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Iotti LR, de Frutos M, Lorenzo-Vidal B, Eiros JM. [Disseminated nocardiosis]. Rev Esp Quimioter 2024; 37:180-182. [PMID: 38287667 PMCID: PMC10945094 DOI: 10.37201/req/119.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/22/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024]
Affiliation(s)
- L R Iotti
- Laura Rita Iotti, Servicio de Microbiología y Parasitología, Hospital Universitario Río Hortega, C. Dulzaina, 2, 47012, Valladolid, Spain.
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Bonavina G, Busnelli A, Salmeri N, Cavoretto PI, Salvatore S, Candiani M, Bulfoni A. Opportunistic salpingectomy at the time of vaginal hysterectomy: A systematic review and meta-analysis. Int J Gynaecol Obstet 2024. [PMID: 38247214 DOI: 10.1002/ijgo.15386] [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: 11/19/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Despite the rising rates of opportunistic salpingectomy at the time of surgery for non-malignant conditions, salpingectomy is not widely adopted during vaginal hysterectomy (VH) and has not been extensively investigated. OBJECTIVES The aim of the primary study was to determine the feasibility of bilateral opportunistic salpingectomy at the time of VH. Secondary aims included surgical outcomes, factors associated with patient selection, and the prevalence of incidental tubal malignancies. SEARCH STRATEGY In this systematic review and meta-analysis we searched Pubmed, Embase and ClinicalTrials.gov databases from inception to September 1, 2023, using relevant keywords. SELECTION CRITERIA Original articles with no language restriction reporting outcomes of women undergoing planned VH with opportunistic salpingectomy, were considered eligible. Studies including patients undergoing VH with and without opportunistic salpingectomy were also included. DATA COLLECTION AND ANALYSIS The Newcastle-Ottawa scale was used to assess quality of observational studies. DerSimonian-Laird random effects meta-analysis was performed and pooled effect estimates and proportions with corresponding 95% confidence intervals were computed. Heterogeneity was assessed using the I2 statistic. RESULTS Seven observational cohort studies including 4808 women undergoing opportunistic salpingectomy at the time of VH and 10 295 patients undergoing VH alone were selected. The pooled proportion of success was 81.83 per 100 observations (95% CI: 75.35-87.54). Opportunistic salpingectomy at the time of VH, when feasible, was associated with a significant reduction in intraoperative complications (OR 0.06, 95% CI: 0.01, -0.37, P = 0.03) and total operative time (95% CI: -17.80, -1.07, P = 0.03) compared to those where it failed. Successful salpingectomy was significantly hindered by nulliparity (OR 0.12, 95% CI: -17.69, -1.21, P < 0.001) and favored by pelvic organ prolapse (OR 3.20, 95% CI: 1.35, 7.55, P = 0.008). Immunohistochemical tubal abnormalities were found in 13/579 (2.1%) patients. The overall quality of the evidence, according to the GRADE assessment, was low. CONCLUSION Opportunistic salpingectomy is safe, effective, and feasible at the time of VH. Nulliparity and pelvic organ prolapse are factors potentially influencing surgical outcomes.
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Affiliation(s)
- Giulia Bonavina
- Department of Obstetrics and Gynecology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Andrea Busnelli
- Department of Obstetrics and Gynecology, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
| | - Noemi Salmeri
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy
| | - Paolo I Cavoretto
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy
| | - Stefano Salvatore
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy
| | - Alessandro Bulfoni
- Department of Obstetrics and Gynecology, IRCCS Humanitas Research Hospital, Milan, Italy
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Bhaumik R, Aungkur NZ, Anderson GG. A guide to Stenotrophomonas maltophilia virulence capabilities, as we currently understand them. Front Cell Infect Microbiol 2024; 13:1322853. [PMID: 38274738 PMCID: PMC10808757 DOI: 10.3389/fcimb.2023.1322853] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
The Gram-negative pathogen Stenotrophomonas maltophilia causes a wide range of human infections. It causes particularly serious lung infections in individuals with cystic fibrosis, leading to high mortality rates. This pathogen is resistant to most known antibiotics and harbors a plethora of virulence factors, including lytic enzymes and serine proteases, that cause acute infection in host organisms. S. maltophilia also establishes chronic infections through biofilm formation. The biofilm environment protects the bacteria from external threats and harsh conditions and is therefore vital for the long-term pathogenesis of the microbe. While studies have identified several genes that mediate S. maltophilia's initial colonization and biofilm formation, the cascade of events initiated by these factors is poorly understood. Consequently, understanding these and other virulence factors can yield exciting new targets for novel therapeutics.
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Affiliation(s)
| | | | - Gregory G. Anderson
- Department of Biology, Purdue School of Science, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States
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Cantatore F, Agrillo N, Camussi A, Origoni M. HPV Opportunistic Vaccination: A Literature Review and a Single-Center Experience in Northern Italy through the COVID-19 Pandemic. Vaccines (Basel) 2023; 11:1435. [PMID: 37766112 PMCID: PMC10535071 DOI: 10.3390/vaccines11091435] [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: 07/21/2023] [Revised: 08/20/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
The World Health Organization (WHO) set the goal of 90% HPV vaccination coverage in the population to eliminate cervical cancer. Opportunistic vaccination is performed outside the free vaccination or catch-up programs. Both free and opportunistic HPV vaccination programs experienced slowdowns during the COVID-19 pandemic. In this retrospective study, we aimed to identify the benefits and the obstacles of opportunistic vaccination among male and female individuals who took advantage of the "on-demand" service offered by San Raffaele Hospital in Milan from April 2018 to May 2023. The impact that the COVID-19 pandemic had on vaccination adherence was also analyzed. Data on a total of 527 subjects were collected from an in-house database and through personal interviews. Women in the cohort of older patients (over 25) adhered to the vaccination schedule more than younger women. Opportunistic vaccination request is influenced by the need of a gynecologist, a general practitioner, or public health clinic availability. Women also showed good adherence to screening, demonstrating awareness of the importance of cervical cancer secondary prevention despite vaccination. Opportunistic vaccination offers the possibility of including individuals excluded from the free vaccination campaigns, often already affected by lesions caused by HPV, providing increased viral clearance and faster lesion regression. The main limit remains the economic burden.
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Affiliation(s)
- Francesco Cantatore
- Department of Gynecology & Obstetrics, Vita Salute San Raffaele University School of Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milano, Italy
| | - Nadia Agrillo
- Department of Gynecology & Obstetrics, Vita Salute San Raffaele University School of Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milano, Italy
| | - Alessandro Camussi
- Department of Gynecology & Obstetrics, Vita Salute San Raffaele University School of Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milano, Italy
| | - Massimo Origoni
- Department of Gynecology & Obstetrics, Vita Salute San Raffaele University School of Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132 Milano, Italy
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Natsheh IY, Elkhader MT, Al-Bakheit AA, Alsaleh MM, El-Eswed BI, Hosein NF, Albadawi DK. Inhibition of Acinetobacter baumannii Biofilm Formation Using Different Treatments of Silica Nanoparticles. Antibiotics (Basel) 2023; 12:1365. [PMID: 37760662 PMCID: PMC10525453 DOI: 10.3390/antibiotics12091365] [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: 06/30/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
There exists a multitude of pathogens that pose a threat to human and public healthcare, collectively referred to as ESKAPE pathogens. These pathogens are capable of producing biofilm, which proves to be quite resistant to elimination. Strains of A. baumannii, identified by the "A" in the acronym ESKAPE, exhibit significant resistance to amoxicillin in vivo due to their ability to form biofilm. This study aims to inhibit bacterial biofilm formation, evaluate novel silica nanoparticles' effectiveness in inhibiting biofilm, and compare their effectiveness. Amoxicillin was utilized as a positive control, with a concentration exceeding twice that when combined with silica NPs. Treatments included pure silica NPs, silica NPs modified with copper oxide (CuO.SiO2), sodium hydroxide (NaOH.SiO2), and phosphoric acid (H3PO4.SiO2). The characterization of NPs was conducted using scanning electron microscopy (SEM), while safety testing against normal fibroblast cells was employed by MTT assay. The microtiter plate biofilm formation assay was utilized to construct biofilm, with evaluations conducted using three broth media types: brain heart infusion (BHI) with 2% glucose and 2% sucrose, Loria broth (LB) with and without glucose and sucrose, and Dulbecco's modified eagle medium/nutrient (DMEN/M). Concentrations ranging from 1.0 mg/mL to 0.06 µg/mL were tested using a microdilution assay. Results from SEM showed that pure silica NPs were mesoporous, but in the amorphous shape of the CuO and NaOH treatments, these pores were disrupted, while H3PO4 was composed of sheets. Silica NPs were able to target Acinetobacter biofilms without harming normal cells, with viability rates ranging from 61-73%. The best biofilm formation was achieved using a BHI medium with sugar supplementation, with an absorbance value of 0.35. Biofilms treated with 5.0 mg/mL of amoxicillin as a positive control alongside 1.0 mg/mL of each of the four silica treatments in isolation, resulting in the inhibition of absorbance values of 0.04, 0.13, 0.07, 0.09, and 0.08, for SiO2, CuO.SiO2, NaOH.SiO2 and H3PO4.SiO2, respectively. When amoxicillin was combined, inhibition increased from 0.3 to 0.04; NaOH with amoxicillin resulted in the lowest minimum biofilm inhibitory concentration (MBIC), 0.25 µg/mL, compared to all treatments and amoxicillin, whereas pure silica and composite had the highest MBIC, even when combined with amoxicillin, compared to all treatments, but performed better than that of the amoxicillin alone which gave the MBIC at 625 µg/mL. The absorbance values of MBIC of each treatment showed no significant differences in relation to amoxicillin absorbance value and relation to each other. Our study showed that smaller amoxicillin doses combined with the novel silica nanoparticles may reduce toxic side effects and inhibit biofilm formation, making them viable alternatives to high-concentration dosages. Further investigation is needed to evaluate in vivo activity.
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Affiliation(s)
- Iyad Y. Natsheh
- Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt 19117, Jordan; (I.Y.N.); (M.T.E.); (N.F.H.); (D.K.A.)
| | - Mallak T. Elkhader
- Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt 19117, Jordan; (I.Y.N.); (M.T.E.); (N.F.H.); (D.K.A.)
| | - Ala’a A. Al-Bakheit
- Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa Applied University, Salt 19117, Jordan;
| | - Majd M. Alsaleh
- Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt 19117, Jordan; (I.Y.N.); (M.T.E.); (N.F.H.); (D.K.A.)
- Department of Biology, School of Science, University of Jordan, Amman 11942, Jordan
| | - Bassam I. El-Eswed
- Department of Basic Science, Zarqa University College, Al-Balqa Applied University, Salt 19117, Jordan;
| | - Nedaa F. Hosein
- Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt 19117, Jordan; (I.Y.N.); (M.T.E.); (N.F.H.); (D.K.A.)
| | - Duaa K. Albadawi
- Department of Medical Applied Sciences, Zarqa University College, Al-Balqa Applied University, Salt 19117, Jordan; (I.Y.N.); (M.T.E.); (N.F.H.); (D.K.A.)
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Borrero LA. The ephemeral record: The role of opportunistic animal resources in the archaeology of Pampa and Patagonia. Proc Natl Acad Sci U S A 2023; 120:e2208971120. [PMID: 37399386 PMCID: PMC10334724 DOI: 10.1073/pnas.2208971120] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 05/22/2023] [Indexed: 07/05/2023] Open
Abstract
The acquisition of opportunistic animal resources by hunter-gatherers-such as scavenged carcasses-is a well-known subsistence strategy. It is frequently mentioned in the context of the history of early human evolution, but not regularly considered among the strategies utilized by more recent foragers of the Southern Cone of South America. Historical and ethnographic information presented here suggests that the use of opportunistic animal resources was a strategy used under a number of conditions but only partially documented in the archaeological literature. We also present archaeological evidence from four sites-Guardia del Río, Paso Otero 1, Ponsonby, and Myren-in different Pampean and Patagonian settings where relevant guanaco (Lama guanicoe) bone assemblages were recovered. These sites record minimal anthropic involvement, basically cut marks on some guanaco bones accompanied by few stone tools, that we interpret as evidence for access and use of water logged immobilized or recently dead animals. Archaeological evidence for the use of these scavenging strategies is difficult to obtain at large archaeological sites that usually result from multiple occupations, since the distinction between the acquisition of actively pursued versus opportunistic animal resources is not straightforward. One conclusion from our review is that the best places to find and recognize this evidence are archaeological sites resulting from ephemeral occupations. The inclusion of these sites gives us access to crucial and rarely documented evidence for the long-term survival of hunter-gatherers.
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Affiliation(s)
- Luis A. Borrero
- Instituto Multidisciplinario de Ciencias Históricas y Humanas-Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires1083ACA, Argentina
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Boyanova L. Cutibacterium acnes (formerly Propionibacterium acnes): friend or foe? Future Microbiol 2023; 18:235-244. [PMID: 37042433 DOI: 10.2217/fmb-2022-0191] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
Cutibacterium acnes protects skin homeostasis. The species has three subspecies, and associations between C. acnes subsp. acnes and acne, C. acnes subsp. defendens and prostate cancer, and C. acnes subsp. elongatum and progressive macular hypomelanosis have recently been suggested. Different phylotypes/clonal complexes may cause prosthetic joint and other infections, and virulence factors such as fimbriae, biofilms, multidrug-resistance plasmids, porphyrin, Christie-Atkins-Munch-Petersen factors and cytotoxicity contribute to infections. Isolates are subtyped by multiplex PCR or multi- or single-locus sequence typing; however, these methods could be better synchronized. Resistance of acneic strains to macrolides (25.0-73.0%), clindamycin (10.0-59.0%) and tetracyclines (up to 37.0%) is worrisome, but susceptibility testing is now facilitated by European Committee on Antimicrobial Susceptibility Testing disk diffusion breakpoints. New therapeutic approaches include sarecycline, antimicrobial peptides and bacteriophages.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, 1431 Sofia, Bulgaria
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Rajni E, Goel P, Sarna MK, Jorwal A, Sharma C, Rijhwani P. The genus Ralstonia: The new kid on the block. J R Coll Physicians Edinb 2023; 53:44-52. [PMID: 36683331 DOI: 10.1177/14782715221145579] [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] [Indexed: 01/24/2023] Open
Abstract
The genus Ralstonia comprises of aerobic, gram-negative, oxidase positive, nonfermentative, largely environmental organisms. They are an emerging pathogen in the hospital setting and are increasingly associated with opportunistic infections and outbreaks. We hereby present a case series of six patients diagnosed with bacteraemia caused by Ralstonia spp. and a brief review of literature. These cases highlight that isolation of a nonfermenting gram-negative bacillus from blood culture of a patient admitted in critical care setting should not be ignored as mere contaminant. Clinicians and microbiologists need to work as a team to combat this novel bug.
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Affiliation(s)
- Ekadashi Rajni
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Pallaavi Goel
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Mukesh Kumar Sarna
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Ayushi Jorwal
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Chinkle Sharma
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
| | - Puneet Rijhwani
- Mahatma Gandhi University of Medical Science & Technology, Jaipur, India
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Patel R, Jethva J, Bhagat PR, Prajapati V, Thakkar H, Prajapati K. Rhino-orbital-cerebral mucormycosis: An epidemiological study from a tertiary care referral center in Western India. Indian J Ophthalmol 2022; 70:1371-1375. [PMID: 35326057 PMCID: PMC9240514 DOI: 10.4103/ijo.ijo_2943_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/26/2022] Open
Abstract
Purpose: Rhino-orbital-cerebral mucormycosis (ROCM) is a rare opportunistic fungal infection with a fulminant course and an often fatal outcome. It can occur in immune-compromised patients such as those having uncontrolled diabetes, on long-term corticosteroid or immunosuppressive therapy, with COVID-19 infection, renal failure, AIDS, malignancy, or organ transplant. The aim of our study was to study the epidemiology of mucormycosis in COVID-19 patients and identify its risk factors. Methods: Ours was an epidemiological study wherein we gathered the demographic, clinical, histopathological, and radiological data of 458 patients of mucormycosis who presented to us between August 2020 and May 2021. Mucormycosis was defined through clinical and radiological findings or positive culture reports. Results: Out of all, 20.74% of patients did not have any past or concurrent history of COVID-19. The most common symptom of mucormycosis was orbital/facial pain (38.64%) and the most common sign was periocular/facial edema (50.74%). Mucormycosis involving the nose and sinuses (94.54%) was most common followed by rhino-orbital (45.41%) and brain involvement (10.04%). The most common risk factor for mucormycosis was diabetes [81.92%], followed by corticosteroid use [79.69%] and supplemental oxygen [48.90%]. Most of the patients received similar treatment with IV amphotericin B [88.64%] and local debridement [80.74%] Conclusion: With the third wave of COVID-19 still lurking, a fatal fungal infection should be kept in mind in COVID-19 active as well as recovered patients, especially those who have co-morbid medical conditions such as uncontrolled diabetes and who are treated with large doses of corticosteroids.
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Affiliation(s)
- Ravija Patel
- Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Jignesh Jethva
- Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Purvi R Bhagat
- Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Vipul Prajapati
- Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Hansa Thakkar
- Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Kamini Prajapati
- Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
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Saltović E, Mijandrušić-Sinčić B, Braut A, Škrobonja I, Sever E, Glažar I, Pezelj-Ribarić S, Muhvić-Urek M. Absence of Oral Opportunistic Infections in Patients with Inflammatory Bowel Disease Receiving Anti-TNF-α and Anti-Integrin-α 4β 7 Therapy. Dent J (Basel) 2022; 10:dj10030032. [PMID: 35323234 PMCID: PMC8947472 DOI: 10.3390/dj10030032] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023] Open
Abstract
Biological therapy of inflammatory bowel disease (IBD) carries an increased risk for the development of opportunistic infections due to immunomodulation. The aim of this study was to determine the prevalence and types of oral infections in IBD patients treated with biological (anti-TNF-α and anti-integrin-α4β7) and conventional medication protocols. The study included 20 IBD patients receiving anti-TNF-α therapy, 20 IBD patients receiving anti-integrin-α4β7 therapy and 20 IBD patients without immunomodulatory therapy. Participants completed questionnaires on medical information, oral lesions and symptoms. For each patient, clinical examination and a salivary flow rate test were performed, followed by a swab of the oral mucosa. The swab samples were cultured to identify Candida spp. and oral bacteria. No bacterial opportunistic infections were detected. Candidiasis was detected in four participants, with no significant difference between groups (p = 0.765). Hyposalivation was most common in the anti-TNF-α group, with a significant difference between groups (p = 0.036). There were no significant differences between groups in self-reported oral mucosal lesions and symptoms (p > 0.05), or in the distribution of oral mucosal lesions (p > 0.05). This study suggests that IBD patients receiving biological therapy are at no greater risk of developing oral opportunistic infections than IBD patients not receiving immunomodulatory therapy.
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Affiliation(s)
- Ema Saltović
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 40, 51000 Rijeka, Croatia; (E.S.); (A.B.); (I.G.); (S.P.-R.)
| | - Brankica Mijandrušić-Sinčić
- Clinic of Internal Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia;
- Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia
| | - Alen Braut
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 40, 51000 Rijeka, Croatia; (E.S.); (A.B.); (I.G.); (S.P.-R.)
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Ivana Škrobonja
- Clinical Department for Clinical Microbiology, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia;
| | - Ella Sever
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia;
| | - Irena Glažar
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 40, 51000 Rijeka, Croatia; (E.S.); (A.B.); (I.G.); (S.P.-R.)
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia;
| | - Sonja Pezelj-Ribarić
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 40, 51000 Rijeka, Croatia; (E.S.); (A.B.); (I.G.); (S.P.-R.)
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia;
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Miranda Muhvić-Urek
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 40, 51000 Rijeka, Croatia; (E.S.); (A.B.); (I.G.); (S.P.-R.)
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia;
- Correspondence:
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Bhosale NK, Parija SC. Balamuthia mandrillaris: An opportunistic, free-living ameba - An updated review. Trop Parasitol 2021; 11:78-88. [PMID: 34765527 PMCID: PMC8579774 DOI: 10.4103/tp.tp_36_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023] Open
Abstract
Balamuthia mandrillaris is an opportunistic, free-living ameba that is pathogenic to humans. It has a worldwide distribution but is mainly detected in warmer regions. Balamuthia infections are rare but have been reported in both immunocompetent and immunocompromised individuals of all ages. B. mandrillaris can enter through wounds on the skin or the nose and cause cutaneous lesions and the usually fatal Balamuthia amebic encephalitis (BAE). Infection usually spreads from the lungs or through nerve fibers, and attacks the central nervous system, forming granulomatous lesions and necrosis in the brain. Balamuthia infection is usually chronic, and patients initially present with nonspecific symptoms, including headache, nausea, myalgia, and low-grade fever. As the disease progresses, the patient becomes paralyzed and comatose, often leading to death. Lack of knowledge of predisposing factors, specific treatment, and standardized detection tools have resulted in a nearly cent percent fatality rate. Although only about 200 cases have been reported worldwide since its characterization in the 1990s, the number of reported cases has increased over the years. BAE is an emerging disease and a major health concern. Few patients have survived Balamuthia infections with antimicrobial treatment that has largely been empirical. Early diagnosis is the key and requires familiarity with the disease and a high degree of suspicion on the part of the diagnostician. There are currently no specific treatment and prevention recommendations. This review highlights our current understanding of B. mandrillaris in terms of its pathogenicity, genomics, and novel diagnostic and therapeutic approaches against BAE infections.
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Affiliation(s)
- Namrata K Bhosale
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Papantoniou S, Tsakiris A, Ladopoulos T, Kranidiotis G, Tamvakos C. A Case of Bordetella bronchiseptica Bacteremia in a Patient With COVID-19: Brief Report. Cureus 2021; 13:e15976. [PMID: 34336468 PMCID: PMC8318613 DOI: 10.7759/cureus.15976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 11/12/2022] Open
Abstract
Bordetella bronchiseptica is a gram-negative coccobacillus that colonizes the respiratory system of mammals such as dogs, cats, rabbits and others and might cause upper respiratory tract infections. Although it can be rarely pathogenic in humans, there are several case reports describing infections in humans. We describe the case of a patient without prolonged immunosuppression or underlying diseases, with bacteremia from Bordetella bronchiseptica, while being treated in a tertiary hospital for COVID-19 infection.
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Affiliation(s)
- Styliani Papantoniou
- Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Piraeus, GRC
| | - Antonios Tsakiris
- Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Piraeus, GRC
| | - Theodoros Ladopoulos
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, DEU
| | - Georgios Kranidiotis
- Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Piraeus, GRC
| | - Charalampos Tamvakos
- Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, Piraeus, GRC
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13
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Palou EY, Ramos MA, Cherenfant E, Duarte A, Fuentes-Barahona IC, Zambrano LI, Muñoz-Lara F, Montoya-Ramirez SA, Cardona-Ortiz AF, Valle-Reconco JA, Montenegro-Idrogo JJ, Bonilla-Aldana DK, Paniz-Mondolfi AE, Rodriguez-Morales AJ. COVID-19 Associated Rhino-Orbital Mucormycosis Complicated by Gangrenous and Bone Necrosis-A Case Report from Honduras. Vaccines (Basel) 2021; 9:826. [PMID: 34451951 PMCID: PMC8402527 DOI: 10.3390/vaccines9080826] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/20/2021] [Accepted: 07/24/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Mucormycosis is a life-threatening invasive fungal infection most commonly observed in immunocompromised patients. Throughout the COVID-19 pandemic, a growing number of Mucorales associated infections, now termed COVID-19 associated mucormycosis (CAM), have been reported. Despite an increase in fatality reports, no cases of rhino-orbital CAM complicated with gangrenous bone necrosis have been described in the literature to date. CASE A 56-year-old male with a recent COVID-19 diagnosis developed rhino-orbital mucormycosis after 22 days of treatment with dexamethasone. Cultures and histopathological assessment of tissue biopsy confirmed the diagnosis. The patient survived after treatment with amphotericin B. CONCLUSIONS Mucormycosis is an invasive fungal infection affecting mostly immunocompromised patients. Along with the COVID-19 pandemic, the inappropriate use of steroids, in addition to concurrent risk factors, such as diabetes, has led to an increase in the occurrence of these devastating mycoses, leading to the development of severe presentations and complications, as observed in many cases. Early diagnosis and prompt treatment are crucial in order to avoid dissemination and fatal outcomes.
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Affiliation(s)
- Elsa Yolanda Palou
- Department of Internal Medicine, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (E.Y.P.); (F.M.-L.)
| | | | - Emec Cherenfant
- Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
| | - Adoni Duarte
- Department of Morphological Sciences, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
| | - Itzel Carolina Fuentes-Barahona
- Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
- Department of Gynecology and Obstetrics, Hospital Escuela, Tegucigalpa 11101, Honduras
| | - Lysien I. Zambrano
- Unit of Scientific Research (UIC), Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
- Latin American Network of Coronavirus Disease 2019 Research (LANCOVID), Pereira, Risaralda 660003, Colombia; (J.J.M.-I.); (D.K.B.-A.); (A.E.P.-M.)
| | - Fausto Muñoz-Lara
- Department of Internal Medicine, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (E.Y.P.); (F.M.-L.)
- Department of Internal Medicine, Hospital Escuela, Tegucigalpa 11101, Honduras;
| | | | - Alex Francisco Cardona-Ortiz
- Post-Graduate Internal Medicine, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
| | - Jorge Alberto Valle-Reconco
- Deanship, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
| | - Juan J. Montenegro-Idrogo
- Latin American Network of Coronavirus Disease 2019 Research (LANCOVID), Pereira, Risaralda 660003, Colombia; (J.J.M.-I.); (D.K.B.-A.); (A.E.P.-M.)
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15046, Peru
- Infectious and Tropical Diseases Service, Hospital Nacional Dos de Mayo, Lima 15072, Peru
| | - D. Katterine Bonilla-Aldana
- Latin American Network of Coronavirus Disease 2019 Research (LANCOVID), Pereira, Risaralda 660003, Colombia; (J.J.M.-I.); (D.K.B.-A.); (A.E.P.-M.)
- Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación GISCA, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira 660003, Colombia
| | - Alberto E. Paniz-Mondolfi
- Latin American Network of Coronavirus Disease 2019 Research (LANCOVID), Pereira, Risaralda 660003, Colombia; (J.J.M.-I.); (D.K.B.-A.); (A.E.P.-M.)
- Laboratory of Microbiology, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
- Instituto de Investigaciones Biomédicas IDB/Incubadora Venezolana de la Ciencia, Barquisimeto 3001, Venezuela
| | - Alfonso J. Rodriguez-Morales
- Latin American Network of Coronavirus Disease 2019 Research (LANCOVID), Pereira, Risaralda 660003, Colombia; (J.J.M.-I.); (D.K.B.-A.); (A.E.P.-M.)
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Americas, Pereira, Risaralda 660003, Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima 15046, Peru
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14
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Basile FW, Fedele MC, Lo Vecchio A. Gastrointestinal Diseases in Children Living with HIV. Microorganisms 2021; 9:microorganisms9081572. [PMID: 34442651 PMCID: PMC8398799 DOI: 10.3390/microorganisms9081572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/06/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Thanks to the advances in antiretroviral therapies (ART) and early diagnosis, pediatric HIV has turned into a chronic infection that requires the collaboration of all pediatric subspecialists for holistic patient management. Gastrointestinal complaints are a frequent reason for seeking access to medical care in all pediatric patients worldwide. Intestinal involvement is present in virtually all children with HIV infections. In high-prevalence settings, up to 25% of children accessing the hospital for diarrhea are diagnosed with HIV. More than half of patients with advanced disease present with gastrointestinal symptoms, from mild infectious diarrhea to severe gastrointestinal impairment, malabsorption and failure to thrive. Gastrointestinal disorders do not spare children on ART, particularly in the initial months of therapy. ART-associated pancreatitis and hepatitis are rare but potentially severe adverse events, whereas lower abdominal symptoms have been reported in more than a third of patients. The latter are usually mild and transient, but may limit ART adherence; a correct framing of the problem is necessary to minimize therapy switches while optimizing the quality of life of children on ART. This review aims to provide state-of-the-art guidance for the initial approach to gastrointestinal diseases in children living with HIV.
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Affiliation(s)
- Francesca Wanda Basile
- Baylor International Pediatric AIDS Initiative, Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA;
| | - Maria Cristina Fedele
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Via Luigi De Crecchio 2, 80138 Naples, Italy;
| | - Andrea Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics—University of Naples Federico II, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-7463365; Fax: +39-081-7464232
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15
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Garcia Rivera MV, Aponte A, Ko WW. Coinfection of Tuberculosis in an Undiagnosed HIV, AIDS Patient Presenting With Shortness of Breath, Constitutional Symptoms and Lymphadenopathy. Cureus 2021; 13:e15925. [PMID: 34336428 PMCID: PMC8312766 DOI: 10.7759/cureus.15925] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 11/05/2022] Open
Abstract
Tuberculosis (TB) has long been known as an acquired immunodeficiency syndrome (AIDS) defining illness in human immunodeficiency virus (HIV) patients, causing reciprocal advantage for both pathogens throughout the course of the disease, not just constituting a burden for the patient, but also impacting public health globally. We report a case of a 42-year-old man who presented with shortness of breath, generalized lymphadenopathy and weight loss. Subsequently diagnosed with HIV/AIDS and generalized ganglionar TB. Initial computed tomography (CT) of the chest showed extensive mediastinal involvement with large right loculated pleural effusion, with growth of acid-fast bacilli (AFB) on culture. Biopsy of lymph nodes confirmed pathologic changes correlating with M. tuberculosis (Caseating granulomatous inflammation), ruling out the possibility of lymphoproliferative disorder. Multiple factors contribute to the immune system decline in AIDS patients, moreover the rapid depletion of Tuberculosis antigen-specific CD4+ T before generalized CD4+T cells. Early assessment for the presence of co-infection and guidance of targeted therapy is critical for management and an important factor in the expected recovery of such patients. Therefore, understanding the pathogenesis of the co-infection, diagnostic approach, possible complications, and the action of concurrent therapy highly active antiretroviral therapy (HAART)/anti-Tuberculosis treatment as well as drug cytotoxicity is paramount.
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Affiliation(s)
| | - Angel Aponte
- Internal Medicine, St. John's Episcopal Hospital, Far Rockaway, New York, USA
| | - War War Ko
- Internal Medicine, St. John's Episcopal Hospital, Far Rockaway, New York, USA
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16
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Crespo-Szabo SM, Stafford JR. Diagnosis, treatment, and outcome in a dog with systemic Mycoleptodiscus indicus infection. J Vet Intern Med 2021; 35:1972-1976. [PMID: 34048620 PMCID: PMC8295661 DOI: 10.1111/jvim.16182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/01/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 01/12/2023] Open
Abstract
Objective Describe the diagnosis, clinical course, and management of a dog with systemic Mycoleptodiscus indicus infection. Case Summary A 5‐year‐old male neutered Giant Schnauzer presented with left eye anterior uveitis, peripheral lymphadenopathy, hyperglobulinemia, anemia, and thrombocytopenia. A diagnosis of M. indicus infection was made based on histopathology and PCR. Treatment with itraconazole and terbinafine resulted in resolution of the hyperglobulinemia, anemia, thrombocytopenia, and peripheral lymphadenopathy. No evidence of fungal organisms was identified on lymph node, liver, or ocular histopathology after 7 months of treatment. New or Unique Information Provided This case is the first report of a systemic M. indicus infection in an apparently immunocompetent dog. Clinical resolution was achieved with systemic itraconazole and terbinafine.
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17
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Woisetschläger M, Hägg M, Spångeus A. Computed tomography-based opportunistic osteoporosis assessment: a comparison of two software applications for lumbar vertebral volumetric bone mineral density measurements. Quant Imaging Med Surg 2021; 11:1333-1342. [PMID: 33816172 DOI: 10.21037/qims-20-1013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/12/2022]
Abstract
Background We aimed to compare two volumetric bone mineral density (vBMD) analysis programs, regarding (I) agreement of vBMD values based on mono- and dual-energy computed tomography (MECT and DECT) scans and (II) suitability for analyzing DECT data obtained at different energies. Methods We retrospectively analyzed two abdominal CT datasets: one performed in a MECT scan (vertebrae L1-L3) and one in a DECT scan (vertebrae L1-L4). Each dataset included different individuals [MECT 15 patients (45 vertebrae) and DECT 12 patients (48 vertebrae), respectively]. vBMD analysis was conducted using Philips IntelliSpace (IP) and Mindways qCT Pro (MW). Regarding the DECT scans, vBMD analysis was done at three different energies: 80, 150 and synthetic 120 kVp and for MECT scan at 120 kVp. For comparison of vBMD results between different software (aim 1) MECT 120 kVp and DECT synthetic 120 kVp data was used. For analyzing suitability of using different DECT energies for vBMD assessment (aim 2) all three DECT energies were used and results from each software was analyzed separately. Results vBMD assessed with MW and IP, respectively correlated significantly for both the MECT (r=0.876; P<0.001) and DECT (r=0.837; P<0.001) scans, but the vBMD values were lower in using IP for vBMD assessment (8% and 14% lower for MECT and DECT, respectively; P=0.001). Regarding the different DECT energies, using MW for vBMD assessment showed significant correlations in vBMD results between 120 kVp and the two other energies (r=0.988 and r=0.939) and no significant differences in absolute vBMD values (P>0.05). The IP analysis as well showed significant correlation between 120 kVp and the other energies (r=0.769 and r=0.713, respectively), but differences in absolute vBMD values between the energies (P≤0.001). Conclusions We show that the correlations between the vBMD derived from the two investigated software solutions were generally good but that absolute vBMD value did differ and might impact the clinical diagnosis of osteoporosis. Though small, our study data indicate that vBMD might be assessed in energies other than 120 kVp when using MW but not when using IP.
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Affiliation(s)
- Mischa Woisetschläger
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Martin Hägg
- Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anna Spångeus
- Department of Acute Internal Medicine and Geriatrics and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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18
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Pearce E, Sivaprasad S. A Review of Advancements and Evidence Gaps in Diabetic Retinopathy Screening Models. Clin Ophthalmol 2020; 14:3285-3296. [PMID: 33116380 PMCID: PMC7569040 DOI: 10.2147/opth.s267521] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/06/2020] [Indexed: 12/03/2022] Open
Abstract
Diabetic retinopathy (DR) is a microvascular complication of diabetes with a prevalence of ~35%, and is one of the leading causes of visual impairment in people of working age in most developed countries. The earliest stage of DR, non-proliferative DR (NPDR), may progress to sight-threatening DR (STDR). Thus, early detection of DR and active regular screening of patients with diabetes are necessary for earlier intervention to prevent sight loss. While some countries offer systematic DR screening, most nations are reliant on opportunistic screening or do not offer any screening owing to limited healthcare resources and infrastructure. Currently, retinal imaging approaches for DR screening include those with and without mydriasis, imaging in single or multiple fields, and the use of conventional or ultra-wide-field imaging. Advances in telescreening and automated detection facilitate screening in previously hard-to-reach communities. Despite the heterogeneity in approaches to fit local needs, an evidence base must be created for each model to inform practice. In this review, we appraise different aspects of DR screening, including technological advances, identify evidence gaps, and propose several studies to improve DR screening globally, with a view to identifying patients with moderate-to-severe NPDR who would benefit if a convenient treatment option to delay progression to STDR became available.
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Affiliation(s)
- Elizabeth Pearce
- Department of Ocular Biology, Institute of Ophthalmology, University College London, London, UK
| | - Sobha Sivaprasad
- Department of Ocular Biology, Institute of Ophthalmology, University College London, London, UK.,Medical Retina Department, NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK
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19
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Styles KM, Thummeepak R, Leungtongkam U, Smith SE, Christie GS, Millard A, Moat J, Dowson CG, Wellington EMH, Sitthisak S, Sagona AP. Investigating Bacteriophages Targeting the Opportunistic Pathogen Acinetobacter baumannii. Antibiotics (Basel) 2020; 9:antibiotics9040200. [PMID: 32331271 PMCID: PMC7235909 DOI: 10.3390/antibiotics9040200] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 03/30/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/19/2022] Open
Abstract
The multi-drug resistance of the opportunistic pathogen Acinetobacter baumannii is of growing concern, with many clinical isolates proving to be resistant to last resort as well as front line antibiotic treatments. The use of bacteriophages is an attractive alternative to controlling and treating this emerging nosocomial pathogen. In this study, we have investigated bacteriophages collected from hospital wastewater in Thailand and we have explored their activity against clinical isolates of A. baumannii. Bacteriophage vB_AbaM_PhT2 showed 28% host range against 150 multidrug resistant (MDR) isolates and whole genome sequencing did not detect any known virulence factors or antibiotic resistance genes. Purified vB_AbaM_PhT2 samples had endotoxin levels below those recommended for preclinical trials and were not shown to be directly cytotoxic to human cell lines in vitro. The treatment of human brain and bladder cell lines grown in the presence of A. baumannii with this bacteriophage released significantly less lactate dehydrogenase compared to samples with no bacteriophage treatment, indicating that vB_AbaM_PhT2 can protect from A. baumannii induced cellular damage. Our results have also indicated that there is synergy between this bacteriophage and the end line antibiotic colistin. We therefore propose bacteriophage vB_AbaM_PhT2 as a good candidate for future research and for its potential development into a surface antimicrobial for use in hospitals.
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Affiliation(s)
- Kathryn M. Styles
- School of Life Sciences, University of Warwick, Coventry CV4 7AL, UK; (K.M.S.); (S.E.S.); (J.M.); (C.G.D.); (E.M.H.W.)
| | - Rapee Thummeepak
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Muang, Phitsanulok 65000, Thailand; (R.T.); (U.L.); (S.S.)
| | - Udomluk Leungtongkam
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Muang, Phitsanulok 65000, Thailand; (R.T.); (U.L.); (S.S.)
| | - Sophie E. Smith
- School of Life Sciences, University of Warwick, Coventry CV4 7AL, UK; (K.M.S.); (S.E.S.); (J.M.); (C.G.D.); (E.M.H.W.)
| | | | - Andrew Millard
- Department of Genetics and Genome Biology, Leicester University, Leicester LE1 7RH, UK;
| | - John Moat
- School of Life Sciences, University of Warwick, Coventry CV4 7AL, UK; (K.M.S.); (S.E.S.); (J.M.); (C.G.D.); (E.M.H.W.)
- Warwick Antimicrobial Screening Facility, University of Warwick, Coventry CV4 7AL, UK
| | - Christopher G. Dowson
- School of Life Sciences, University of Warwick, Coventry CV4 7AL, UK; (K.M.S.); (S.E.S.); (J.M.); (C.G.D.); (E.M.H.W.)
- Warwick Antimicrobial Screening Facility, University of Warwick, Coventry CV4 7AL, UK
| | - Elizabeth M. H. Wellington
- School of Life Sciences, University of Warwick, Coventry CV4 7AL, UK; (K.M.S.); (S.E.S.); (J.M.); (C.G.D.); (E.M.H.W.)
| | - Sutthirat Sitthisak
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Muang, Phitsanulok 65000, Thailand; (R.T.); (U.L.); (S.S.)
| | - Antonia P. Sagona
- School of Life Sciences, University of Warwick, Coventry CV4 7AL, UK; (K.M.S.); (S.E.S.); (J.M.); (C.G.D.); (E.M.H.W.)
- Correspondence:
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20
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Kaur R, Kant S, Mathur VP, Lohia A. Feasibility of opportunistic screening for oral cancers in a dental outpatient department of a secondary care hospital in Northern India. J Family Med Prim Care 2020; 9:909-914. [PMID: 32318444 PMCID: PMC7114040 DOI: 10.4103/jfmpc.jfmpc_999_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/20/2019] [Accepted: 01/23/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Oral cancer is one of the most common forms of cancer in India. Majority of the patients are diagnosed at advanced stages, resulting in poor outcomes. Most of the oral cancers are preceded by visible lesions known as potentially malignant disorders (PMDs), which are amenable to early detection by screening. Oral visual examination is an established method of screening, and dentists have a unique opportunity to screen patients who come for various dental morbidities. Opportunistic screening is being recommended as a measure of cancer control. This study was conducted to assess the feasibility of opportunistic screening in a public health facility. Methods: Patients coming to the dental outpatient department (OPD) of a secondary care hospital were screened for oral cancer or PMD by a trained dental surgeon by visual inspection of the oral cavity. In-depth interviews were conducted with the dental surgeon and officer-in-charge of dental OPD to identify barriers and facilitators for screening. A feasibility model was used to assess the acceptability, implementation, practicality, and integration of opportunistic screening. Results: All patients attending dental OPD underwent screening. PMDs were detected in 0.5% of the new OPD attendees. Leukoplakia was found to be the most common lesion. Biopsy for suspected lesions was not conducted. The shortage of support staff was identified as a barrier to documenting risk factors. There was a lack of follow-up and referral linkages. Conclusion: Opportunistic screening for oral cancers is feasible at a secondary care public health care facility. However, a well-developed system for follow-up and linkage with referral sites is required.
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Affiliation(s)
- Ravneet Kaur
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ayush Lohia
- Super Specialty Cancer Institute and Hospital, Lucknow, Uttar Pradesh, India
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21
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Sarlo KM, Dixon BN, Ni A, Straus DJ. Incidence of infectious complications with the combination of bendamustine and an anti-CD20 monoclonal antibody .. Leuk Lymphoma 2019; 61:364-369. [PMID: 31603363 DOI: 10.1080/10428194.2019.1666378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 10/25/2022]
Abstract
Combination of bendamustine (B) and rituximab (R) has been associated with opportunistic infections (OI) in case reports. This retrospective analysis evaluated the incidence, risk factors, and types of infectious complications (IC) in adults with CD20+ non-Hodgkin lymphoma who received ≥2 cycles of B and either R or ofatumumab. Infection data were collected up to 1-year post-B-based treatment. Potential risk factors for IC were assessed using univariate analysis with Fisher's exact test. Four-hundred and sixteen patients were included. Incidence of IC and OI was 20 and 6%, respectively. Viral (n = 19), fungal (n = 1), and Pneumocystis jiroveci pneumonia (n = 5) infections occurred. OI was associated with lack of antimicrobial prophylaxis analysis (p = .048). The incidences of IC and OI with B and anti-CD20 antibody combination at our institution appear lower than those previously reported, possibly due to antimicrobial prophylaxis and G-CSF use.
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Affiliation(s)
- Kristen M Sarlo
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Pharmaceutical Company, Daiichi Sankyo, Basking Ridge, NJ, USA
| | - Brianne N Dixon
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ai Ni
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David J Straus
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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22
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Sun CC, Royle JA, Fuller AK. Incorporating citizen science data in spatially explicit integrated population models. Ecology 2019; 100:e02777. [PMID: 31168779 DOI: 10.1002/ecy.2777] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 09/21/2018] [Revised: 04/04/2019] [Accepted: 04/16/2019] [Indexed: 11/09/2022]
Abstract
Information about population abundance, distribution, and demographic rates is critical for understanding a species' ecology and for effective conservation and management. To collect data over large spatial and temporal extents for such inferences, especially for species with low densities or wide distributions, citizen science can be an efficient approach. Integrated models have also emerged as an important methodology to estimate population parameters by combining multiple types of data, including citizen science data. We developed a spatially explicit integrated model that combines opportunistically collected presence-absence (PA) data, commonly collected in citizen science efforts, with systematically collected spatial capture-recapture (SCR) data, which are often limited to small spatial and temporal extents. We conducted single and multi-season simulations with parameters informed by North American black bear (Ursus americanus) populations, to evaluate the influence of varying amounts of opportunistic PA data collected at larger spatial and temporal extents on the estimation of population-level parameters. Integrating opportunistic PA data increased the precision and accuracy of posterior estimates of abundance, and survival and recruitment rates. In some cases, adding PA locations improved abundance estimates more than increasing PA detection probability. Posterior estimates were as precise and unbiased as when higher quality, but sparse, SCR data were available. We also applied the integrated model to SCR and citizen science PA data collected on black bears in New York, with results consistent with our simulations. Our findings indicate that citizen science in integrated models can be a cost-efficient way to improve estimates of population parameters and increase the spatiotemporal extent of inference. Continued developments with integrated models and citizen science data will offer additional ways to improve our understanding of population structure and demographics.
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Affiliation(s)
- Catherine C Sun
- New York Cooperative Fish and Wildlife Research Unit, Department of Natural Resources, Cornell University, 226 Mann Drive, Ithaca, New York, 14853, USA
| | - J Andrew Royle
- U.S. Geological Survey, Patuxent Wildlife Research Center, Laurel, Maryland, 20708, USA
| | - Angela K Fuller
- U.S. Geological Survey, New York Cooperative Fish and Wildlife Research Unit, Department of Natural Resources, Cornell University, 226 Mann Drive, Ithaca, NY, 14853, USA
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23
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Anderson NW, Muehlenbachs A, Arif S, Bruminhent J, Deziel PJ, Razonable RR, Wilhelm MP, Metcalfe MG, Qvarnstrom Y, Pritt BS. A Fatal Case of Disseminated Microsporidiosis Due to Anncaliia algerae in a Renal and Pancreas Allograft Recipient. Open Forum Infect Dis 2019; 6:ofz285. [PMID: 31304191 DOI: 10.1093/ofid/ofz285] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/29/2019] [Indexed: 11/13/2022] Open
Abstract
Microsporidiosis is an emerging opportunistic infection in immunocompromised patients. We report a case of fatal disseminated Anncaliia algerae infection in a profoundly immunosuppressed pancreas and kidney transplant recipient.
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Affiliation(s)
- Neil W Anderson
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Atis Muehlenbachs
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sana Arif
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Jackrapong Bruminhent
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Paul J Deziel
- William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota
| | - Raymund R Razonable
- William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota.,Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mark P Wilhelm
- William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota.,Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Maureen G Metcalfe
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yvonne Qvarnstrom
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bobbi S Pritt
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.,Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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24
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Tjalma W, Bosteels J, Cooremans I, Cosyns S, De Greve M, De Vree BP, Debruyne D, De Jonge ET, Desmedt E, Dubois P, Faes T, Francx M, Hamerlynck T, Makar AP, Maryns AS, Michiels I, Orye G, Platteeuw L, Pouseele B, Schutyser V, Segaert A, Stevens M, Tomassetti C, Trinh XB, Tummers P, van Calenbergh S, van Dam PA, Van Herendael B, Vanspauwen R, Vergote IB, Verguts J, Watty K, Weyers S. The rationale of opportunistic bilateral salpingectomies (OBS) during benign gynaecological and obstetric surgery: a consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG). Facts Views Vis Obgyn 2019; 11:177-187. [PMID: 31824638 PMCID: PMC6897518] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Ovarian cancer (OC), is a disease difficult to diagnose in an early stage implicating a poor prognosis. The 5-year overall survival in Belgium has not changed in the last 18 years and remains 44 %. There is no effective screening method (secondary prevention) to detect ovarian cancer at an early stage. Primary prevention of ovarian cancer came in the picture through the paradigm shift that the fallopian tube is often the origin of ovarian cancer and not the ovary itself. Opportunistic bilateral salpingectomy (OBS) during benign gynaecological and obstetric surgery might have the potential to reduce the risk of ovarian cancer by as much as 65 %. Bilateral risk-reducing salpingectomy during a benign procedure is feasible, safe, appears to have no impact on the ovarian function and seems to be cost effective. The key question is whether we should wait for a RCT or implement OBS directly in our daily practice. Guidelines regarding OBS within our societies are therefore urgently needed. Our recommendation is to inform all women without a child wish, undergoing a benign gynaecological or obstetrical surgical procedure about the pro's and the con's of OBS and advise a bilateral salpingectomy. Furthermore, there is an urgent need for a prospective registry of OBS. The present article is the consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG) regarding OBS.
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Affiliation(s)
- Waa Tjalma
- Antwerp University Hospital - University of Antwerp, Antwerpen
| | | | | | - S Cosyns
- Vrije Universiteit Brussel - Universitair Ziekenhuis Brussel, Brussel
| | | | - B P De Vree
- Antwerp University Hospital - University of Antwerp, Antwerpen
- ZNA Middelheim, Antwerpen
| | | | | | | | | | - T Faes
- AZ Sint Blasius Dendermonde, Dendermonde
| | | | | | - A P Makar
- ZNA Middelheim, Antwerpen
- Universitair Ziekenhuis Gent, Gent
| | | | | | - G Orye
- Jessa Ziekenhuis, Hasselt
| | | | | | - V Schutyser
- Vrije Universiteit Brussel - Universitair Ziekenhuis Brussel, Brussel
| | | | - M Stevens
- AZ Rivierenland campus Bornem, Bornem
| | | | - X B Trinh
- Antwerp University Hospital - University of Antwerp, Antwerpen
| | | | | | - P A van Dam
- Antwerp University Hospital - University of Antwerp, Antwerpen
| | | | | | | | - J Verguts
- OLV van Lourdes Ziekenenhuis, Waregem
| | - K Watty
- AZ Delta campus Roeselare, Roeselare, Belgium
| | - S Weyers
- Universitair Ziekenhuis Gent, Gent
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25
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Esteghamati A, Khanaliha K, Bokharaei-Salim F, Sayyahfar S, Ghaderipour M. Prevalence of Intestinal Parasitic Infection in Cancer, Organ Transplant and Primary Immunodeficiency Patients in Tehran, Iran. Asian Pac J Cancer Prev 2019; 20:495-501. [PMID: 30803212 PMCID: PMC6897035 DOI: 10.31557/apjcp.2019.20.2.495] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 12/23/2022] Open
Abstract
Background: Intestinal parasitic infection in immunodeficient patients especially those with impaired cellular immunity, like neoplasia, renal or heart transplant needs careful consideration. The objective of this study is to evaluate the prevalence of intestinal parasites in different group of patients including cancer patients; organ transplants recipients, and primary immunodeficiency patients. Methods: Stool samples from 190 patients including 80 patients with Primary Immunodeficiency, 85 cancer patients and 25 organ transplant recipients were collected; a direct examination with Phosphate buffered saline (PBS) and formalin ether concentration was performed. The DNA was extracted from parasitologically confirmed patients and nested PCR and sequencing was performed and new obtained sequences of Cryptosporidium parvum and Enterocytozoon bieneusi were compared with deposited ones. Results: In general, the prevalence of parasites was 26/80 (32.5%) in primary immunodeficiency, 22/85(25.9%) in cancer group, and 7/25 (28%) in organ transplant. The prevalence of intestinal parasitic infections in primary immunodeficiency patients were Blastocystis hominis 13 (16.2%), Giardia lamblia 10 (12.5%), Cryptosporidium 1(1.2%), Chilomastix mesnilii 1 (1.2%), Dientamoeba fragilis 1(1.2%). Of 25 organ transplants, 6 (24%) Cryptosporidium sp were found, all of which were confirmed as Cryptosporidium parvum and one case of Microspora in a heart transplant recipient was confirmed as Enterocytozoon bieneusi by PCR sequencing. The predominant intestinal parasitic infection in cancer patients was 19 (22.3%) Blastocystis hominis followed by two (2.3%) Giardia lamblia and one Dientamoeba fragilis 1 (1.1%). Conclusion: The high rate of infection with Blastocystis hominis was found in cancer patients especially colorectal cancer patients, so careful consideration should be given by physicians. Cryptosporidium sp was found to be the major cause of parasitic intestinal infection in patients with organ transplant compared to primary immunodeficiency patients; so transplant recipients undergoing immunosuppressive therapy should be considered as a risk group for acquiring microsporidiosis and Cryptosporidium infection.
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Affiliation(s)
- Abdoulreza Esteghamati
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
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26
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Stamatiades GA, Ioannou P, Petrikkos G, Tsioutis C. Fungal infections in patients with inflammatory bowel disease: A systematic review. Mycoses 2018; 61:366-376. [PMID: 29453860 DOI: 10.1111/myc.12753] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 11/05/2017] [Revised: 02/03/2018] [Accepted: 02/03/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite reports of fungal infections in patients with inflammatory bowel disease (IBD), their clinical and microbiological characteristics remain unknown. OBJECTIVES The aim of this systematic review was to examine all available evidence regarding fungal infections in patients with IBD. METHODS Systematic search of PubMed (through 27 May 2017) for studies providing data on clinical, microbiological, treatment and outcome data of fungal infections in patients with IBD. The primary study outcome was to record the most common fungal species in patients with IBD. Secondary outcomes were classified into 3 categories: (i) characteristics of fungal infections; (ii) data on IBD and (iii) treatment and outcomes of fungal infections in patients with IBD. RESULTS Fourteen studies with data on 1524 patients were included in final analysis. The most common fungal infections in patients with IBD were caused by Candida species (903 infections); the most commonly reported site of Candida infection was the gastrointestinal tract. Available evidence shows that most fungal infections occur within 12 months of IBD treatment and within 6 months when anti-TNFa agents are used. CONCLUSIONS This systematic review thoroughly describes fungal infections in patients with IBD and provides important information for the early detection and management of these infections.
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Affiliation(s)
- George A Stamatiades
- Infectious Diseases Working Group, Society of Junior Doctors, Athens, Greece.,Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Petros Ioannou
- Infectious Diseases Working Group, Society of Junior Doctors, Athens, Greece.,Internal Medicine & Infectious Diseases Department, University Hospital of Heraklion, Heraklion, Greece
| | - George Petrikkos
- School of Medicine, European University of Cyprus, Nicosia, Cyprus
| | - Constantinos Tsioutis
- Infectious Diseases Working Group, Society of Junior Doctors, Athens, Greece.,School of Medicine, European University of Cyprus, Nicosia, Cyprus
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27
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Gupta A, Dhingra A. Incidental Chronic Neutropenia in an Asymptomatic Adult. Cureus 2017; 9:e1779. [PMID: 29255658 PMCID: PMC5732009 DOI: 10.7759/cureus.1779] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic neutropenia is a rare hematologic abnormality encountered in primary care. It can be caused by a wide range of acquired and congenital factors. Very rarely, it can occur as isolated chronic neutropenia where other hematologic cell lines are completely intact. The case discussed here dealt with a similar situation where a 29-year-old female patient presented with severe neutropenia and otherwise intact cell lines in an asymptomatic fashion. Laboratory testing conducted at multiple intervals showed a consistently and severely depressed absolute neutrophil count (ANC) for a prolonged time. In addition, the patient had some abnormalities in serum immunoglobulin levels that pointed towards an underlying autoimmune or malignant pathology but these were insufficient to arrive at a clear diagnosis. The unique presentation in this patient presents an opportunity to study the pathological causation for neutropenia and, more specifically, isolated neutropenia.
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Affiliation(s)
| | - Anurag Dhingra
- Family Medicine, Star Medical Center, Mississauga, On, Canada
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28
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Lakhdar K, Houari N, Elbouazzaoui A, Ameuraoui T, Boukatta B, Sbai H, Kanjaa N. [Facial mucormycosis complicating severe angiocholitis: about a case]. Pan Afr Med J 2017; 25:246. [PMID: 28293362 PMCID: PMC5337295 DOI: 10.11604/pamj.2016.25.246.10977] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 10/24/2016] [Indexed: 11/18/2022] Open
Abstract
Les mucormycoses sont des infections fongiques opportunistes survenant chez des patients immunodéprimés. C’est une affection grave compromettant le pronostic vital. Même diagnostiquée précocement, la mortalité des mucormycoses atteint 50%. Nous rapportons le cas d’une mucormycose chez une patiente diabétique hospitalisée en réanimation pour angiocholite grave. L’évolution était fatale.
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Affiliation(s)
- Karim Lakhdar
- Service de Réanimation Polyvalente A4, CHU Hassan II, Fès, Maroc
| | - Naoufal Houari
- Service de Réanimation Polyvalente A4, CHU Hassan II, Fès, Maroc
| | | | | | - Brahim Boukatta
- Service de Réanimation Polyvalente A4, CHU Hassan II, Fès, Maroc
| | - Hicham Sbai
- Service de Réanimation Polyvalente A4, CHU Hassan II, Fès, Maroc
| | - Nabil Kanjaa
- Service de Réanimation Polyvalente A4, CHU Hassan II, Fès, Maroc
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29
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Balhara M, Chaudhary R, Ruhil S, Singh B, Dahiya N, Parmar VS, Jaiwal PK, Chhillar AK. Siderophores; iron scavengers: the novel & promising targets for pathogen specific antifungal therapy. Expert Opin Ther Targets 2016; 20:1477-1489. [PMID: 27797604 DOI: 10.1080/14728222.2016.1254196] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 10/20/2022]
Abstract
INTRODUCTION The recent emergence of resistance, toxicity paradigm and limited efficacy of conventional antifungal drugs necessitate the identification of de novo targets in fungal metabolism. One of the most critical physiological processes during in vivo pathogenesis is maintenance of iron homeostasis. The most life threatening opportunistic human fungal pathogens like Aspergillus, Candida and Cryptococcus exploit the siderophore mediated iron uptake mechanism either for survival, virulence, propagation or resistance to oxidative stress envisaged in vivo during infection. Areas covered: In this review, we will highlight the metabolic pathways; specifically siderophore biosynthesis, uptake and utilisation, triggered in the fungal pathogens in iron starving conditions and the various putative targets viable in these pathways to be recruited as novel therapeutic antidotes either via biosynthetic enzymes catalytic site inhibitors or as drug conjugates through trojan horse approach and further role in the development of fungal specific reliable diagnostic markers. Expert opinion: Siderophores are the weapons released by a pathogen to conquer the battle for iron acquisition. Hence, the fungal siderophore biosynthetic pathways along with their uptake and utilisation mechanisms represent an ideal target for pathogen specific, host friendly therapeutic strategy which would block the proliferation of parasite without causing any harm to the mammalian host.
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Affiliation(s)
- Meenakshi Balhara
- a Centre for Biotechnology , Maharshi Dayanand University , Rohtak , Haryana , India
| | - Renu Chaudhary
- a Centre for Biotechnology , Maharshi Dayanand University , Rohtak , Haryana , India
| | - Sonam Ruhil
- a Centre for Biotechnology , Maharshi Dayanand University , Rohtak , Haryana , India
| | - Bharat Singh
- a Centre for Biotechnology , Maharshi Dayanand University , Rohtak , Haryana , India
| | - Nisha Dahiya
- b Division of Epidemiology and Communicable Diseases , Indian Council of Medical Research , Delhi , India
| | - Virinder S Parmar
- c Bioorganic Laboratory, Department of Chemistry , University of Delhi , Delhi , India
| | - Pawan K Jaiwal
- a Centre for Biotechnology , Maharshi Dayanand University , Rohtak , Haryana , India
| | - Anil K Chhillar
- a Centre for Biotechnology , Maharshi Dayanand University , Rohtak , Haryana , India
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30
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Pozza R, Georgoulas S, Moessner K, Nati M, Gluhak A, Krco S. An Arrival and Departure Time Predictor for Scheduling Communication in Opportunistic IoT. Sensors (Basel) 2016; 16:s16111852. [PMID: 27827909 PMCID: PMC5134511 DOI: 10.3390/s16111852] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/19/2016] [Accepted: 10/24/2016] [Indexed: 06/06/2023]
Abstract
In this article, an Arrival and Departure Time Predictor (ADTP) for scheduling communication in opportunistic Internet of Things (IoT) is presented. The proposed algorithm learns about temporal patterns of encounters between IoT devices and predicts future arrival and departure times, therefore future contact durations. By relying on such predictions, a neighbour discovery scheduler is proposed, capable of jointly optimizing discovery latency and power consumption in order to maximize communication time when contacts are expected with high probability and, at the same time, saving power when contacts are expected with low probability. A comprehensive performance evaluation with different sets of synthetic and real world traces shows that ADTP performs favourably with respect to previous state of the art. This prediction framework opens opportunities for transmission planners and schedulers optimizing not only neighbour discovery, but the entire communication process.
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Affiliation(s)
- Riccardo Pozza
- Institute for Communication Systems, University of Surrey, Guildford GU2 7XH, UK.
| | - Stylianos Georgoulas
- Institute for Communication Systems, University of Surrey, Guildford GU2 7XH, UK.
| | - Klaus Moessner
- Institute for Communication Systems, University of Surrey, Guildford GU2 7XH, UK.
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31
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Sav H, Ozakkas F, Altınbas R, Kiraz N, Tümgör A, Gümral R, Döğen A, Ilkit M, de Hoog GS. Virulence markers of opportunistic black yeast in Exophiala. Mycoses 2016; 59:343-50. [PMID: 26857806 DOI: 10.1111/myc.12478] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 12/03/2015] [Revised: 01/10/2016] [Accepted: 01/12/2016] [Indexed: 12/26/2022]
Abstract
The black yeast genus Exophiala is known to cause a wide variety of diseases in severely ill individuals but can also affect immunocompetent individuals. Virulence markers and other physiological parameters were tested in eight clinical and 218 environmental strains, with a specific focus on human-dominated habitats for the latter. Urease and catalase were consistently present in all samples; four strains expressed proteinase and three strains expressed DNase, whereas none of the strains showed phospholipase, haemolysis, or co-haemolysis activities. Biofilm formation was identified in 30 (13.8%) of the environmental isolates, particularly in strains from dishwashers, and was noted in only two (25%) of the clinical strains. These results indicate that virulence factors are inconsistently present in the investigated Exophiala species, suggesting opportunism rather than pathogenicity.
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Affiliation(s)
- Hafize Sav
- Department of Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fatma Ozakkas
- Department of Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Rabiye Altınbas
- Department of Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nuri Kiraz
- Department of Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ayşegül Tümgör
- Department of Microbiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Ramazan Gümral
- Department of Microbiology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Aylin Döğen
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Mersin, Mersin, Turkey
| | - Macit Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey
| | - G Sybren de Hoog
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.,Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.,Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil.,King Abdulaziz University, Jeddah, Saudi Arabia
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32
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Pérez-Torrado R, Querol A. Opportunistic Strains of Saccharomyces cerevisiae: A Potential Risk Sold in Food Products. Front Microbiol 2016; 6:1522. [PMID: 26779173 PMCID: PMC4705302 DOI: 10.3389/fmicb.2015.01522] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [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] [Received: 10/15/2015] [Accepted: 12/17/2015] [Indexed: 12/28/2022] Open
Abstract
In recent decades, fungal infections have emerged as an important health problem associated with more people who present deficiencies in the immune system, such as HIV or transplanted patients. Saccharomyces cerevisiae is one of the emerging fungal pathogens with a unique characteristic: its presence in many food products. S. cerevisiae has an impeccably good food safety record compared to other microorganisms like virus, bacteria and some filamentous fungi. However, humans unknowingly and inadvertently ingest large viable populations of S. cerevisiae (home-brewed beer or dietary supplements that contain yeast). In the last few years, researchers have studied the nature of S. cerevisiae strains and the molecular mechanisms related to infections. Here we review the last advance made in this emerging pathogen and we discuss the implication of using this species in food products.
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Affiliation(s)
- Roberto Pérez-Torrado
- Food Biotechnology Department, Instituto de Agroquímica y Tecnología de los Alimentos - Consejo Superior de Investigaciones Científicas Valencia, Spain
| | - Amparo Querol
- Food Biotechnology Department, Instituto de Agroquímica y Tecnología de los Alimentos - Consejo Superior de Investigaciones Científicas Valencia, Spain
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33
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Ojuromi OT, Duan L, Izquierdo F, Fenoy SM, Oyibo WA, Del Aguila C, Ashafa AOT, Feng Y, Xiao L. Genotypes of Cryptosporidium spp. and Enterocytozoon bieneusi in Human Immunodeficiency Virus-Infected Patients in Lagos, Nigeria. J Eukaryot Microbiol 2015; 63:414-8. [PMID: 26662459 DOI: 10.1111/jeu.12285] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 11/03/2015] [Accepted: 11/25/2015] [Indexed: 11/27/2022]
Abstract
Molecular characterization of Cryptosporidium spp. and Enterocytozoon bieneusi has improved our understanding of the transmission of both organisms in humans. In this study, to infer possible infection sources, Cryptosporidium spp. and E. bieneusi in fecal specimens from 90 HIV-infected patients attending antiretroviral clinics in Lagos, Nigeria were detected and genotyped by PCR and DNA sequencing. Cryptosporidium spp. and E. bieneusi were identified in four and five patients, respectively, including the occurrence of subtype IeA11T3G3 of Cryptosporidium hominis in two patients, subtype IIcA5G3k of Cryptosporidium parvum in one patient, and Type IV of E. bieneusi in four patients. Among the remaining positive patients, one had mixed infection of Cryptosporidium meleagridis and C. hominis and one had mixed E. bieneusi genotypes. These data highlight a possible difference in major transmission routes (anthroponotic vs. zoonotic) between Cryptosporidium spp. and E. bieneusi in HIV+ patients in the study area.
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Affiliation(s)
- Oladele T Ojuromi
- Faculty of Natural and Agricultural Sciences, University of the Free State, Qwaqwa Campus, Phuthaditjhaba, 9866, South Africa
| | - Liping Duan
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers Disease Control and Prevention, Atlanta, Georgia, 30329, USA.,State Key Laboratory of Bioreactor Engineering, School of Resources and Environmental Engineering, East China University of Science and Technology, Shanghai, 200237, China
| | | | - Soledad M Fenoy
- Facultad de Farmacia, Universidad CEU San Pablo, Madrid, 28003, Spain
| | - Wellington A Oyibo
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Carmen Del Aguila
- Facultad de Farmacia, Universidad CEU San Pablo, Madrid, 28003, Spain
| | - Anofi O T Ashafa
- Faculty of Natural and Agricultural Sciences, University of the Free State, Qwaqwa Campus, Phuthaditjhaba, 9866, South Africa
| | - Yaoyu Feng
- State Key Laboratory of Bioreactor Engineering, School of Resources and Environmental Engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Lihua Xiao
- Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers Disease Control and Prevention, Atlanta, Georgia, 30329, USA
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Bin Zikria Y, Nosheen S, Ishmanov F, Kim SW. Opportunistic Hybrid Transport Protocol (OHTP) for Cognitive Radio Ad Hoc Sensor Networks. Sensors (Basel) 2015; 15:31672-86. [PMID: 26694396 DOI: 10.3390/s151229871] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 12/02/2022]
Abstract
The inefficient assignment of spectrum for different communications purposes, plus technology enhancements and ever-increasing usage of wireless technology is causing spectrum scarcity. To address this issue, one of the proposed solutions in the literature is to access the spectrum dynamically or opportunistically. Therefore, the concept of cognitive radio appeared, which opens up a new research paradigm. There is extensive research on the physical, medium access control and network layers. The impact of the transport layer on the performance of cognitive radio ad hoc sensor networks is still unknown/unexplored. The Internet’s de facto transport protocol is not well suited to wireless networks because of its congestion control mechanism. We propose an opportunistic hybrid transport protocol for cognitive radio ad hoc sensor networks. We developed a new congestion control mechanism to differentiate true congestion from interruption loss. After such detection and differentiation, we propose methods to handle them opportunistically. There are several benefits to window- and rate-based protocols. To exploit the benefits of both in order to enhance overall system performance, we propose a hybrid transport protocol. We empirically calculate the optimal threshold value to switch between window- and rate-based mechanisms. We then compare our proposed transport protocol to Transmission Control Protocol (TCP)-friendly rate control, TCP-friendly rate control for cognitive radio, and TCP-friendly window-based control. We ran an extensive set of simulations in Network Simulator 2. The results indicate that the proposed transport protocol performs better than all the others.
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Uribe-Alvarez C, Chiquete-Félix N, Contreras-Zentella M, Guerrero-Castillo S, Peña A, Uribe-Carvajal S. Staphylococcus epidermidis: metabolic adaptation and biofilm formation in response to different oxygen concentrations. Pathog Dis 2015; 74:ftv111. [PMID: 26610708 DOI: 10.1093/femspd/ftv111] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2015] [Indexed: 11/14/2022] Open
Abstract
Staphylococcus epidermidis has become a major health hazard. It is necessary to study its metabolism and hopefully uncover therapeutic targets. Cultivating S. epidermidis at increasing oxygen concentration [O2] enhanced growth, while inhibiting biofilm formation. Respiratory oxidoreductases were differentially expressed, probably to prevent reactive oxygen species formation. Under aerobiosis, S. epidermidis expressed high oxidoreductase activities, including glycerol-3-phosphate dehydrogenase, pyruvate dehydrogenase, ethanol dehydrogenase and succinate dehydrogenase, as well as cytochromes bo and aa3; while little tendency to form biofilms was observed. Under microaerobiosis, pyruvate dehydrogenase and ethanol dehydrogenase decreased while glycerol-3-phosphate dehydrogenase and succinate dehydrogenase nearly disappeared; cytochrome bo was present; anaerobic nitrate reductase activity was observed; biofilm formation increased slightly. Under anaerobiosis, biofilms grew; low ethanol dehydrogenase, pyruvate dehydrogenase and cytochrome bo were still present; nitrate dehydrogenase was the main terminal electron acceptor. KCN inhibited the aerobic respiratory chain and increased biofilm formation. In contrast, methylamine inhibited both nitrate reductase and biofilm formation. The correlation between the expression and/or activity or redox enzymes and biofilm-formation activities suggests that these are possible therapeutic targets to erradicate S. epidermidis.
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Affiliation(s)
- Cristina Uribe-Alvarez
- Department of Molecular Genetics, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, 04510, México DF, México
| | - Natalia Chiquete-Félix
- Department of Molecular Genetics, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, 04510, México DF, México
| | - Martha Contreras-Zentella
- Department of Cellular and Developmental Biology, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, 04510, México DF, México
| | - Sergio Guerrero-Castillo
- Nijmegen Center for Mitochondrial Disorders, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Antonio Peña
- Department of Molecular Genetics, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, 04510, México DF, México
| | - Salvador Uribe-Carvajal
- Department of Molecular Genetics, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, 04510, México DF, México
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Tarale P, Gawande S, Jambhulkar V. Antibiotic susceptibility profile of bacilli isolated from the skin of healthy humans. Braz J Microbiol 2015; 46:1111-8. [PMID: 26691469 PMCID: PMC4704625 DOI: 10.1590/s1517-838246420131366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 10/07/2014] [Indexed: 03/17/2023] Open
Abstract
In the present work, twelve bacilli were isolated from four different regions of human skin from Bela population of Nagpur district, India. The isolated bacilli were identified by their morphological, cultural and biochemical characteristics. Seven isolates were Gram negative rods, out of which five were belong to genus Pseudomonas. Three among the five Gram positive isolates were identified as Dermabactor and the remaining two Bacillus. Their antimicrobial susceptibility profile was determined by Kirby-Bauer disc diffusion method. The isolates showed resistance to several currently used broad-spectrum antibiotics. The Dermabactor genus was resistant to vancomycin, although it was earlier reported to be susceptible. Imipenem was found to be the most effective antibiotic for Pseudomonas while nalidixic acid, ampicillin and tetracycline were ineffective. Isolates of Bacillus displayed resistance to the extended spectrum antibiotics cephalosporin and ceftazidime. Imipenem, carbenicillin and ticarcillin were found to be the most effective antibiotics as all the investigated isolates were susceptible to them. Antibiotic resistance may be due to the overuse or misuse of antibiotics during the treatment, or following constant exposure to antibiotic-containing cosmetic formulations.
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Affiliation(s)
- Prashant Tarale
- Deparment of Biotechnology, Sindhu Mahavidyalaya Center for
Biotechnology, Maharashtra, India
| | - Sonali Gawande
- Deparment of Biotechnology, Sindhu Mahavidyalaya Center for
Biotechnology, Maharashtra, India
| | - Vinay Jambhulkar
- Deparment of Biotechnology, Sindhu Mahavidyalaya Center for
Biotechnology, Maharashtra, India
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Arriola E, Wheater M, Krishnan R, Smart J, Foria V, Ottensmeier C. Immunosuppression for ipilimumab-related toxicity can cause pneumocystis pneumonia but spare antitumor immune control. Oncoimmunology 2015; 4:e1040218. [PMID: 26451305 PMCID: PMC4589063 DOI: 10.1080/2162402x.2015.1040218] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 04/08/2015] [Indexed: 02/07/2023] Open
Abstract
Ipilimumab is a standard therapy for advanced melanoma. Severe immune related adverse events occur in up to 30% of patients and require treatment with immunosuppressants such as steroids or the anti-TNFα antibody, infliximab. We describe two patients with advanced melanoma treated with ipilimumab. Both suffered from severe immune related side effects and required prolonged immunosuppression with steroids and/or infliximab. Both patients recovered and in spite of the immune suppression, demonstrate clinical evidence of tumor control. This argues that distinct immunological effector functions control nosocomial infection and tumor, respectively. To our knowledge, these are also the first two case reports of pneumocystis pneumonia in this setting.
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Affiliation(s)
- Edurne Arriola
- Cancer Sciences Unit; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton, UK
- University Hospital Southampton NHS Foundation Trust; Southampton, UK
- Southampton Experimental Cancer Medicine Center; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton, UK
| | - Matthew Wheater
- University Hospital Southampton NHS Foundation Trust; Southampton, UK
- Southampton Experimental Cancer Medicine Center; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton, UK
| | - Radhika Krishnan
- University Hospital Southampton NHS Foundation Trust; Southampton, UK
| | - James Smart
- University Hospital Southampton NHS Foundation Trust; Southampton, UK
| | - Vipul Foria
- University Hospital Southampton NHS Foundation Trust; Southampton, UK
| | - Christian Ottensmeier
- Cancer Sciences Unit; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton, UK
- University Hospital Southampton NHS Foundation Trust; Southampton, UK
- Southampton Experimental Cancer Medicine Center; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton, UK
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Brett AD, Brown JK. Quantitative computed tomography and opportunistic bone density screening by dual use of computed tomography scans. J Orthop Translat 2015; 3:178-184. [PMID: 30035056 PMCID: PMC5986997 DOI: 10.1016/j.jot.2015.08.006] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/25/2015] [Accepted: 08/26/2015] [Indexed: 01/08/2023] Open
Abstract
Central dual-energy X-ray absorptiometry (DXA) of the lumbar spine and proximal femur is the preferred method for bone mineral density (BMD) testing. Despite the fracture risk statistics, osteoporosis testing with DXA remains underused. However, BMD can also be assessed with quantitative computed tomography (QCT) that may be available when access to DXA is restricted. For patients undergoing a primary CT study of the abdomen or pelvis, a potential opportunity exists for concurrent BMD screening by QCT without the need for any additional imaging, radiation exposure, or patient time.
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Affiliation(s)
| | - J. Keenan Brown
- Corresponding author. Mindways Software Inc., 3001 S Lamar Blvd, Suite 302, Austin, TX 78704, USA.
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Kapurubandara S, Qin V, Gurram D, Anpalagan A, Merkur H, Hogg R, Brand A. Opportunistic bilateral salpingectomy during gynaecological surgery for benign disease: A survey of current Australian practice. Aust N Z J Obstet Gynaecol 2015; 55:606-11. [PMID: 26768958 DOI: 10.1111/ajo.12402] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 02/08/2015] [Accepted: 08/01/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Recent evidence supports the fallopian tube as the site of origin for many pelvic serous cancers (PSC) including epithelial ovarian cancers (EOC). As a result, a change in practice with opportunistic bilateral salpingectomy (OBS) at the time of hysterectomy has been advocated as a preventative strategy for PSC in a low-risk population. AIMS The aim of this study was to assess current clinical practice in Australia with respect to OBS during gynaecological surgery for benign indications. MATERIALS AND METHODS An anonymous online survey was sent to all active Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG) Fellows in Australia. Data regarding clinician demographics and the proportion of clinicians offering OBS were collected. Reasons for and against offering or discussing OBS were sought. A descriptive analysis was performed. RESULTS The response rate was 26% (280/1490) with 70% of respondents offering or discussing OBS to women undergoing gynaecological surgery for benign indications, usually at the time of abdominal (96%) or laparoscopic (76%) hysterectomy. The main reason for offering or discussing OBS was current evidence to suggest the fallopian tubes as the site of origin for most EOC. Main reasons for not offering OBS were insufficient evidence to benefit the woman (36%) or being unaware of recent evidence (33%). CONCLUSIONS The survey responses indicate that OBS is frequently discussed or offered in Australia, usually at the time of hysterectomy. Given the lack of robust evidence to suggest a benefit at a population-based level, a national registry is recommended to monitor outcomes.
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Affiliation(s)
- Supuni Kapurubandara
- Department of Obstetrics and Gynaecology, Westmead Hospital, Westmead, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia.,Sydney West Advanced Pelvic Surgery Unit, Sydney, New South Wales, Australia
| | - Victoria Qin
- Sydney West Advanced Pelvic Surgery Unit, Sydney, New South Wales, Australia.,Department of Obstetrics and Gynaecology, Sydney, New South Wales, Australia
| | - Divya Gurram
- Department of Obstetrics and Gynaecology, Westmead Hospital, Westmead, New South Wales, Australia.,Department of Obstetrics and Gynaecology, Sydney, New South Wales, Australia
| | - Anbu Anpalagan
- Department of Obstetrics and Gynaecology, Westmead Hospital, Westmead, New South Wales, Australia.,Sydney West Advanced Pelvic Surgery Unit, Sydney, New South Wales, Australia
| | - Harry Merkur
- Sydney West Advanced Pelvic Surgery Unit, Sydney, New South Wales, Australia.,Department of Obstetrics and Gynaecology, Sydney, New South Wales, Australia
| | - Russell Hogg
- University of Sydney, Sydney, New South Wales, Australia.,Gynaecological Oncology Department, Westmead Hospital, Westmead, New South Wales, Australia
| | - Alison Brand
- University of Sydney, Sydney, New South Wales, Australia.,Gynaecological Oncology Department, Westmead Hospital, Westmead, New South Wales, Australia
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Royle J, Lambert SB. Fifty years of immunisation in Australia (1964-2014): the increasing opportunity to prevent diseases. J Paediatr Child Health 2015; 51:16-20. [PMID: 25586840 DOI: 10.1111/jpc.12796] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Accepted: 10/08/2014] [Indexed: 01/21/2023]
Abstract
Medicine has seen dramatic changes in the last 50 years, and vaccinology is no different. Australia has made a significant contribution to world knowledge on vaccine-preventable diseases. Certain deadly diseases have disappeared or become rare in Australia following successful introduction of vaccines. As diseases become rarer, public knowledge about the diseases and their serious consequences has decreased, and concerns about potential vaccine side effects have increased. To maintain confidence in immunisations, sharing of detailed information about the vaccines and the diseases we are trying to prevent is integral to the continued success of our public health programme. Modern quality immunisation programmes need to communicate complex information to immunisation providers and also to the general community. Improving immunisation coverage rates and eliminating the gap in coverage and timeliness between Aboriginal and Torres Strait Islander peoples and non-Indigenous people has become a high priority.
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Affiliation(s)
- Jenny Royle
- NHMRC Centre of Research Excellence in Population Health Research - Immunisation in Understudied and Special Risk Populations, The School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia; Community Immunisation Paediatrician, NEST Family Wellness Clinic, Melbourne, Victoria, Australia
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Majumdar A, Chinnakali P, Vinayagamoorthy V, Daya PA, Shidam UG, Roy G. Opportunistic Screening for Hypertension and Selected Cardiovascular Risk Factors among Adults Attending a Primary Health Center in Puducherry, India. Int J Prev Med 2014; 5:1616-20. [PMID: 25709799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 10/28/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND India is currently suffering from an epidemic of noncommunicable diseases; it is thus imperative to screen for cardiovascular risk factors in people visiting Primary Health Centers (PHCs). The objective of the study was to measure the amount of undiagnosed hypertension and selected cardiovascular risk factors present among the adult population through opportunistic screening at the PHC. METHODS A facility-based opportunistic screening program was carried out in a PHC in rural Puducherry. Patients and accompanying persons aged 30 years and above, who attended the daily outpatient department (OPD) were included. The OPD provides outpatient services and medical procedures or tests without requirement of an overnight stay, and functions for 4 h a day. Known hypertensive patients and pregnant women were excluded. Information on age, gender, diabetes status, and personal history of tobacco and alcohol use were collected using an interview schedule. Height, weight and waist circumference were measured, along with blood pressure and blood sugar using standard protocols. Systolic blood pressure (SBP) ≥140 and/or diastolic blood pressure (DBP) ≥90 mm Hg was taken as hypertension. SBP of 120-139 mm Hg and/or DBP of 80-89 mm Hg were taken as prehypertension. RESULTS A total of 324 participants were screened; 56.8% were females. The mean standard deviation (SD) age of the participants was 47.7 (SD 12.6) years. Hypertension and prehypertension were present in 17.9% and 37.7% of the participants respectively. 17.3% participants had diabetes. 22.2% and 21.3% of all participants were current users of tobacco and alcohol respectively. Generalized obesity was present in 31.8% of the participants; 19.1% were overweight. 45.1% participants had central obesity. CONCLUSIONS A relatively large proportion of adults were found to have prehypertension and obesity, thus showing the need for early intervention.
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Abstract
BACKGROUND Headaches are commonly seen in those patients with human immunodeficiency virus (HIV) and are the most common form of pain reported among HIV patients. There have been relatively few studies attempting to determine the rates and phenotypes of the headaches that occur in patients with HIV. DISCUSSION Patients with HIV are susceptible to a much broader array of secondary headache causes, sometimes with atypical manifestations due to a dampened inflammatory response. The investigation of a headache in the HIV patient should be thorough and focused on making sure that secondary and HIV-specific causes are either ruled out or treated if present. CONCLUSION An effective treatment plan should incorporate the use of appropriate pharmacological agents along with the integration of non-pharmacological therapies, such as relaxation and lifestyle regulation. When treating for headaches in patients with HIV, it is important to keep in mind comorbidities and other medications, especially combination antiretroviral therapy. For those with complicated headache histories, referral to a specialized headache center may be appropriate.
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Affiliation(s)
- Huma U Sheikh
- Department of Neurology, Harvard Medical School, John Graham Headache Center, Brigham and Women's Faulkner Hospital, Boston, MA, USA
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Abstract
Background: Diarrhea is one of the most common presenting complaints in human immunodeficiency virus-infected individuals. Aims: The study was designed to determine the magnitude of opportunistic and nonopportunistic intestinal parasitic infections among diarrheal patients and association between CD4+ T-cell counts and human immunodeficiency virus (HIV)-infected intestinal parasites. Materials and Methods: A cross-sectional study was conducted among 207 enrolled diarrheal patients attending HIV integrated counseling and testing center from January 2012 to December 2012. Stool samples were subjected to special modified Ziehl-Neelsen and chromotrope staining method for detection of opportunistic protozoans. Blood samples were also collected from all study subjects for HIV testing and CD4+ T-cell counts were estimated by only in HIV-infected patients. Results: Intestinal parasitic pathogens were detected in 46.1% HIV-infected patients and the major pathogens were opportunistic protozoans 32.2% (37/115), most common being Isospora belli 16.5% (19/115) followed by Cryptosporidium parvum 12.2% (14/115). In HIV noninfected diarrheal patients, major pathogens detected were Entamoeba histolytica/Entamoeba dispar 8.7% (8/92) and Ascaris lumbricoides 3.3% (3/92). Conclusions: The opportunistic intestinal protozoans especially I. belli and C. parvum were most commonly isolated in HIV-infected patients with diarrhea. Majority of the infections occurred in patients when a CD4+ T-cell counts were less than 200 cells/μl.
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Affiliation(s)
- Muktikesh Dash
- Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
| | - Sanghamitra Padhi
- Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
| | - Pritilata Panda
- Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
| | - Banojini Parida
- Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University, Odisha, India
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Handley KM, Lloyd JR. Biogeochemical implications of the ubiquitous colonization of marine habitats and redox gradients by Marinobacter species. Front Microbiol 2013; 4:136. [PMID: 23734151 PMCID: PMC3660661 DOI: 10.3389/fmicb.2013.00136] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [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: 02/15/2013] [Accepted: 05/07/2013] [Indexed: 11/30/2022] Open
Abstract
The Marinobacter genus comprises widespread marine bacteria, found in localities as diverse as the deep ocean, coastal seawater and sediment, hydrothermal settings, oceanic basalt, sea-ice, sand, solar salterns, and oil fields. Terrestrial sources include saline soil and wine-barrel-decalcification wastewater. The genus was designated in 1992 for the Gram-negative, hydrocarbon-degrading bacterium Marinobacter hydrocarbonoclasticus. Since then, a further 31 type strains have been designated. Nonetheless, the metabolic range of many Marinobacter species remains largely unexplored. Most species have been classified as aerobic heterotrophs, and assessed for limited anaerobic pathways (fermentation or nitrate reduction), whereas studies of low-temperature hydrothermal sediments, basalt at oceanic spreading centers, and phytoplankton have identified species that possess a respiratory repertoire with significant biogeochemical implications. Notable physiological traits include nitrate-dependent Fe(II)-oxidation, arsenic and fumarate redox cycling, and Mn(II) oxidation. There is also evidence for Fe(III) reduction, and metal(loid) detoxification. Considering the ubiquity and metabolic capabilities of the genus, Marinobacter species may perform an important and underestimated role in the biogeochemical cycling of organics and metals in varied marine habitats, and spanning aerobic-to-anoxic redox gradients.
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Affiliation(s)
- Kim M. Handley
- Searle Chemistry Laboratory, Computation Institute, University of ChicagoChicago, IL, USA
- Computing, Environment and Life Sciences, Argonne National LaboratoryChicago, IL, USA
| | - Jonathan R. Lloyd
- School of Earth, Atmospheric, and Environmental Sciences, University of ManchesterManchester, UK
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Abstract
Aspergillosis is a common opportunistic fungal infection affecting the nose and paranasal sinuses. The disease presents in various forms ranging from non-invasive to invasive, destructive and allergic types. We report here a rare case of invasive aspergillosis in an immunocompetent host with the literature review.
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Affiliation(s)
- Preeti Sethi
- Department of Oral and Maxillofacial Pathology, Swami Devi Dyal Hospital and Dental College, Golpura, Distt - Panchkula, Haryana, India
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Jain A, Jain S, Rawat S. Emerging fungal infections among children: A review on its clinical manifestations, diagnosis, and prevention. J Pharm Bioallied Sci 2011; 2:314-20. [PMID: 21180463 PMCID: PMC2996076 DOI: 10.4103/0975-7406.72131] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 07/16/2010] [Accepted: 08/07/2010] [Indexed: 12/02/2022] Open
Abstract
The incidence of fungal infections is increasing at an alarming rate, presenting an enormous challenge to healthcare professionals. This increase is directly related to the growing population of immunocompromised individuals especially children resulting from changes in medical practice such as the use of intensive chemotherapy and immunosuppressive drugs. Although healthy children have strong natural immunity against fungal infections, then also fungal infection among children are increasing very fast. Virtually not all fungi are pathogenic and their infection is opportunistic. Fungi can occur in the form of yeast, mould, and dimorph. In children fungi can cause superficial infection, i.e., on skin, nails, and hair like oral thrush, candida diaper rash, tinea infections, etc., are various types of superficial fungal infections, subcutaneous fungal infection in tissues under the skin and lastly it causes systemic infection in deeper tissues. Most superficial and subcutaneous fungal infections are easily diagnosed and readily amenable to treatment. Opportunistic fungal infections are those that cause diseases exclusively in immunocompromised individuals, e.g., aspergillosis, zygomycosis, etc. Systemic infections can be life-threatening and are associated with high morbidity and mortality. Because diagnosis is difficult and the causative agent is often confirmed only at autopsy, the exact incidence of systemic infections is difficult to determine. The most frequently encountered pathogens are Candida albicans and Aspergillus spp. But other fungi such as non-albicans Candida spp. are increasingly important.
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Affiliation(s)
- Akansha Jain
- SAFE Institute of Pharmacy, Gram Kanadiya, Indore, India
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Dachsel M, Lee E. Opportunistic health checks in a retail environment. London J Prim Care (Abingdon) 2011; 4:5-10. [PMID: 25949641 DOI: 10.1080/17571472.2011.11493321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 03/22/2011] [Accepted: 04/14/2011] [Indexed: 10/23/2022]
Abstract
Cardiovascular disease remains common and accounts for many deaths, but primary cardiovascular risk factors are consistently underdiagnosed in the UK. NHS health checks are being implemented nationally in the next five years, targeting those aged 40 to 74 years, and many primary care trusts have commissioned health checks to be carried out opportunistically as an outreach programme in public places to aid uptake and improve access. However, there is little published evidence on the effectiveness and subsequent follow-up rates in such a model. This service evaluation verifies the effectiveness of primary cardiovascular screening in a supermarket setting in south east London. Eight consecutive Saturday clinics were carried out at the entrance of a local supermarket offering opportunistic health screening including blood pressure, random glucose, body mass index and screening spirometry. The primary outcomes are rate of uptake of the service, the proportion of participants with previously undiagnosed cardiovascular risk factors that were identified from the screening, and the subsequent rate of follow-up. Over the eight-week period, 1024 participants (457 males, 44.6%; 567 females 567, 55.4%) undertook the screening. Four hundred and twenty-two participants (41.2%) required follow-up for abnormal readings. Of these, 325 (76.4%) were abnormal readings in participants with previously unknown disease (raised blood glucose, 95 participants (9.3%); raised blood pressure, 172 participants (16.8%); FEV1 < 80%, 93 participants (9.1%)). Using the NHS health check age range, 34.3% of raised blood pressure measurements and 38.9% of raised blood glucose measurements would not have been picked up. The cost per patient was £19, the cost per abnormal finding was £43.66. Opportunistic health screening targeting particular groups of individuals appears to be highly effective in identifying significant pathology. The main limitation of this pilot was that cholesterol measurement was not performed and therefore full cardiovascular risk assessment could not be offered.
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Affiliation(s)
- Martin Dachsel
- Acute Medicine Trainee, Kent and Sussex Hospital, Tunbridge Wells, UK
| | - Eugenia Lee
- GP, Thamesmead Medical Associates, London, UK
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Frank M, Woschnagg H, Mölzer G, Finsterer J. Cerebellar nocardiosis and myopathy from long-term corticosteroids for idiopathic thrombocytopenia. Yonsei Med J 2010; 51:131-7. [PMID: 20046527 PMCID: PMC2799960 DOI: 10.3349/ymj.2010.51.1.131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 01/22/2008] [Revised: 05/09/2008] [Accepted: 05/14/2008] [Indexed: 11/30/2022] Open
Abstract
Infection of the central nervous system with Nocardia sp. usually manifests as supratentorial abscesses. Supratentorial and cerebellar abscesses from infection with Nocardia sp. following immunosuppression with long-term corticosteroids for idiopathic thrombocytopenia (ITP) have not been reported. An 83 years-old, human immunodeficiency virus (HIV)-negative, polymorbid male with ITP for which he required corticosteroids since age 53 years developed tiredness, dyspnoea, hemoptysis, abdominal pain, and progressive gait disturbance. Imaging studies of the lung revealed an enhancing tumour in the right upper lobe with central and peripheral necrosis, multiple irregularly contoured hyperdensities over both lungs, and right-sided pleural effusions. Sputum culture grew Nocardia sp. Neurological diagnostic work-up revealed dysarthria, dysphagia, ptosis, hypoacusis, tremor, dysdiadochokinesia, proximal weakness of the lower limbs, diffuse wasting, and stocking-type sensory disturbances. The neurological deficits were attributed to an abscess in the upper cerebellar vermis, myopathy from corticosteroids, and polyneuropathy. Meropenem for 37 days and trimethoprime-sulfamethoxazole for 3 months resulted in a reduction of the pulmonary, but not the cerebral lesions. Therefore, sultamicillin was begun, but without success. Long-term therapy with corticosteroids for ITP may induce not only steroid myopathy but also immune-incompetence with the development of pulmonary and cerebral nocardiosis. Cerebral nocardiosis may not sufficiently respond to long-term antibiotic therapy why switching to alternative antibiotics or surgery may be necessary.
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Abstract
The case history of a 56-year-old man is described who suffered from severe adrenocorticotrophic hormone (ACTH)-dependent Cushing's syndrome. The clinical course was complicated by simultaneous infections with Pneumocystis carinii, Staphylococcus aureus, Candida albicans, Aspergillus fumigatus and Herpes simplex, which proved to be fatal. A study of the literature shows that opportunistic infections in endogenous Cushing's syndrome are associated with severe cortisol excess and carry a high mortality. Opportunistic infections are most prevalent in the ectopic ACTH syndrome explained by the very high plasma cortisol concentrations in this condition. Infections with Aspergillus species, Cryptoccus neoformans, Pneumocystis carinii and Nocardia asteroides predominated. Cushing's syndrome with a very high plasma cortisol concentration causes a severe immunocompromized state. Prompt evaluation of the cause of the hypercortisolism, initiation of cortisol lowering therapy, primary prophylaxis for Pneumocystis carinii infection when plasma cortisol exceeds 2500 nmol L-1 and a search for concomitant infectious disease is recommended.
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Affiliation(s)
- R C Bakker
- Department of Endocrinology and Metabolism, Academic Medical Centre, Amsterdam, The Netherlands
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