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Can adverse cardiac events of the COVID-19 vaccine exacerbate preexisting diseases? COVID-19 疫苗的心脏不良反应会加重原有疾病吗?
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-04-01 Epub Date: 2024-02-02 DOI: 10.1080/14787210.2024.2311837
Mohammed S Razzaque

Introduction: SARS-CoV-2 infection and COVID-19 vaccination can both lead to serious cardiac conditions such as myocarditis, arrhythmia, acute myocardial infarction, and coagulopathy. Further studies are needed to better understand the risks and benefits of COVID-19 vaccination, and to determine the best course of action for individuals with preexisting heart conditions.

Areas covered: The current knowledge and challenges in understanding vaccine-associated heart issues concerning the COVID-19 pandemic are briefly summarized, highlighting similar cardiac conditions caused by either SARS-CoV-2 infection or COVID-19 vaccination and the potential clinical impacts.

Expert opinion: The short-term risks of severe cardiovascular side effects following COVID-19 vaccination are relatively low. However, further studies are needed to determine whether adverse vaccination events outweigh the long-term benefits in specific groups of individuals. Since cardiac inflammation, blood pressure dysregulation, coagulopathy, acute myocardial infarction, or arrhythmia could be the consequences of either SARS-CoV-2 infection or COVID-19 vaccination, clinical questions should be asked whether the COVID-19 vaccine worsens the condition in persons with preexisting heart diseases. It is important to carefully assess the potential risks and benefits of COVID-19 vaccination, especially for individuals with preexisting heart conditions, and to continue monitoring and studying the long-term effects of vaccination on cardiovascular health.

导言感染 SARS-CoV-2 和接种 COVID-19 疫苗都可能导致严重的心脏疾病,如心肌炎、心律失常、急性心肌梗塞和凝血功能障碍。为了更好地了解接种 COVID-19 疫苗的风险和益处,并确定对已有心脏疾病的患者的最佳治疗方案,还需要进一步的研究:专家观点:简要概述了目前在了解与 COVID-19 疫苗相关的心脏问题方面的知识和挑战,强调了由 SARS-CoV-2 感染或接种 COVID-19 疫苗引起的类似心脏疾病及其潜在的临床影响:专家意见:接种 COVID-19 疫苗后出现严重心血管副作用的短期风险相对较低。专家意见:接种 COVID-19 疫苗后出现严重心血管副作用的短期风险相对较低,但需要进行进一步研究,以确定在特定人群中接种疫苗的不良反应是否超过长期益处。由于SARS-CoV-2感染或接种COVID-19疫苗都可能导致心脏炎症、血压失调、凝血功能障碍、急性心肌梗塞或心律失常,因此临床上应询问COVID-19疫苗是否会加重原有心脏病患者的病情。重要的是要仔细评估接种 COVID-19 疫苗的潜在风险和益处,特别是对已有心脏病的人,并继续监测和研究接种疫苗对心血管健康的长期影响。
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引用次数: 0
Evaluation of health-related quality of life in patients receiving outpatient parenteral antimicrobial therapy (OPAT) in a UK setting. 对英国接受门诊肠外抗菌疗法(OPAT)患者的健康相关生活质量进行评估。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-03-25 DOI: 10.1080/14787210.2024.2334059
Oyewole Christopher Durojaiye, Evangelos I Kritsotakis

Background: Studies assessing the benefits of outpatient parenteral antimicrobial therapy (OPAT) have paid less attention to patient-centered factors such as patients' experiences and their health-related quality of life (HRQoL).

Research design and methods: Prospective before-and-after quasi-experimental study enrolled adult patients receiving OPAT at a tertiary hospital in Derbyshire, UK, between October 2022 and October 2023. Consenting patients completed paired EQ-5D-3 L questionnaires before OPAT initiation and upon completion of therapy or 30 days after its commencement (whichever occurred first). Changes and predictors of change in HRQoL indicators and associations with clinical outcomes (treatment failure, adverse events, and 30-day unplanned readmission) were examined.

Results: Health state index and visual analogue scale (EQ VAS) scores of 162 enrolled patients at baseline were significantly lower than the UK population averages, but the patients experienced significant improvements in both scores and in four EQ-5D dimensions (mobility, self-care, usual activities, and pain/discomfort). Baseline health index and EQ VAS scores were significant independent predictors of positive changes in HRQoL scores.

Conclusions: OPAT is associated with improved patient-reported quality of life and facilitates early return to work or school. Nevertheless, it is crucial to closely monitor patients with a lower baseline quality of life to optimize their overall OPAT experience.

背景:评估门诊肠外抗菌疗法(OPAT)益处的研究较少关注以患者为中心的因素,如患者的经历及其与健康相关的生活质量(HRQoL):前瞻性前后准实验研究招募了2022年10月至2023年10月期间在英国德比郡一家三级医院接受OPAT治疗的成年患者。获得同意的患者在开始接受 OPAT 治疗前、治疗结束后或开始治疗 30 天后(以先发生者为准)填写成对的 EQ-5D-3 L 问卷。研究人员考察了患者的 HRQoL 指标变化和预测因素,以及与临床结果(治疗失败、不良事件和 30 天非计划再入院)的关联:结果:162 名入选患者的健康状态指数和视觉模拟量表(EQ VAS)得分明显低于英国人口平均水平,但患者的健康状态指数和视觉模拟量表得分以及四个 EQ-5D 维度(行动能力、自理能力、日常活动和疼痛/不适)均有显著改善。基线健康指数和EQ VAS评分是HRQoL评分积极变化的重要独立预测因素:OPAT 与患者报告的生活质量改善相关,并有助于患者早日重返工作或学校。然而,密切监测基线生活质量较低的患者以优化他们的整体 OPAT 体验至关重要。
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引用次数: 0
Bismuth add-on improves the efficacy of 2-week tegoprazan-based triple therapy for first-line Helicobacter pylori eradication: a real-world evidence study. 添加铋剂可提高基于替戈普拉赞的两周三联疗法一线根除幽门螺旋杆菌的疗效:一项真实世界证据研究。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-03-13 DOI: 10.1080/14787210.2024.2329251
Jun-Hyung Cho

Background: This study aimed to investigate the efficacy of bismuth added to a 2-week triple therapy consisting of tegoprazan (TPZ), amoxicillin, and clarithromycin for first-line Helicobacter pylori eradication.

Research design and methods: We reviewed the retrospective data of patients who received a 2-week TPZ-based triple therapy with or without 300 mg bismuth twice daily. The primary endpoint was the H. pylori eradication rate of adding bismuth to the TPZ-based triple regimen (TAC-B group), compared to no bismuth added (TAC group).

Results: In total, 306 and 256 patients were included in the intention-to-treat (ITT) and per-protocol (PP) analyses, respectively. The eradication success rates were significantly higher in the TAC-B group than in the TAC group (ITT, 82.9% vs. 71.8%, p = 0.029; PP, 95.8% vs. 87.5%, p = 0.027, respectively). The adherence rate to the eradication regimen was 100% in the TAC-B group and 97.0% in the TAC group. The adverse drug event rate in the TAC-B group was comparable to that in the TAC group (29.2% vs. 27.3%, p = 0.742). No use of bismuth was significantly associated with eradication failure (p = 0.038).

Conclusions: The bismuth add-on increased the first-line H. pylori eradication rate of 2-week TPZ-based triple therapy.

Clinical trial registration: www.clinicaltrials.gov identifier is NCT05453994.

研究背景本研究旨在探讨在由替戈普拉赞(TPZ)、阿莫西林和克拉霉素组成的为期两周的三联疗法中添加铋剂对一线根除幽门螺旋杆菌的疗效:我们回顾了接受了为期两周的基于 TPZ 的三联疗法(含或不含 300 毫克铋剂,每日两次)的患者的回顾性数据。主要终点是在基于 TPZ 的三联疗法中添加铋剂(TAC-B 组)与不添加铋剂(TAC 组)相比的幽门螺杆菌根除率:共有 306 名和 256 名患者分别纳入意向治疗(ITT)和按协议(PP)分析。TAC-B组的根除成功率明显高于TAC组(ITT分别为82.9%对71.8%,P=0.029;PP分别为95.8%对87.5%,P=0.027)。TAC-B组对根除方案的依从率为100%,TAC组为97.0%。TAC-B组的药物不良事件发生率与TAC组相当(29.2% vs. 27.3%,p = 0.742)。未使用铋剂与根除失败显著相关(p = 0.038):结论:添加铋剂提高了基于TPZ的2周三联疗法的一线幽门螺杆菌根除率。
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引用次数: 0
Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge. 耐碳青霉烯类肺炎克雷伯菌:质粒在重大临床挑战的出现、传播和演变中的作用。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2024.2305854
Vincenzo Di Pilato, Simona Pollini, Vivi Miriagou, Gian Maria Rossolini, Marco Maria D'Andrea

Introduction: Klebsiella pneumoniae is a major agent of healthcare-associated infections and a cause of some community-acquired infections, including severe bacteremic infections associated with metastatic abscesses in liver and other organs. Clinical relevance is compounded by its outstanding propensity to evolve antibiotic resistance. In particular, the emergence and dissemination of carbapenem resistance in K. pneumoniae has posed a major challenge due to the few residual treatment options, which have only recently been expanded by some new agents. The epidemiological success of carbapenem-resistant K. pneumoniae (CR-Kp) is mainly linked with clonal lineages that produce carbapenem-hydrolyzing enzymes (carbapenemases) encoded by plasmids.

Areas covered: Here, we provide an updated overview on the mechanisms underlying the emergence and dissemination of CR-Kp, focusing on the role that plasmids have played in this phenomenon and in the co-evolution of resistance and virulence in K. pneumoniae.

Expert opinion: CR-Kp have disseminated on a global scale, representing one of the most important contemporary public health issues. These strains are almost invariably associated with complex multi-drug resistance (MDR) phenotypes, which can also include recently approved antibiotics. The heterogeneity of the molecular bases responsible for these phenotypes poses significant hurdles for therapeutic and diagnostic purposes.

导言:肺炎克雷伯菌是医疗相关感染的主要病原体,也是一些社区获得性感染的病因,包括与肝脏和其他器官转移性脓肿相关的严重菌血症感染。由于它具有突出的抗生素耐药性进化倾向,因此与临床的关系更为密切。尤其是肺炎克雷伯菌中碳青霉烯类耐药性的出现和传播带来了巨大的挑战,因为它的治疗方案寥寥无几,直到最近才通过一些新制剂得到扩展。耐碳青霉烯肺炎克氏菌(CR-Kp)在流行病学上的成功主要与产生由质粒编码的碳青霉烯水解酶(碳青霉烯酶)的克隆系有关:在此,我们将对 CR-Kp 的出现和传播机制进行最新概述,重点关注质粒在这一现象中以及在肺炎双球菌耐药性和毒力的共同进化中发挥的作用:CR-Kp已在全球范围内传播,是当代最重要的公共卫生问题之一。这些菌株几乎无一例外地具有复杂的 MDR 表型,其中也可能包括最近批准的抗生素。造成这些表型的分子基础的异质性给治疗和诊断带来了巨大障碍。
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引用次数: 0
Clinical efficacy of nirmatrelvir plus ritonavir in patients with COVID-19 and preexisting cardiovascular diseases. 尼马特利韦联合利托那韦治疗新冠肺炎合并既往心血管疾病的临床疗效。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2023.2284367
Ting-Hui Liu, Jheng-Yan Wu, Po-Yu Huang, Wan-Hsuan Hsu, Min-Hsiang Chuang, Ya-Wen Tsai, Chih-Cheng Lai, Chun-Yen Huang

Background: This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with COVID-19 who have preexisting cardiovascular diseases (CVDs).

Methods: Patients with underlying CVDs and COVID-19 were included from the TriNetX network. We employed a 1:1 propensity score matching to create two comparable cohorts: patients receiving NMV-r and those not receiving NMV-r. The primary outcome was the composite outcome of all-cause hospitalization or death within 30 days.

Results: Propensity score matching yielded two matched cohorts of 10,847 patients each. The composite outcomes of all-cause hospitalization or death within 30 days were 2.2% (239 patients) in the NMV-r cohort and 4.7% (512 patients) in the control cohort, indicating reduced risk in the NMV-r cohort (hazard ratio [HR], 0.475; 95% confidence interval [CI], 0407-0.533). The NMV-r cohort exhibited lower risks of all-cause hospitalization (HR, 0.525; 95% CI, 0.449-0.615) and mortality (HR, 0.113; 95% CI, 0.052-0.246) compared with the control group. A similar trend was observed across most of the subgroups.

Conclusions: Our findings indicate that NMV-r to treat COVID-19 could reduce all-cause hospitalization and death in patients with CVDs.

背景:本研究评估了尼马特利韦联合利托那韦(NMV-r)治疗已存在心血管疾病(cvd)的COVID-19患者的临床疗效。方法:从TriNetX网络中纳入基础cvd和COVID-19患者。我们采用1:1的倾向评分匹配来创建两个可比较的队列:接受NMV-r的患者和未接受NMV-r的患者。主要转归是30天内全因住院或死亡的综合转归。结果:倾向评分匹配产生两个匹配的队列,每个队列10,847例患者。NMV-r组30天内全因住院或死亡的综合结局为2.2%(239例),对照组为4.7%(512例),表明NMV-r组的风险降低(危险比[HR], 0.475;95%置信区间[CI], 0407-0.533)。NMV-r组全因住院风险较低(HR, 0.525;95% CI, 0.449-0.615)和死亡率(HR, 0.113;95% CI, 0.052-0.246)与对照组比较。在大多数亚组中也观察到类似的趋势。结论:我们的研究结果表明,NMV-r治疗COVID-19可减少心血管疾病患者的全因住院和死亡。
{"title":"Clinical efficacy of nirmatrelvir plus ritonavir in patients with COVID-19 and preexisting cardiovascular diseases.","authors":"Ting-Hui Liu, Jheng-Yan Wu, Po-Yu Huang, Wan-Hsuan Hsu, Min-Hsiang Chuang, Ya-Wen Tsai, Chih-Cheng Lai, Chun-Yen Huang","doi":"10.1080/14787210.2023.2284367","DOIUrl":"10.1080/14787210.2023.2284367","url":null,"abstract":"<p><strong>Background: </strong>This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with COVID-19 who have preexisting cardiovascular diseases (CVDs).</p><p><strong>Methods: </strong>Patients with underlying CVDs and COVID-19 were included from the TriNetX network. We employed a 1:1 propensity score matching to create two comparable cohorts: patients receiving NMV-r and those not receiving NMV-r. The primary outcome was the composite outcome of all-cause hospitalization or death within 30 days.</p><p><strong>Results: </strong>Propensity score matching yielded two matched cohorts of 10,847 patients each. The composite outcomes of all-cause hospitalization or death within 30 days were 2.2% (239 patients) in the NMV-r cohort and 4.7% (512 patients) in the control cohort, indicating reduced risk in the NMV-r cohort (hazard ratio [HR], 0.475; 95% confidence interval [CI], 0407-0.533). The NMV-r cohort exhibited lower risks of all-cause hospitalization (HR, 0.525; 95% CI, 0.449-0.615) and mortality (HR, 0.113; 95% CI, 0.052-0.246) compared with the control group. A similar trend was observed across most of the subgroups.</p><p><strong>Conclusions: </strong>Our findings indicate that NMV-r to treat COVID-19 could reduce all-cause hospitalization and death in patients with CVDs.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"121-128"},"PeriodicalIF":5.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107590554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Phage therapy: resurrecting a historical solution for the contemporary challenge of rising antibiotic resistance in Latin America. 噬菌体疗法:复活历史解决方案,应对拉丁美洲抗生素耐药性上升的当代挑战。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2024.2305842
Justin Yeager, Ana María Gómez-Jaramillo, Esteban Ortiz-Prado, Manuel Calvopiña, Benjamin K Chan

Introduction: Antimicrobial resistance in Latin America is a growing concern in both human and non-human animal populations. The economic burden that is likely to be imposed through increased resistance will cause further strains on public health systems and the population at large.

Areas covered: We propose the rapid adoption and implementation of phage therapy as a necessary addition to the medical arsenal to help mitigate antimicrobial resistance, with an emphasis on considering the potential benefits that highly biodiverse countries such as Ecuador may have on phage discovery. However, programs may count on limited government support and/or facilitation, which could slow progress.

Expert opinion: We highlight the need for educational campaigns to be implemented in parallel with the development of phage therapy programs, particularly to implement these novel treatments in rural and indigenous communities.

导言:在拉丁美洲,人类和非人类动物对抗生素的耐药性日益令人担忧。抗药性增加可能带来的经济负担将进一步加重公共卫生系统和广大民众的负担:我们建议迅速采用和实施噬菌体疗法,将其作为医疗武库的必要补充,以帮助减轻抗菌药耐药性,重点考虑厄瓜多尔等生物多样性高度丰富的国家在噬菌体发现方面可能带来的潜在益处。然而,该计划可能会依赖于有限的政府支持和/或促进,这可能会减缓进展:我们强调,在制定噬菌体疗法计划的同时,有必要开展教育活动,尤其是在农村和土著社区实施这些新型疗法。
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引用次数: 0
Reviewing novel treatment options for carbapenem-resistant Enterobacterales. 回顾耐碳青霉烯类肠杆菌的新型治疗方案。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2024.2303028
Natalie A Mackow, David van Duin

Introduction: Carbapenem resistant Enterobacterales (CRE) are a major threat to global health and hospital-onset CRE infections have risen during the COVID-19 pandemic. Novel antimicrobials are now available for the treatment of CRE infections. There remains an urgent need for new antimicrobials for CRE, especially for those producing metallo-β-lactamases.

Areas covered: This article discusses previously published research supporting currently available novel antimicrobials for the treatment of CRE infections. Newer compounds currently being evaluated in clinical trials are covered. A literature search was conducted in PubMed over all available dates for relevant published papers and conference abstracts with the search terms, 'CRE,' 'carbapenem-resistant Enterobacterales,' 'β-lactam-β-lactamase inhibitor,' 'KPC,' 'NDM,' 'metallo-β-lactamase,' 'ceftazidime-avibactam,' 'meropenem-vaborbactam,' 'imipenem-cilastatin-relebactam,' 'cefiderocol,' 'eravacycline,' 'plazomicin,' 'taniborbactam,' 'zidebactam,' and 'nacubactam.'

Expert opinion: Novel antimicrobials for CRE infections have been developed, most notably the β-lactam-β-lactamase inhibitor combinations, though treatment options for infections with metallo-β-lactamase producing Enterobacterales remain few and have limitations. Development of antibiotics with activity against metallo-β-lactamase producing Enterobacterales is eagerly awaited, and there are promising new compounds in clinical trials. Finally, more clinical research is needed to optimize and individualize treatment approaches, which will help guide antimicrobial stewardship initiatives aimed at reducing the spread of CRE and development of further resistance.

导言:对碳青霉烯类(Carbapenem)耐药的肠杆菌(CRE)是全球健康的一大威胁,在 COVID-19 大流行期间,医院发病的 CRE 感染率有所上升。目前已有新型抗菌药物可用于治疗 CRE 感染。目前仍急需针对 CRE 的新型抗菌药物,尤其是针对产生金属-β-内酰胺酶的 CRE:本文讨论了以前发表的支持目前可用的治疗 CRE 感染的新型抗菌药物的研究。文章还讨论了目前正在临床试验中进行评估的新型化合物。KPC"、"NDM"、"金属-β-内酰胺酶"、"头孢唑肟-阿维巴坦"、"美罗培南-伐硼巴坦"、"亚胺培南-西司他丁-雷巴坦"、"头孢克肟"、"克拉维酸"、"普拉唑米星"、"他尼巴坦"、"齐德巴坦 "和 "纳库巴坦"。专家意见:针对 CRE 感染的新型抗菌药物已经开发出来,其中最引人注目的是β-内酰胺-β-内酰胺酶抑制剂组合,但针对产金属-β-内酰胺酶肠杆菌感染的治疗方案仍然很少,而且存在局限性。人们热切期待开发出对产金属-β-内酰胺酶肠杆菌具有活性的抗生素,目前有一些前景看好的新化合物正在进行临床试验。最后,需要开展更多临床研究来优化和个性化治疗方法,这将有助于指导旨在减少 CRE 传播和耐药性进一步发展的抗菌药物管理措施。
{"title":"Reviewing novel treatment options for carbapenem-resistant <i>Enterobacterales</i>.","authors":"Natalie A Mackow, David van Duin","doi":"10.1080/14787210.2024.2303028","DOIUrl":"10.1080/14787210.2024.2303028","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenem resistant <i>Enterobacterales</i> (CRE) are a major threat to global health and hospital-onset CRE infections have risen during the COVID-19 pandemic. Novel antimicrobials are now available for the treatment of CRE infections. There remains an urgent need for new antimicrobials for CRE, especially for those producing metallo-β-lactamases.</p><p><strong>Areas covered: </strong>This article discusses previously published research supporting currently available novel antimicrobials for the treatment of CRE infections. Newer compounds currently being evaluated in clinical trials are covered. A literature search was conducted in PubMed over all available dates for relevant published papers and conference abstracts with the search terms, 'CRE,' 'carbapenem-resistant Enterobacterales,' 'β-lactam-β-lactamase inhibitor,' 'KPC,' 'NDM,' 'metallo-β-lactamase,' 'ceftazidime-avibactam,' 'meropenem-vaborbactam,' 'imipenem-cilastatin-relebactam,' 'cefiderocol,' 'eravacycline,' 'plazomicin,' 'taniborbactam,' 'zidebactam,' and 'nacubactam.'</p><p><strong>Expert opinion: </strong>Novel antimicrobials for CRE infections have been developed, most notably the β-lactam-β-lactamase inhibitor combinations, though treatment options for infections with metallo-β-lactamase producing Enterobacterales remain few and have limitations. Development of antibiotics with activity against metallo-β-lactamase producing Enterobacterales is eagerly awaited, and there are promising new compounds in clinical trials. Finally, more clinical research is needed to optimize and individualize treatment approaches, which will help guide antimicrobial stewardship initiatives aimed at reducing the spread of CRE and development of further resistance.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"71-85"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Could Herpesviridae be the cause of severe acute hepatitis of unknown origin in children? 疱疹病毒科可能是儿童不明原因重症急性肝炎的病因吗?
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2024.2304637
Livia Melo Villar, Lucas Lima da Silva, Barbara Vieira do Lago, Jessica Gonçalves Pereira, Ana Carolina Silva Guimarães, Francisco Campello do Amaral Mello, Vanessa Salete de Paula

Introduction: Severe acute hepatitis (SAH) is defined by a severe inflammation of hepatocytes in the liver parenchyma which can lead to an acute liver failure, a clinical condition with high mortality rate that can be triggered by several factors but is usually associated to hepatotropic viruses' infection. In 2022, cases of children with severe acute hepatitis of unknown origin hospitalized in Glasgow, Scotland, were reported. Possible causes of this condition include, but are not limited to, undiagnosed viral (and non-viral) infections, autoimmune hepatitis, drug and/or chemical toxicity, mitochondrial chain respiratory and metabolic disorders.

Areas covered: Herpesviruses can cause severe acute hepatitis, but little is known about the role and the mechanisms of herpesviruses as a causative agent of this type of hepatitis. We review the role of herpesviruses as causative agent of SAH in children and other possible mechanisms involved in this disease.

Expert opinion: Differential diagnosis for herpesvirus in SAH should be implemented in all settings. Alternative fluids, such as saliva and dried blood, could be used in the diagnosis to overwhelm the availability of biological specimens at sufficient volume. In the future, genetic studies could also be added to increase the knowledge about severe acute hepatitis in children.

简介重症急性肝炎(SAH)是指肝实质中的肝细胞发生严重炎症,可导致急性肝功能衰竭,是一种死亡率很高的临床病症,可由多种因素引发,但通常与致肝病毒感染有关。2022 年,苏格兰格拉斯哥报告了几例儿童因不明原因的重症急性肝炎住院治疗的病例。这种病症的可能原因包括但不限于未确诊的病毒(和非病毒)感染、自身免疫性肝炎、药物和/或化学毒性、线粒体链呼吸和代谢紊乱:疱疹病毒可导致重症急性肝炎,但人们对疱疹病毒作为此类肝炎致病因子的作用和机制知之甚少。我们回顾了疱疹病毒在儿童 SAH 中的致病作用及其他可能的发病机制:专家意见:应在所有情况下对 SAH 中的疱疹病毒进行鉴别诊断。在诊断中可使用唾液和干血等替代液体,以克服生物标本数量不足的问题。将来,还可以增加基因研究,以增加对儿童重症急性肝炎的了解。
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引用次数: 0
Health literacy, knowledge, household disposal, and misuse practices of antibiotics among UAE residents: a nationwide cross-sectional study. 健康素养,知识,家庭处置和滥用抗生素的做法在阿联酋居民:一个全国性的横断面研究。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2023.2284878
Zelal Kharaba, Sayer Al-Azzam, Shoroq M Altawalbeh, Alin Alkwarit, Noor Abdulkareem Salmeh, Yassen Alfoteih, Mohammad Araydah, Reema Karasneh, Mamoon A Aldeyab

Background: The study aimed to evaluate health literacy, knowledge, household disposal, and misuse practices of antibiotics among the United Arab Emirates (UAE) residents.

Research design and methods: An observational cross-sectional study was conducted between May 1st and August 31st, 2022. The study encompassed a sample of 1074 participants.

Results: Participants involved in a medical field (OR: 1.98, 95% CI: 1.45-2.69, p < 0.001) were more likely to have adequate health literacy. Most participants rarely (n = 315; 29.33%) or sometimes (n = 292; 27.19%) sought help from a doctor or pharmacist with reading the instructions and leaflets of antibiotics. A bachelor`s degree was associated with a reduced odds ratio of self-medication with antibiotics (OR: 0.46, 95% CI: 0.29-0.75, p = 0.002). Only 10.61% of unneeded antibiotics were returned to the pharmacy, 79.42% were disposed of at home and 10% were disposed of using other disposal practices.

Conclusions: Higher levels of adequate health literacy were observed in those involved in the medical field and those with higher educational levels. The prevalence of self-medication with antibiotics among the UAE population was low. These findings highlight the importance of improving health literacy, promoting responsible antibiotic use, and encouraging proper disposal practices among the population.

背景:本研究旨在评估阿拉伯联合酋长国(UAE)居民对抗生素的卫生素养、知识、家庭处置和滥用做法。研究设计与方法:在5月1日至无效日期期间进行观察性横断面研究。这项研究包括1074名参与者的样本。结果:参与医学领域的参与者(OR: 1.98, 95% CI: 1.45-2.69, p n = 315;29.33%)或有时(n = 292;27.19%)通过阅读抗生素说明书和说明书向医生或药剂师寻求帮助。学士学位与使用抗生素自行用药的优势比降低相关(OR: 0.46, 95% CI: 0.29-0.75, p = 0.002)。不需要的抗生素只有10.61%返回药房,79.42%在家中处理,10%采用其他处理方式处理。结论:医疗从业人员和受教育程度较高的人员具有较高的健康素养。在阿联酋人群中使用抗生素自我药疗的流行率很低。这些发现强调了提高卫生素养、促进负责任地使用抗生素和鼓励人群采取适当处置做法的重要性。
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引用次数: 0
Understanding Staphylococcus aureus internalisation and induction of antimicrobial tolerance. 了解金黄色葡萄球菌的内化和抗菌耐受性诱导。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI: 10.1080/14787210.2024.2303018
Frédéric Goormaghtigh, Françoise Van Bambeke

Introduction: Staphylococcus aureus, a human commensal, is also one of the most common and serious pathogens for humans. In recent years, its capacity to survive and replicate in phagocytic and non-phagocytic cells has been largely demonstrated. In these intracellular niches, bacteria are shielded from the immune response and antibiotics, turning host cells into long-term infectious reservoirs. Moreover, neutrophils carry intracellular bacteria in the bloodstream, leading to systemic spreading of the disease. Despite the serious threat posed by intracellular S. aureus to human health, the molecular mechanisms behind its intracellular survival and subsequent antibiotic treatment failure remain elusive.

Area covered: We give an overview of the killing mechanisms of phagocytes and of the impressive arsenal of virulence factors, toxins and stress responses deployed by S. aureus as a response. We then discuss the different barriers to antibiotic activity in this intracellular niche and finally describe innovative strategies to target intracellular persisting reservoirs.

Expert opinion: Intracellular niches represent a challenge in terms of diagnostic and treatment. Further research using ad-hoc in-vivo models and single cell approaches are needed to better understand the molecular mechanisms underlying intracellular survival and tolerance to antibiotics in order to identify strategies to eliminate these persistent bacteria.

导言:金黄色葡萄球菌是一种人类共生菌,也是人类最常见和最严重的病原体之一。近年来,它在吞噬细胞和非吞噬细胞中生存和复制的能力已得到广泛证实。在这些细胞内的龛位中,细菌不受免疫反应和抗生素的影响,从而使宿主细胞成为长期的传染源。此外,中性粒细胞会将细胞内的细菌带入血液,导致疾病的全身传播。尽管细胞内金黄色葡萄球菌对人类健康构成严重威胁,但其在细胞内存活以及随后的抗生素治疗失败背后的分子机制仍然难以捉摸:我们概述了吞噬细胞的杀灭机制,以及金黄色葡萄球菌作为应对措施所使用的大量毒力因子、毒素和应激反应。然后,我们讨论了抗生素在这种细胞内壁龛中发挥作用的不同障碍,最后介绍了针对细胞内持久储库的创新策略:专家观点:细胞内龛位是诊断和治疗方面的一项挑战。为了更好地了解细胞内生存和对抗生素耐受性的分子机制,以确定消灭这些顽固细菌的策略,需要利用体内特设模型和单细胞方法开展进一步研究。
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Expert Review of Anti-infective Therapy
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