, MRI-derived VBQ score is both an independent predictor of fragility fracture in at-risk patients and a superior predictor of fracture risk than DXA-measured BMD. Given the frequency with which MRIs are obtained by patients undergoing spine surgery consultation, we believe the VBQ score could be a valuable tool for estimating bone quality in order to optimize the management of these patients.
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Affiliation(s)
- Jeff Ehresman
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA
| | - Andrew Schilling
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA
| | - Xinghai Yang
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA; Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Zach Pennington
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA
| | - Ali Karim Ahmed
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA
| | - Ethan Cottrill
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA
| | - Daniel Lubelski
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA
| | - Majid Khan
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kendall F Moseley
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 5-185A, Baltimore, MD 21287, USA.
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Hu L, Wang S, Sun D, Chu J, Lai B, Liu Y. First case of bloodstream infection of Trichosporon loubieri in a patient with B-cell lymphocytic leukemia in China. J Infect Chemother 2021; 27:86-9. [PMID: 32933860 DOI: 10.1016/j.jiac.2020.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/13/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022]
Abstract
Trichosporon loubieri is an opportunistic pathogenic fungus that could causes invasive infections for human, which rarely been reported. In the present study, we reported a case of bloodstream infection from a patient with Ph-positive B-cell acute lymphocytic leukemia (B-ALL) due to Trichosporon loubieri. Trichosporon loubieri was identified by Internal Transcribed Spacer (ITS) gene sequencing. The patient was treated by intravenous voriconazole (VCZ) and amphotericin B (AmB) according to antifungal susceptibility testing and he was still alive so far. To the best of our knowledge, this is the fourth report of human bloodstream infection due to Trichosporon loubieri and the first survival case of its kind in an immunocompromised patient.
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15
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Mearns H, Otiku PK, Shelton M, Kredo T, Kagina BM, Schmidt BM. Screening strategies for adults with type 2 diabetes mellitus: a systematic review protocol. Syst Rev 2020; 9:156. [PMID: 32660625 PMCID: PMC7359237 DOI: 10.1186/s13643-020-01417-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 06/30/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is limited evidence on whether screening for type 2 diabetes mellitus affects health outcomes. A recent systematic review of randomised clinical trials found only one trial that met their inclusion criteria; therefore, current guidelines for screening interventions for type 2 diabetes mellitus are based on expert opinions and best practice rather than synthesised evidence. This systematic review seeks to collate evidence from non-randomised studies to investigate the effect of screening for adults with type 2 diabetes on outcomes including diabetes-related morbidity, mortality (all-cause and diabetes-related) and harms. METHODS This systematic review will follow Effective Practice and Organisation of Care (EPOC) guidelines for the synthesis of non-randomised studies. We will search PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Academic Search Premier and Health Source Nursing Academic (from inception onwards). We will include non-randomised trials, controlled before-after studies, interrupted time-series studies, repeated measures studies and concurrently controlled prospective cohort studies. The primary outcome will be diabetes-related morbidity (microvascular complications of diabetic retinopathy, nephropathy or neuropathy or macrovascular complications of non-fatal myocardial infarction, peripheral arterial disease or non-fatal stroke). The secondary outcomes will be mortality (all-cause and diabetes-related) and harms of screening strategies to patients (including psychological harms or adverse events following treatments) or to health care system (including resource allocation for false-positives or overdiagnosis). Two reviewers will independently screen all citations and full-text articles. Data will be abstracted by one reviewer and checked by a second. The risk of bias of individual studies will be appraised using the ROBINS-I tool. GRADE will be used to determine the quality of the scientific evidence. If feasible, we will conduct random effects meta-analysis where appropriate. If necessary, analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, sex, socio-economic status, rural versus urban or low-middle income versus high-income country). We will disseminate the findings via publications and through relevant networks. DISCUSSION The protocol outlines the methods for systematically reviewing and synthesising evidence of screening strategies for type 2 diabetes mellitus and their effect on health outcomes associated with the disease. The potential impact of this systematic review is improved evidence-informed decision-making for policies and practice for screening of type-2 diabetes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020147439.
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Affiliation(s)
- Helen Mearns
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa.
- School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Paul Kuodi Otiku
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mary Shelton
- Health Sciences Library, University of Cape Town, Cape Town, South Africa
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Benjamin M Kagina
- Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa
- School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Bey-Marrié Schmidt
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
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16
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Abstract
Colorectal cancer incidence and mortality have decreased in the United States in recent decades, largely through opportunistic screening. Although certain organizations have improved internal screening rates by implementing programmatic screening, most of the United States undergoes opportunistic screening. Much effort and resources have been expended comparing screening tests to determine the most effective; however, deeper analysis of the US population has revealed subsets of ethnicities may be grossly underscreened. The most effective screening test remains the test that is completed and adhered to, and a better question may concern the best method of discussing screening.
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Affiliation(s)
- Andrew Han
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA.
| | - Jennifer Maratt
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA; Richard L. Roudebush VA Medical Center, 1481 West 10th Street, 111G, Indianapolis, IN 46202, USA
| | - Charles Kahi
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA; Richard L. Roudebush VA Medical Center, 1481 West 10th Street, 111G, Indianapolis, IN 46202, USA
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Giancane G, Swart JF, Castagnola E, Groll AH, Horneff G, Huppertz HI, Lovell DJ, Wolfs T, Herlin T, Dolezalova P, Sanner H, Susic G, Sztajnbok F, Maritsi D, Constantin T, Vargova V, Sawhney S, Rygg M, K Oliveira S, Cattalini M, Bovis F, Bagnasco F, Pistorio A, Martini A, Wulffraat N, Ruperto N. Opportunistic infections in immunosuppressed patients with juvenile idiopathic arthritis: analysis by the Pharmachild Safety Adjudication Committee. Arthritis Res Ther 2020; 22:71. [PMID: 32264969 PMCID: PMC7136994 DOI: 10.1186/s13075-020-02167-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/27/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To derive a list of opportunistic infections (OI) through the analysis of the juvenile idiopathic arthritis (JIA) patients in the Pharmachild registry by an independent Safety Adjudication Committee (SAC). METHODS The SAC (3 pediatric rheumatologists and 2 pediatric infectious disease specialists) elaborated and approved by consensus a provisional list of OI for use in JIA. Through a 5 step-procedure, all the severe and serious infections, classified as per MedDRA dictionary and retrieved in the Pharmachild registry, were evaluated by the SAC by answering six questions and adjudicated with the agreement of 3/5 specialists. A final evidence-based list of OI resulted by matching the adjudicated infections with the provisional list of OI. RESULTS A total of 772 infectious events in 572 eligible patients, of which 335 serious/severe/very severe non-OI and 437 OI (any intensity/severity), according to the provisional list, were retrieved. Six hundred eighty-two of 772 (88.3%) were adjudicated as infections, of them 603/682 (88.4%) as common and 119/682 (17.4%) as OI by the SAC. Matching these 119 opportunistic events with the provisional list, 106 were confirmed by the SAC as OI, and among them infections by herpes viruses were the most frequent (68%), followed by tuberculosis (27.4%). The remaining events were divided in the groups of non-OI and possible/patient and/or pathogen-related OI. CONCLUSIONS We found a significant number of OI in JIA patients on immunosuppressive therapy. The proposed list of OI, created by consensus and validated in the Pharmachild cohort, could facilitate comparison among future pharmacovigilance studies. TRIAL REGISTRATION Clinicaltrials.gov NCT01399281; ENCePP seal: awarded on 25 November 2011.
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Affiliation(s)
- Gabriella Giancane
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia, PRINTO, Genoa, Italy
| | - Joost F Swart
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University Utrecht, European Reference Network-RITA, Utrecht, The Netherlands
| | - Elio Castagnola
- Department of Infectious Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Andreas H Groll
- Infectious Disease Research Program, Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany
| | - Gerd Horneff
- Asklepios Clinic Sankt Augustin, Department of General Paediatrics, Sankt Augustin, Germany
- Medical Faculty, Department of Paediatric and Adolescents Medicine, University Hospital of Cologne, Cologne, Germany
| | - Hans-Iko Huppertz
- Clinic Bremen-Mitte, Prof.-Hesse Children's Hospital and Pediatric Intensive Care Medicine, Bremen, Germany
| | - Daniel J Lovell
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tom Wolfs
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University Utrecht, European Reference Network-RITA, Utrecht, The Netherlands
| | - Troels Herlin
- Pediatric Rheumatology Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Pavla Dolezalova
- 1st Faculty of Medicine, Department of Pediatrics and Adolescent Medicine, Charles University in Prague and General University Hospital, Praha, Czech Republic
| | - Helga Sanner
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
- Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo, Norway
| | - Gordana Susic
- Institute of Rheumatology of Belgrade, Division of Pediatric Rheumatology, Belgrade, Serbia
| | - Flavio Sztajnbok
- Hospital Universitario Pedro Ernesto, Nucleo de Estudos da Saúde do Adolescente, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Despoina Maritsi
- 2nd Department of Pediatrics Athens Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Tamas Constantin
- Unit of Pediatric Rheumatology-Immunology, Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Veronika Vargova
- Faculty of Medicine, Department of Paediatrics and Adolescent Medicine, Pavol Jozef Šafárik University in Košice, Kosice, Slovakia
| | - Sujata Sawhney
- Sir Ganga Ram Hospital Marg, Centre for Child Health, Sir Ganga Ram Hospital, New Delhi, India
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs University Hospital of Trondheim, Trondheim, Norway
| | - Sheila K Oliveira
- Instituto de Puericultura e Pediatria Martagao Gesteira (IPPMG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Cattalini
- Clinica Pediatrica dell'Università di Brescia, Spedali Civili, Unità di Immunologia e Reumatologia Pediatrica, Brescia, Italy
| | - Francesca Bovis
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia, PRINTO, Genoa, Italy
| | - Francesca Bagnasco
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia, PRINTO, Genoa, Italy
| | - Angela Pistorio
- IRCCS Istituto Giannina Gaslini, Servizio di Epidemiologia e Biostatistica, Genoa, Italy
| | - Alberto Martini
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Nico Wulffraat
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, University Utrecht, European Reference Network-RITA, Utrecht, The Netherlands
| | - Nicolino Ruperto
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia, PRINTO, Genoa, Italy.
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Ehresman J, Pennington Z, Schilling A, Lubelski D, Ahmed AK, Cottrill E, Khan M, Sciubba DM. Novel MRI-based score for assessment of bone density in operative spine patients. Spine J 2020; 20:556-562. [PMID: 31683066 DOI: 10.1016/j.spinee.2019.10.018] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/16/2019] [Accepted: 10/28/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Good bone quality is key in avoiding a multitude of afflictions, including osteoporotic fragility fractures and poor outcomes after spine surgery. In patients undergoing instrumented spine fusion, bone quality often dictates screw pullout strength, insertional torque, and vertebral body loading properties. While dual-energy X-ray absorptiometry (DEXA) screening is the current method of assessing bone mineral density, the majority of patients do not have DEXA measurements available before undergoing surgical instrumentation. PURPOSE To create a simple magnetic resonance imaging (MRI)-based score to evaluate bone quality and evaluate the degree to which it correlates with conventional DEXA scores. STUDY DESIGN/SETTING Retrospective cohort. PATIENT SAMPLE Patients ≥18 years of age undergoing spine surgery for degenerative conditions between 2013 and 2018. OUTCOME MEASURES Correlation of the vertebral bone quality (VBQ) score with DEXA T-scores, and association between VBQ score and presence of osteopenia/osteoporosis. METHODS Using noncontrast T1-weighted MRIs of the lumbar spine, the novel VBQ score was calculated for each patient. DEXA T-scores of the femoral neck and total hip were obtained and were compared with patient VBQ scores using linear regression and Pearson's correlation. RESULTS Among 68 patients included in this study, 37 were found to have osteopenia/osteoporosis (T-score < -1.0) based on DEXA. A greater VBQ score was significantly associated with the presence of osteopenia/osteoporosis with a predictive accuracy of 81%. VBQ scores correlated moderately with femoral neck T-scores, the lowest overall T-scores of each patient, and correlated fairly with total hip T-scores. CONCLUSIONS This is the first study to correlate the novel VBQ score obtained from MRIs with DEXA T-score. We found this score to be a significant predictor of healthy versus osteopenic/osteoporotic bone with an accuracy of 81%, and found that VBQ score was moderately correlated with femoral neck and overall lowest T-score.
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Affiliation(s)
- Jeff Ehresman
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Zach Pennington
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Andrew Schilling
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Daniel Lubelski
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - A Karim Ahmed
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Ethan Cottrill
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Majid Khan
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA.
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Abstract
Fungus is well capable of producing reproductive failures in bovines. As fungus is an opportunistic pathogen, there are more chances for fungus to cause infection in the uterus when certain predisposing factors like prolonged intra-uterine antibiotic therapy, persistent endometritis, presence of necrotic foci, immunosuppression, and pneumovagina are available. Various authors have reported the incidence of fungal endometritis in repeat breeder endometritic cows and buffaloes. Uterine culture along with the cytological examination of the uterine secretions considered being best way to diagnose this condition; however, endometrial biopsy can be used to access the efficacy of treatment to invasive yeast. Intra-uterine treatment with antiseptic solutions and Lugol’s iodine had been found effective in bovines..
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Affiliation(s)
- Pinki Saini
- Veterinary Gynaecologist, Zonal Veterinary Hospital, Mandi, India
| | - Madhumeet Singh
- Department of Veterinary Gynaecology and Obstetrics, College of Veterinary and Animal Sciences, CSK Himachal Pradesh Agricultural University, Palampur, India
| | - Pravesh Kumar
- Department of Veterinary Gynaecology and Obstetrics, College of Veterinary and Animal Sciences, CSK Himachal Pradesh Agricultural University, Palampur, India
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Eljaaly K, Enani MA, Al-Tawfiq JA. Impact of carbapenem versus non-carbapenem treatment on the rates of superinfection: A meta-analysis of randomized controlled trials. J Infect Chemother 2018; 24:915-920. [PMID: 30197092 DOI: 10.1016/j.jiac.2018.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/29/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022]
Abstract
Imipenem and meropenem are the recommended antipseudomonal carbapenems for nosocomial pneumonia per clinical practice guidelines. However, these agents have a relatively broader spectrum of activity than other antibiotics and need to be reserved. Carbapenems might cause higher rate of superinfection. The aim of this study was to compare the rate of superinfection between patients who received imipenem or meropenem versus those who received non-carbapenem treatment. PubMed, EMBASE, Cochrane Library databases and two trial registries were searched for relevant randomized controlled trials of hospitalized adults with pneumonia through February 24, 2017 without date or language restrictions. Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using random-effects models. The primary outcome was based on the intention-to-treat analysis while clinically evaluable patients were analyzed as secondary outcome. Eight RCTs were included in this meta-analysis. A statistically higher risk of superinfection with low heterogeneity (RR = 1.690, 95% CI 1.247-2.291, p = 0.001, I2 = 0%) was associated with the two carbapenems compared to non-carbapenems. However, in comparison with non-carbapenems, superinfection with imipenem was significantly higher (RR = 1.694, 95% CI 1.234-2.325, p = 0.001, I2 = 0%), while it was non-significant with meropenem (RR = 1.647, 95% CI 0.552-4.919, p = 0.371, I2 = 0%). Superinfection was statistically higher in both double-blind and open-label studies and when carbapenems were compared to other antipseudomonal beta-lactams. This meta-analysis identified significantly higher superinfection with imipenem compared to non-carbapenems. The findings confirm the theory of higher superinfections with broader spectrum agents and provide additional support for reserving carbapenems for the treatment of infections caused by multidrug-resistant organisms.
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Affiliation(s)
- Khalid Eljaaly
- Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; College of Pharmacy, University of Arizona, Tucson, AZ, USA.
| | - Mushira A Enani
- Medical Specialties Department, Section of Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Department of Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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21
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O'Brien KR, Waycott M, Maxwell P, Kendrick GA, Udy JW, Ferguson AJP, Kilminster K, Scanes P, McKenzie LJ, McMahon K, Adams MP, Samper-Villarreal J, Collier C, Lyons M, Mumby PJ, Radke L, Christianen MJA, Dennison WC. Seagrass ecosystem trajectory depends on the relative timescales of resistance, recovery and disturbance. Mar Pollut Bull 2018; 134:166-176. [PMID: 28935363 DOI: 10.1016/j.marpolbul.2017.09.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/30/2017] [Accepted: 09/06/2017] [Indexed: 05/20/2023]
Abstract
Seagrass ecosystems are inherently dynamic, responding to environmental change across a range of scales. Habitat requirements of seagrass are well defined, but less is known about their ability to resist disturbance. Specific means of recovery after loss are particularly difficult to quantify. Here we assess the resistance and recovery capacity of 12 seagrass genera. We document four classic trajectories of degradation and recovery for seagrass ecosystems, illustrated with examples from around the world. Recovery can be rapid once conditions improve, but seagrass absence at landscape scales may persist for many decades, perpetuated by feedbacks and/or lack of seed or plant propagules to initiate recovery. It can be difficult to distinguish between slow recovery, recalcitrant degradation, and the need for a window of opportunity to trigger recovery. We propose a framework synthesizing how the spatial and temporal scales of both disturbance and seagrass response affect ecosystem trajectory and hence resilience.
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Affiliation(s)
- Katherine R O'Brien
- School of Chemical Engineering, The University of Queensland, St Lucia 4072, Queensland, Australia.
| | - Michelle Waycott
- School of Biological Sciences, The University of Adelaide, Adelaide, SA 5005, Australia; State Herbarium of South Australia, Botanic Gardens and State Herbarium, Department of Environment and Natural Resources, GPO Box 1047, Adelaide, SA, Australia
| | - Paul Maxwell
- School of Chemical Engineering, The University of Queensland, St Lucia 4072, Queensland, Australia; Healthy Land and Water, PO Box 13204, George St, Brisbane 4003, Queensland, Australia
| | - Gary A Kendrick
- The Oceans Institute (M470), The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - James W Udy
- Healthy Land and Water, PO Box 13204, George St, Brisbane 4003, Queensland, Australia; School of Earth, Environmental and Biological Sciences, Queensland University of Technology, P.O. Box 2434, Brisbane, Queensland 4001, Australia
| | - Angus J P Ferguson
- NSW Office of Environment and Heritage, PO Box A290, Sydney South, NSW 1232, Australia
| | - Kieryn Kilminster
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; Department of Water and Environmental Regulation, Locked Bag 33, Cloisters Square, Perth, WA 6842, Australia
| | - Peter Scanes
- NSW Office of Environment and Heritage, PO Box A290, Sydney South, NSW 1232, Australia
| | - Len J McKenzie
- Centre for Tropical Water and Aquatic Ecosystem Research (TropWATER), James Cook University, Cairns, Queensland 4870, Australia
| | - Kathryn McMahon
- School of Sciences, Edith Cowan University, WA, 6027, Australia; Centre for Marine Ecosystems Research, Edith Cowan University, WA, 6027, Australia
| | - Matthew P Adams
- School of Chemical Engineering, The University of Queensland, St Lucia 4072, Queensland, Australia
| | - Jimena Samper-Villarreal
- Marine Spatial Ecology Lab, The University of Queensland, St Lucia, Queensland 4072, Australia; Centro de Investigación en Ciencias del Mar y Limnología, Universidad de Costa Rica, San Pedro, 11501-2060, San José, Costa Rica
| | - Catherine Collier
- Centre for Tropical Water and Aquatic Ecosystem Research (TropWATER), James Cook University, Cairns, Queensland 4870, Australia
| | - Mitchell Lyons
- Centre for Ecosystem Science, School of Biological, Earth and Environmental Sciences, University of New South Wales, 2052 NSW, Australia
| | - Peter J Mumby
- Marine Spatial Ecology Lab, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Lynda Radke
- Coastal, Marine and Climate Change Group, Geoscience Australia, GPO Box 378, Canberra, ACT 2601, Australia
| | - Marjolijn J A Christianen
- Groningen Institute of Evolutionary Life Sciences (GELIFES), University of Groningen, P.O. Box 11103, 9700, CC, Groningen, Netherlands
| | - William C Dennison
- University of Maryland Center for Environmental Science, Cambridge, MD 21613, USA
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22
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Wilmes D, Coche E, Rodriguez-Villalobos H, Kanaan N. Bacterial pneumonia in kidney transplant recipients. Respir Med 2018; 137:89-94. [PMID: 29605219 DOI: 10.1016/j.rmed.2018.02.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 12/16/2022]
Abstract
Bacterial pathogens are the most frequent cause of pneumonia after transplantation. Early after transplantation, recipients are at higher risk for nosocomial infections. The most commonly encountered pathogens during this period are gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa …), but gram-positive coccus such as Staphylococcus aureus or Streptococcus pneumoniae and anaerobic bacteria can also be found. Empirical antibiotic therapy should be guided by previous colonisation of the recipient and bacterial resistance pattern in the hospital. Six months after transplantation, pneumonias are mostly due to community-acquired bacteria (S. pneumonia, H. influenza, Mycoplasma, Chlamydia and others). Opportunistic pathogens take advantage of the state of immunosuppression which is usually highest from one to six months after transplantation. During this period, but also occurring many years later in the setting of a chronically depressed immune system, bacterial pathogens with low intrinsic virulence can cause pneumonia. The diagnosis of pneumonia caused by opportunistic pathogens can be challenging. The delay in diagnosis preventing the early instauration of adequate treatment in kidney transplant recipients with a depressed immune system, frequently coupled with co-morbid conditions and a state of frailty, will affect prognosis and outcome, increasing morbidity and mortality. This review will focus on the most common opportunistic bacterial pathogens causing pneumonia in kidney transplant recipients: Legionella, Nocardia, Mycobacterium tuberculosis/nontuberculous, and Rhodococcus. Recognition of their specificities in the setting of immunosuppression will allow early diagnosis, crucial for initiation of effective therapy and successful outcome. Interactions with immunosuppressive therapy should be considered as well as reducing immunosuppression if necessary.
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Affiliation(s)
- D Wilmes
- Division of Internal Medicine, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - E Coche
- Division of Radiology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - H Rodriguez-Villalobos
- Division of Microbiology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - N Kanaan
- Division of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
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23
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Piszczek C, Ma J, Gould CH, Tseng P. Cancer Risk-Reducing Opportunities in Gynecologic Surgery. J Minim Invasive Gynecol 2017; 25:1179-1193. [PMID: 29097232 DOI: 10.1016/j.jmig.2017.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/20/2017] [Accepted: 10/21/2017] [Indexed: 12/16/2022]
Abstract
This review article discusses cancer risk-reducing opportunities in gynecologic surgery. We cover strategies to reduce ovarian and uterine cancer risk by presenting general practice guidelines and expanding on the literature behind clinical decision points. We address populations of women at increased hereditary risk and those at population risk. We specifically discuss risk-reducing salpingo-oophorectomy, prophylactic salpingectomy with delayed oophorectomy, concomitant hysterectomy, opportunistic salpingectomy, bilateral tubal ligation, and hysterectomy. For clinical scenarios in which data are limited or conflicting, we detail the studies on which clinicians' decisions hinge to allow the reader to weigh the available evidence.
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Affiliation(s)
- Carolyn Piszczek
- Division of Women's Services, Legacy Health System, Portland, Oregon.
| | - Jun Ma
- Divisions of Gynecologic Oncology, Legacy Medical Group, Portland, Oregon
| | - Claire H Gould
- Advanced Gynecology, Legacy Medical Group, Portland, Oregon
| | - Paul Tseng
- Divisions of Gynecologic Oncology, Legacy Medical Group, Portland, Oregon
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24
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Till SR, Kobernik EK, Kamdar NS, Edwards MG, As-Sanie S, Campbell DA, Morgan DM. The Use of Opportunistic Salpingectomy at the Time of Benign Hysterectomy. J Minim Invasive Gynecol 2017; 25:53-61. [PMID: 28712794 DOI: 10.1016/j.jmig.2017.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/27/2017] [Accepted: 07/06/2017] [Indexed: 01/22/2023]
Abstract
STUDY OBJECTIVE To delineate the use of opportunistic salpingectomy over the study period, to examine factors associated with its use, and to evaluate whether salpingectomy was associated with perioperative complications. DESIGN A retrospective cross-sectional study (Canadian Task Force classification II-2). SETTING The Michigan Surgical Quality Collaborative. PATIENTS Women undergoing ovarian-conserving hysterectomy for benign indications from January 2013 through April 2015. INTERVENTIONS The primary outcome was the performance of opportunistic salpingectomy with ovarian preservation during benign hysterectomy. The change in the rate of salpingectomy was examined at 4-month intervals to assess a period effect over the study period. Multivariate logistic regression was performed to evaluate independent effects of patient, operative, and period factors. Perioperative outcomes were compared using propensity score matching. MEASUREMENTS AND MAIN RESULTS There were 10 676 (55.9%) ovarian-conserving hysterectomies among 19 090 benign hysterectomies in the Michigan Surgical Quality Collaborative in the study period. The rate of opportunistic salpingectomy was 45.8% (n = 4890). Rates of opportunistic salpingectomy increased over the study period from 27.5% to 61.6% (p < .001), demonstrating a strong period effect in the consecutive 4-month period analysis. Salpingectomy was more likely with the laparoscopic approach (odds ratio = 3.48; 95% confidence interval, 3.15-3.85) and among women younger than 60 years of age (odds ratio = 1.60; 95% CI, 1.34-1.92). There was substantial variation in salpingectomy across hospital sites, ranging from 3.6% to 79.9%. Salpingectomy was associated with a 12-minute increase in operative time (p < .001), but there were no differences in the estimated blood loss or perioperative complications. CONCLUSION The rates of salpingectomy increased significantly over the study period. The laparoscopic approach and younger age are associated with an increased probability of salpingectomy. Salpingectomy is not associated with increased blood loss or perioperative complications.
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Affiliation(s)
- Sara R Till
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
| | - Emily K Kobernik
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Neil S Kamdar
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Madeline G Edwards
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | | | - Daniel M Morgan
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; Gynecology Health Services Group, University of Michigan, Ann Arbor, Michigan
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25
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Aberkane S, Didelot MN, Carrière C, Laurens C, Sanou S, Godreuil S, Jean-Pierre H. [Weissella confusa bacteremia: An underestimated opportunistic pathogen]. Med Mal Infect 2017; 47:297-299. [PMID: 28325577 DOI: 10.1016/j.medmal.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/25/2017] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Affiliation(s)
- S Aberkane
- Département de bactériologie-virologie, CHU Arnaud-de-Villeneuve, centre hospitalier régional universitaire (CHRU) de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France; Université de Montpellier, 34093 Montpellier, France; Inserm U1058, Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention, 34295 Montpellier, France.
| | - M-N Didelot
- Département de bactériologie-virologie, CHU Arnaud-de-Villeneuve, centre hospitalier régional universitaire (CHRU) de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - C Carrière
- Département de bactériologie-virologie, CHU Arnaud-de-Villeneuve, centre hospitalier régional universitaire (CHRU) de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - C Laurens
- Département de bactériologie-virologie, CHU Arnaud-de-Villeneuve, centre hospitalier régional universitaire (CHRU) de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - S Sanou
- Service de bactériologie-virologie, CHU Souro Sanou de Bobo-Dioulasso, Souro Sanou de Bobo-Dioulasso, Burkina Faso
| | - S Godreuil
- Département de bactériologie-virologie, CHU Arnaud-de-Villeneuve, centre hospitalier régional universitaire (CHRU) de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France; Université de Montpellier, 34093 Montpellier, France; Inserm U1058, Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention, 34295 Montpellier, France
| | - H Jean-Pierre
- Département de bactériologie-virologie, CHU Arnaud-de-Villeneuve, centre hospitalier régional universitaire (CHRU) de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France; Équipe pathogènes hydriques santé environnement, UMR 5569 hydrosciences, UFR de pharmacie, 34093 Montpellier, France
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26
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Keven JB, Reimer L, Katusele M, Koimbu G, Vinit R, Vincent N, Thomsen E, Foran DR, Zimmerman PA, Walker ED. Plasticity of host selection by malaria vectors of Papua New Guinea. Parasit Vectors 2017; 10:95. [PMID: 28222769 PMCID: PMC5320767 DOI: 10.1186/s13071-017-2038-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/15/2017] [Indexed: 11/20/2022] Open
Abstract
Background Host selection is an important determinant of vectorial capacity because malaria transmission increases when mosquitoes feed more on humans than non-humans. Host selection also affects the outcome of long-lasting insecticidal nets (LLIN). Despite the recent nationwide implementation of LLIN-based malaria control program in Papua New Guinea (PNG), little is known about the host selection of the local Anopheles vectors. This study investigated the host selection of Anopheles vectors in PNG. Methods Blood-engorged mosquitoes were sampled using the barrier screen method and blood meals analyzed for vertebrate host source with PCR-amplification of the mitochondrial cytochrome b gene. Abundance of common hosts was estimated in surveys. The test of homogeneity of proportions and the Manly resource selection ratio were used to determine if hosts were selected in proportion to their abundance. Results Two thousand four hundred and forty blood fed Anopheles females of seven species were sampled from five villages in Madang, PNG. Of 2,142 samples tested, 2,061 (96.2%) yielded a definitive host source; all were human, pig, or dog. Hosts were not selected in proportion to their abundance, but rather were under-selected or over-selected by the mosquitoes. Four species, Anopheles farauti (sensu stricto) (s.s.), Anopheles punctulatus (s.s.), Anopheles farauti no. 4 and Anopheles longirostris, over-selected humans in villages with low LLIN usage, but over-selected pigs in villages with high LLIN usage. Anopheles koliensis consistently over-selected humans despite high LLIN usage, and Anopheles bancroftii over-selected pigs. Conclusions The plasticity of host selection of an Anopheles species depends on its opportunistic, anthropophilic or zoophilic behavior, and on the extent of host availability and LLIN usage where the mosquitoes forage for hosts. The high anthropophily of An. koliensis increases the likelihood of contacting the LLIN inside houses. This allows its population size to be reduced to levels insufficient to support transmission. In contrast, by feeding on alternative hosts the likelihood of the opportunistic species to contact LLIN is lower, making them difficult to control. By maintaining high population size, the proportion that feed on humans outdoors can sustain residual transmission despite high LLIN usage in the village. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2038-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John B Keven
- Papua New Guinea Institute of Medical Research, Vector Borne Diseases Unit, Madang, 511, Madang, Papua New Guinea. .,Department of Microbiology and Molecular Genetics, Michigan State University, 48824, East Lansing, MI, USA.
| | - Lisa Reimer
- Liverpool School of Tropical Medicine and Hygiene, Liverpool, UK
| | - Michelle Katusele
- Papua New Guinea Institute of Medical Research, Vector Borne Diseases Unit, Madang, 511, Madang, Papua New Guinea
| | - Gussy Koimbu
- Papua New Guinea Institute of Medical Research, Vector Borne Diseases Unit, Madang, 511, Madang, Papua New Guinea
| | - Rebecca Vinit
- Papua New Guinea Institute of Medical Research, Vector Borne Diseases Unit, Madang, 511, Madang, Papua New Guinea.,Department of Entomology, Michigan State University, 48824, East Lansing, MI, USA
| | - Naomi Vincent
- Papua New Guinea Institute of Medical Research, Vector Borne Diseases Unit, Madang, 511, Madang, Papua New Guinea
| | - Edward Thomsen
- Liverpool School of Tropical Medicine and Hygiene, Liverpool, UK
| | - David R Foran
- School of Criminal Justice and Department of Integrative Biology, Michigan State University, 48824, East Lansing, MI, USA
| | - Peter A Zimmerman
- Center for Global Health and Diseases, Case Western Reserve University, 44106, Cleveland, OH, USA
| | - Edward D Walker
- Department of Microbiology and Molecular Genetics, Michigan State University, 48824, East Lansing, MI, USA.,Department of Entomology, Michigan State University, 48824, East Lansing, MI, USA
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27
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Kostine M, Chiche L, Lazaro E, Halfon P, Charpin C, Arniaud D, Retornaz F, Blanco P, Jourde-Chiche N, Richez C, Stavris C. Opportunistic autoimmunity secondary to cancer immunotherapy (OASI): An emerging challenge. Rev Med Interne 2017; 38:513-525. [PMID: 28214182 DOI: 10.1016/j.revmed.2017.01.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/05/2017] [Indexed: 12/31/2022]
Abstract
With "checkpoint inhibitors" targeting PD1/PD-1-ligands or CTLA-4/CD28 pathways, immunotherapy has profoundly modified therapeutic strategies in oncology. First approved in refractory metastatic neoplasms (melanoma and lung adenocarcinoma), it is now being tested broadly in other cancers and/or as adjuvant treatment. For a significant proportion of patients, immunotherapy is responsible for "immunological" events, identified as Immune-Related Adverse Events (irAEs). Owing to the increasing number of prescriptions, identification and management of specific immunological side effects is crucial and requires close collaboration between oncologists and internists and/or other organ specialists. Within irAEs, we propose to individualize the induced autoimmunity by the term "Opportunistic Autoimmunity Secondary to Cancer Immunotherapy" (OASI). The aims of this article are (1) to present the different available checkpoint inhibitors and the OASIs reported with these treatments and (2) to propose practical recommendations for diagnosis, pre-therapeutic assessment and management of OASIs. The need for predictive biomarkers of OASIs occurrence will also be discussed.
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Affiliation(s)
- M Kostine
- Département de rhumatologie, hôpital Pellegrin, place Amélie-Raba-Léon, Bordeaux, France
| | - L Chiche
- Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France.
| | - E Lazaro
- Département de médecine interne, hôpital du Haut-Lévêque, Pessac, France
| | - P Halfon
- Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France
| | - C Charpin
- Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France; Département de rhumatologie, hôpital Saint-Joseph, Marseille, France
| | - D Arniaud
- Département de rhumatologie, hôpital Saint-Joseph, Marseille, France
| | - F Retornaz
- Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France
| | - P Blanco
- Département d'immunologie, hôpital Pellegrin, Bordeaux, France
| | - N Jourde-Chiche
- Département de néphrologie, hôpital de la conception, AP-HM, Marseille, France
| | - C Richez
- Département de rhumatologie, hôpital Pellegrin, place Amélie-Raba-Léon, Bordeaux, France
| | - C Stavris
- Service de médecine interne, département de médecine interne et infectiologie, hôpital européen de Marseille, 6, rue Désirée-Clary, Marseille, 13003 France
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Khandelwal N, Sodhi KS, Sinha A, Reddy JG, Chandra EN. Multidetector Computed Tomography and MR Imaging Findings in Mycotic Infections. Radiol Clin North Am 2016; 54:503-18. [PMID: 27153785 DOI: 10.1016/j.rcl.2015.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Fungal infections constitute a diverse spectrum of infections with variable clinical and imaging features. They are commonly opportunistic infections that affect immunocompromised individuals secondary to inherited or acquired disorders. Fungal infections may affect multiple organ systems and contribute to significant morbidity and mortality. Although the imaging features of some fungal infections are characteristic and permit their diagnosis, many mycotic infections manifest nonspecific findings. Definitive diagnosis often depends on histopathological analysis. Early diagnosis requires both clinical suspicion and supporting radiological evidence. Early treatment results in reduced morbidity and mortality. This article reviews the imaging findings in opportunistic and endemic fungal infections.
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Affiliation(s)
- Niranjan Khandelwal
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India.
| | - Kushaljit Singh Sodhi
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India
| | - Anindita Sinha
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India
| | - Jyothi G Reddy
- Department of Radiology, Kamineni Academy of Medical Sciences & Research Centre, LB Nagar, Hyderabad, Telangana 500068, India
| | - Eshwar N Chandra
- Department of Radiology, Kamineni Academy of Medical Sciences & Research Centre, LB Nagar, Hyderabad, Telangana 500068, India
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29
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Lawson B, Petrovan SO, Cunningham AA. Citizen Science and Wildlife Disease Surveillance. Ecohealth 2015; 12:693-702. [PMID: 26318592 DOI: 10.1007/s10393-015-1054-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 07/20/2015] [Accepted: 08/01/2015] [Indexed: 06/04/2023]
Abstract
Achieving effective wildlife disease surveillance is challenging. The incorporation of citizen science (CS) in wildlife health surveillance can be beneficial, particularly where resources are limited and cost-effectiveness is paramount. Reports of wildlife morbidity and mortality from the public facilitate large-scale surveillance, both in time and space, which would otherwise be financially infeasible, and raise awareness of incidents occurring on privately owned land. CS wildlife disease surveillance schemes benefit scientists, the participating public and wildlife alike. CS has been employed for targeted, scanning and syndromic surveillance of wildlife disease. Whilst opportunistic surveillance is most common, systematic observations enable the standardisation of observer effort and, combined with wildlife population monitoring schemes, can allow evaluation of disease impacts at the population level. Near-universal access to digital media has revolutionised reporting modalities and facilitated rapid and economical means of sharing feedback with participants. Here we review CS schemes for wildlife disease surveillance and highlight their scope, benefits, logistical considerations, financial implications and potential limitations. The need to adopt a collaborative and multidisciplinary approach to wildlife health surveillance is increasingly recognised and the general public can make a significant contribution through CS.
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Affiliation(s)
- Becki Lawson
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK.
| | | | - Andrew A Cunningham
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
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30
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ABU-AKKADA SS, EL KERDANY EDH, MADY RF, DIAB RG, KHEDR GAE, ASHMAWY KI, LOTFY WM. Encephalitozoon cuniculi infection among immunocompromised and immunocompetent humans in Egypt. Iran J Parasitol 2015; 10:561-70. [PMID: 26811722 PMCID: PMC4724832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Encephalitozoon cuniculi infects a wide range of homoeothermic animals, including man. Complications due to this microsporidian have been reported only in immunocompromised patients. Reports on E. cuniculi in immunocompetent humans are lacking, most probably, because it is not linked to any clinical manifestations in such hosts. The present work was carried out with the aim of studying, for the first time in Egypt, the prevalence of E. cuniculi infection of urinary tract among non-HIV immunocompromised patients and immunocompetent individuals. It tested also the influence of some factors on the risk of infection. METHODS Blood and urine samples were collected from 88 persons (44 non-HIV immunocompromised patients and 44 subjects as immunocompetent control group). IFAT serological assay and Weber's green modified trichrome stain (MTS) urine smears were carried out. Molecular study by PCR was also performed to detect DNA of E. cuniculi in urine samples. A full history sheet was fulfilled for each subject to test the suspected risk factors. RESULTS The IFAT examination confirmed the presence of antibodies against E. cuniculi in 44.3% of the human subjects. The seroprevalence of E. cuniculi was significantly higher in the immunocompromised patients compared with the immunocompetent individuals (77.3% versus 11.4%). Compared with IFAT (the gold standard), the sensitivity and specificity of Weber's green MTS smears were 69.23% and 89.80%. By using PCR, no positive cases were detected among human subjects. CONCLUSION A high prevalence of E. cuniculi infection in the studied individuals was noted. Although infection was found in some immunocompetent individuals, the immune status of the host remains the corner stone for occurrence of the infection.
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Affiliation(s)
| | | | - Rasha Fadly MADY
- Medical Parasitology Department, Faculty of Medicine, Alexandria University, Egypt
| | - Radwa Galal DIAB
- Medical Parasitology Department, Faculty of Medicine, Alexandria University, Egypt
| | | | - Karam Imam ASHMAWY
- Parasitology Department, Faculty of Veterinary Medicine, Alexandria University, Egypt
| | - Wael Mohamed LOTFY
- Parasitology Department, Medical Research Institute, Alexandria University, Egypt,Correspondence:
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Arnsrud Godtman R, Holmberg E, Lilja H, Stranne J, Hugosson J. Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial. Eur Urol 2014; 68:354-60. [PMID: 25556937 DOI: 10.1016/j.eururo.2014.12.006] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/03/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND It has been shown that organized screening decreases prostate cancer (PC) mortality, but the effect of opportunistic screening is largely unknown. OBJECTIVE To compare the ability to reduce PC mortality and the risk of overdiagnosis between organized and opportunistic screening. DESIGN, SETTING, AND PARTICIPANTS The Göteborg screening study invited 10 000 randomly selected men for prostate-specific antigen (PSA) testing every 2 yr since 1995, with a prostate biopsy recommended for men with PSA ≥2.5 ng/ml. The control group of 10 000 men not invited has been exposed to a previously reported increased rate of opportunistic PSA testing. Both groups were followed until December 31, 2012. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Observed cumulative PC incidence and mortality rates in both groups were calculated using the actuarial method. Using historical data from 1990-1994 (pre-PSA era), we calculated expected PC incidence and mortality rates in the absence of any PSA testing. The number needed to invite (NNI) and the number needed to diagnose (NND) were calculated by comparing the expected versus observed incidence and mortality rates. RESULTS AND LIMITATIONS At 18 yr, 1396 men were diagnosed with PC and 79 men died of PC in the screening group, compared to 962 and 122, respectively, in the control group. In the screening group, the observed cumulative PC incidence/mortality was 16%/0.98% compared to expected values of 6.8%/1.7%. The corresponding values for the control group were 11%/1.5% and 6.9%/1.7%. Organized screening was associated with an absolute PC-specific mortality reduction of 0.72% (95% confidence interval [CI] 0.50-0.94%) and relative risk reduction of 42% (95% CI 28-54%). There was an absolute reduction in PC deaths of 0.20% (95% CI -0.06% to 0.47%) and a relative risk reduction of 12% (95% CI -5 to 26%) associated with opportunistic PSA testing. NNI and NND were 139 (95% CI 107-200) and 13 for organized biennial screening and 493 (95% CI 213- -1563) and 23 for opportunistic screening. The extent of opportunistic screening could not be measured; incidence trends were used as a proxy. CONCLUSIONS Organized screening reduces PC mortality but is associated with overdiagnosis. Opportunistic PSA testing had little if any effect on PC mortality and resulted in more overdiagnosis, with almost twice the number of men needed to be diagnosed to save one man from dying from PC compared to men offered an organized biennial screening program. PATIENT SUMMARY Prostate-specific antigen (PSA) screening within the framework of an organized program seems more effective than unorganized screening.
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Affiliation(s)
- Rebecka Arnsrud Godtman
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Erik Holmberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Hans Lilja
- Departments of Laboratory Medicine, Surgery (Urology), and Medicine (GU Oncology), Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Laboratory Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Johan Stranne
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Middleton A, Bragin E, Morley KI, Parker M. Online questionnaire development: using film to engage participants and then gather attitudes towards the sharing of genomic data. Soc Sci Res 2014; 44:211-223. [PMID: 24468445 PMCID: PMC3969308 DOI: 10.1016/j.ssresearch.2013.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/06/2013] [Accepted: 12/07/2013] [Indexed: 06/03/2023]
Abstract
How can a researcher engage a participant in a survey, when the subject matter may be perceived as 'challenging' or even be totally unfamiliar to the participant? The Genomethics study addressed this via the creation and delivery of a novel online questionnaire containing 10 integrated films. The films documented various ethical dilemmas raised by genomic technologies and the survey ascertained attitudes towards these. Participants were recruited into the research using social media, traditional media and email invitation. The film-survey strategy was successful: 11,336 initial hits on the survey website led to 6944 completed surveys. Participants included from those who knew nothing of the subject matter through to experts in the field of genomics (61% compliance rate), 72% of participants answered every single question. This paper summarises the survey design process and validation methods applied. The recruitment strategy and results from the survey are presented elsewhere.
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Affiliation(s)
- A Middleton
- Wellcome Trust Sanger Institute, Cambridge, UK.
| | - E Bragin
- Wellcome Trust Sanger Institute, Cambridge, UK
| | - K I Morley
- Addictions Department, Institute of Psychiatry, King's College London, UK; Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| | - M Parker
- The Ethox Centre, Department of Public Health, University of Oxford, UK.
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Ramos-Barrón MÁ, Vázquez-Rodríguez JA, García-Garrido AB. [Cost-benefit analysis of a population-based cervical cancer screening program designed for Cantabria]. Semergen 2014; 40:296-304. [PMID: 24534799 DOI: 10.1016/j.semerg.2013.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 10/23/2013] [Accepted: 11/23/2013] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Cervical cancer is the second most common cancer worldwide in women, with an annual mortality of 3.6 per 100.000 women in Spain. An opportunistic screening protocol is currently being developed in Cantabria. The objective of the study is to propose a population-based screening program in Cantabria and assess its cost-benefits. PATIENTS AND METHODS The population-based program design has been carried out according to the description of the natural course of cervical cancer and its incidence and mortality in Cantabria during 2000-2009. There have been some proposals to increase participation in the program and to evaluate its quality. Costs and benefits (direct and indirect) have been analyzed in several scenarios by modifying the frequency of tests (3-5 years), the age at which the program can be accessed (21, 25 or 30 years), the coverage of the program (60-80%), and discount rates (0-3-6%). RESULTS A program carried out with coverage of 80% and tests performed every 3 years generates annual costs of €893.000 (discount rate of 3%) compared to the current opportunistic protocol. Scenarios with tests performed every 5 years generate an annual benefit higher than €618.000, depending on the age of accessing the program. CONCLUSIONS Scenarios with coverage lower than 60% or with women over 30 years old having access to the program are not of interest because of the lower health benefits. However, performing tests every 5 years is more economically advantageous than every 3 years, with similar health benefits.
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Saigal K, Khurana S, Sharma A, Sehgal R, Malla N. Comparison of staining techniques and multiplex nested PCR for diagnosis of intestinal microsporidiosis. Diagn Microbiol Infect Dis 2013; 77:248-9. [PMID: 23993212 DOI: 10.1016/j.diagmicrobio.2013.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/08/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
Abstract
Microsporidiosis is increasingly being recognized as the cause for diarrhea in immunocompromised patients. The 2 most common microsporidia causing gastrointestinal infection worldwide are Enterocytozoon bieneusi and Encephalitozoon intestinalis. The aim of present study was to evaluate different techniques for detection of intestinal microsporidia in human stool samples. The fecal samples of 395 individuals including 125 HIV-seropositive patients with diarrhoea, 158 HIV-seropositive patients without diarrhoea, 55 HIV-seronegative patients with diarrhoea, and 57 healthy controls were used for detection of microsporidia by modified trichrome staining, calcofluor staining, and multiplex polymerase chain reaction (PCR). PCR had the highest sensitivity of 100%, while its specificity was 97.9%. Trichrome staining had highest specificity of 100% but a sensitivity of 63.8% only, and calcofluor white had a sensitivity and specificity of 79.7% and 82.2%, respectively. Thus, for diagnosis of intestinal microsporidiosis, it is important to perform PCR as staining techniques are not good enough to detect microsporidia in stool samples and for their species identification.
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