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Antiviral medication to prevent fetal transmission of maternal CMV during pregnancy 预防妊娠期母体巨细胞病毒胎儿传播的抗病毒药物
Q4 Immunology and Microbiology Pub Date : 2022-06-30 DOI: 10.37897/rjid.2022.2.1
Simona Birsanu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
Background. Cytomegalovirus infection represents the most frequent congenital viral infection, with serious consequences on newborns. Neurosensorial hearing loss is the principal outcome, but also, the infection can cause other central nervous system’s anomalies. Although CMV infection can have a major impact on fetal development, there are not clear directions to follow yet, to prevent or treat this condition. Therefore, our purpose with this paper is to update the knowledge regarding the treatment options in order to prevent fetal transmission of maternal CMV infection, based on the latest data from the specialized literature in this field. Methods. Electronic research and analysis of the relevant articles published mainly in the last 5 years were performed, consulting the web platforms PubMed, ScienceDirect, Mendeley and ClinicalTrials.gov. Results and conclusions. To date, there is not enough evidence to reach a consensus on therapeutic methods to prevent or to treat fetal CMV infections and, as a consequence, antenatal screening is not justified. Many pharmaceutical companies work on vaccines to prevent CMV infection, but the results are only from studies’ second phase. Information on efficiency of hyperimmunoglobulin is mixt and it is necessary to clarify the dosage. Among antiviral agents, valaciclovir, which was studied in recent clinical trials, seems to have the best efficiency to prevent fetal transmission of maternal CMV infection and the best safety profile. Valganciclovir has possible embryotoxic effects, but higher potency and information on it are available only from case reports. The interest of scientific community on this topic is high, thus many studies are underway to bring new clarifications.
背景巨细胞病毒感染是最常见的先天性病毒感染,对新生儿造成严重后果。神经感觉性听力损失是主要结果,但感染也会导致其他中枢神经系统的异常。尽管巨细胞病毒感染会对胎儿发育产生重大影响,但目前还没有明确的预防或治疗方向。因此,我们撰写本文的目的是根据该领域专业文献的最新数据,更新有关治疗方案的知识,以防止母体巨细胞病毒感染的胎儿传播。方法。对主要在过去5年中发表的相关文章进行了电子研究和分析,咨询了网络平台PubMed、ScienceDirect、Mendeley和ClinicalTrials.gov。结果和结论。迄今为止,没有足够的证据就预防或治疗胎儿巨细胞病毒感染的治疗方法达成共识,因此,产前筛查是不合理的。许多制药公司致力于预防巨细胞病毒感染的疫苗,但研究结果仅来自第二阶段。关于高免疫球蛋白效率的信息是混合的,有必要澄清剂量。在抗病毒药物中,在最近的临床试验中研究的伐昔洛韦似乎对预防母体巨细胞病毒感染的胎儿传播具有最佳的效率和最佳的安全性。缬更昔洛韦可能具有胚胎毒性作用,但其更高的效力和信息只能从病例报告中获得。科学界对这一主题的兴趣很高,因此许多研究正在进行中,以带来新的澄清。
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引用次数: 0
Current and future approaches in Clostridioides difficile management 艰难梭菌管理的当前和未来方法
Q4 Immunology and Microbiology Pub Date : 2022-06-30 DOI: 10.37897/rjid.2022.2.6
G. Gherlan
Clostridioides difficile is considered one of the main causes of the healthcare associated infections worldwide and the main cause of antibiotic-associated diarrhea, with forms of clinical disease ranging from mild to deadly. Both 2021 IDSA and ESCMID guidelines recommend that for the first episode of CDI Fidaxomicin should be considered as the preferred regimen of treatment and Vancomycin becomes 2nd Standard of Care (SOC) line, an alternative to fidaxomicin. Monoclonal antibodies, fecal microbiota transplantation and surgery remain other recommendations in the guidelines. New means of management of Clostridioides difficile infection are under development, these including prevention measures (vaccination, population with non-toxigenic strains of the colon, standardized fecal microbiota products) and new antibiotics.
艰难梭菌被认为是全球医疗相关感染的主要原因之一,也是抗生素相关腹泻的主要原因,临床疾病形式从轻度到致命不等。2021年IDSA和ESCMID指南都建议,对于CDI的第一次发作,应将Fidaxomicin视为首选治疗方案,万古霉素成为第二标准护理(SOC)线,是Fidaxoomicin的替代品。单克隆抗体、粪便微生物群移植和手术仍然是指南中的其他建议。管理艰难梭菌感染的新方法正在开发中,包括预防措施(疫苗接种、非产毒结肠菌株人群、标准化粪便微生物群产品)和新的抗生素。
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引用次数: 0
Diagnostic and therapeutic challenges in SARS-CoV-2 and Rotavirus coinfection 严重急性呼吸系统综合征冠状病毒2型和轮状病毒合并感染的诊断和治疗挑战
Q4 Immunology and Microbiology Pub Date : 2022-06-30 DOI: 10.37897/rjid.2022.2.2
Nóra Evelin Jiva-Chiril, L. Meliț, Tudor Fleșeriu, O. Marginean
The SARS-CoV-2 infection in children associates multiple challenges related especially to the diagnosis due to the lack of symptoms or due to the polymorph clinical picture that might occur in these children, and which can often mimic a wider spectrum of pathologies. The Rotavirus infection is one of the most common etiologies of acute gastroenteritis in children which might result in increased mortality rates in small ages or in patients at risk. We report the case of a 2-month-old male infant, without significant personal history admitted to the Pediatrics Clinic 1, COVID Compartment, Targu-Mures, for vomiting, loss of appetite, and diarrhea. The family history revealed that the paternal grandfather was confirmed with SARS-CoV-2 infection. Based on the patient’s symptoms and anamnesis, he was tested and confirmed with SARS-CoV-2 by RT-PCR. The stool viral antigens confirmed also Rotavirus infection. The clinical exam at the time of admission pointed out influenced general status, diminished cutaneous turgor, abdominal tenderness at palpation and accelerated bowel movements. The laboratory tests revealed severe dehydration associated with positive inflammatory biomarkers. Taking into account the small age, the presence of coinfection and the severe dehydration, we initiated supportive treatment with rehydration solutions by vein, antibiotics, anticoagulant and symptomatic treatment. The patient’s evolution was favorable with the previously mentioned treatment. The early diagnosis of a possible coinfection in pediatric ages represents the cornerstone in preventing potential complications.
儿童严重急性呼吸系统综合征冠状病毒2型感染伴随着多种挑战,尤其是由于缺乏症状或这些儿童可能出现的多晶型临床表现,这些挑战与诊断有关,并且通常可以模拟更广泛的病理学。轮状病毒感染是儿童急性肠胃炎最常见的病因之一,这可能导致小年龄或高危患者的死亡率增加。我们报告了一例2个月大的男婴,他没有重大个人病史,因呕吐、食欲不振和腹泻住进了Targu Mures新冠肺炎病房儿科诊所1。家族史显示,祖父被证实感染了严重急性呼吸系统综合征冠状病毒2型。根据患者的症状和记忆,他接受了RT-PCR检测并确诊为严重急性呼吸系统综合征冠状病毒2型。粪便病毒抗原也证实了轮状病毒感染。入院时的临床检查指出影响了一般状态、皮肤膨压减轻、触诊时腹部压痛和排便加速。实验室测试显示,严重脱水与阳性炎症生物标志物有关。考虑到年龄较小、合并感染和严重脱水,我们开始通过静脉补液、抗生素、抗凝剂和症状治疗进行支持性治疗。在前面提到的治疗中,患者的病情发展是有利的。儿童年龄段可能合并感染的早期诊断是预防潜在并发症的基石。
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引用次数: 0
Human papillomavirus infection and associated risk of preterm birth 人乳头瘤病毒感染及相关早产风险
Q4 Immunology and Microbiology Pub Date : 2022-06-30 DOI: 10.37897/rjid.2022.2.3
Simona Daniela Savu (Popescu), Alina Marin, D. Codreanu, R. Vlădăreanu
Introduction. The human papilloma virus (HPV) is a virus usually transmitted through mucocutaneous contact directly with the infected organs, resulting in a sexually transmitted infection that exposes particularly young women to a high risk of developing neoplasia of cervical, anogenital, respectively oropharyngeal origin if the virus persists for more than 1-2 years. Our study aimed to detect the correlation between HPV infection and spontaneous preterm labor. Materials and methods. We conducted an observational comparative case-control study in the Department of Neonatology/Obstetrics and Gynaecology of Elias Emergency University Hospital on women diagnosed with HPV infection to assess the risk of preterm labour associated with this infection. Results. The overall group of patients was divided into two groups (confirmed and unconfirmed (or negative) with HPV infection). We observed that, among positive patients, there was a higher incidence of patients infected with a single HPV strain (n=36), followed by patients infected with 2 strains (n=7). Our study revealed the fact that only 4 cases (22.2%) had a history of preterm birth, as opposed to 77.8% (14 cases) who had no associated preterm birth history in the case of HPV genotype 16 positive patients. The data obtained showed no statistical significance (p=0.977). Conclusions. Preterm birth remains one of the leading causes of perinatal mortality and lifetime morbidity worldwide. HPV is a frequently diagnosed viral infection, but clinical studies have observed mixed results regarding the association of HPV 16 and the risk of preterm birth.
介绍人类乳头状瘤病毒(HPV)是一种通常通过与受感染器官的粘膜皮肤直接接触传播的病毒,如果病毒持续1-2年以上,会导致性传播感染,使年轻女性面临患宫颈、肛门生殖器和口咽肿瘤的高风险。我们的研究旨在检测HPV感染与自发性早产之间的相关性。材料和方法。我们在埃利亚斯急诊大学医院新生儿/妇产科对被诊断为HPV感染的女性进行了一项观察性比较病例对照研究,以评估与这种感染相关的早产风险。后果整个患者组被分为两组(确诊和未确诊(或阴性)HPV感染)。我们观察到,在阳性患者中,感染单一HPV毒株的患者发生率较高(n=36),其次是感染2种毒株的患者(n=7)。我们的研究表明,只有4例(22.2%)有早产史,而在HPV基因型16阳性患者中,77.8%(14例)没有相关早产史。所得数据无统计学意义(p=0.977)。早产仍然是全世界围产期死亡率和终生发病率的主要原因之一。HPV是一种经常被诊断的病毒感染,但临床研究观察到关于HPV 16与早产风险之间的关系的结果喜忧参半。
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引用次数: 0
Diagnostic challenges in neuroinfections: case report and literature review 神经感染的诊断挑战:病例报告和文献综述
Q4 Immunology and Microbiology Pub Date : 2022-06-30 DOI: 10.37897/rjid.2022.2.4
Marius-Costin Chitu, T. Salmen, B. Mihai, Vlad Dima, Claudia-Gabriela Potcovaru, D. Cinteză, R. Bohîlțea, Paula-Roxana Raducanu, D. Marcu, D. Mischianu
Meningitis and encephalitis are a group of neuroinfectious diseases that require both correct and early diagnosis and etiopathogenic treatment, because their potential for severe evolution, is often being associated with sequelae. In addition to the detailed anamnesis and clinical examination, it is important to know the specific neurological manifestations at the beginning in order to decide properly the indication to perform the lumbar puncture for identifying an etiopathogenic agent in order to administer a targeted treatment. We present the approach both in terms of diagnosis and treatment, in case of an elderly patient with a favourable evolution, towards healing, without associating neurological sequelae. At the same time, we present a synthesis of the novelties of diagnostic and treatment methods in infectious meningitis and encephalitis.
脑膜炎和脑炎是一组需要正确和早期诊断和致病性治疗的神经感染性疾病,因为它们有可能严重演变,往往伴有后遗症。除了详细的记忆和临床检查外,重要的是要在一开始就知道具体的神经学表现,以便正确决定进行腰椎穿刺的适应症,以确定病因,以便进行靶向治疗。我们提出的方法,无论是在诊断和治疗方面,在老年患者的情况下,有利的进化,朝着愈合,没有相关的神经系统后遗症。同时,我们提出了在感染性脑膜炎和脑炎的诊断和治疗方法的新合成。
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引用次数: 0
Hydatid cysts of the liver opening in the biliary tracts: about 120 cases comparative study between radical and conservative treatment 胆道肝开口包虫病120例根治与保守治疗的比较研究
Q4 Immunology and Microbiology Pub Date : 2022-03-31 DOI: 10.37897/rjid.2022.1.5
G. Talbi, W. Ferjaoui, S. Omrani, M. Hajri, S. Baccouche, Nizar Cherni, L. Gharbi, Nefaa Arfaa, H. Mestiri, R. Bayar
Background. Hepatic hydatid disease is still common in Tunisia, is deemed benign disease but concerns its complications; the most frequent is the rupture in biliary ducts. The aim of the work was to study the results of surgical treatment of hydatid cysts of the open liver in the bile ducts and to deduce the predictive factors of postoperative complications. Methods. This was a retrospective study, done in the department of general surgery of Mongi Slim hospital, over a period of 11 years (from January 2000 to December 2013) and collecting 115 patients. Judging criteria were specific morbidity, length of postoperative stay and recurrence. Results. The median age was 43 years (62 women and 53 men). The clinic consisted of typical cholangitis episodes (6.95%), 6.95% of patients were asymptomatic. 50 radical interventions and 65 conservative interventions were performed, supplemented by treatment of the fistula as follows: Fistula blindness (43.47%), trans-fistulo-oddian drainage (3.4%), bipolar drainage (2.6%), PERDOMO (6.95%). The overall mortality was zero. The overall morbidity was 27.69% with an overall specific morality of 14.7% mainly represented by the suppuration of the CR and the external biliary fistulas. The median postoperative stay was 6 days; the recurrence rate was 1.7% with a delay of 30 months. The predictive factors of postoperative complications in bi variance were: The size of the cyst (p = 0.02), The location of a cyst in the hepatic dome (p = 0.002), Surgical treatment: radical or conservative (p = 0.02), The sex factor (p = 0.015). The multivariate study who found a significant association between sex only and postoperative complications. Conclusion. Advances in hepatobiliary surgery and anesthesia are changing the surgical attitude in favor of radical procedures with favorable consequences in terms of morbidity, length of stay and recurrence. It is believed that the surgeon’s experience is the most important factor in the success of surgical treatment. This helps to prevent complications.
背景肝棘球蚴病在突尼斯仍然很常见,被认为是良性疾病,但担心其并发症;最常见的是胆管破裂。本工作的目的是研究胆管开放性肝棘球蚴的手术治疗结果,并推断术后并发症的预测因素。方法。这是一项在Mongi Slim医院普通外科进行的为期11年(从2000年1月到2013年12月)的回顾性研究,共收集了115名患者。判断标准是具体的发病率、术后停留时间和复发。后果中位年龄为43岁(62名女性和53名男性)。临床表现为典型的胆管炎发作(6.95%),6.95%的患者无症状。采取50种根治性干预措施和65种保守性干预措施,并辅以瘘管治疗:瘘管盲(43.47%)、经瘘管oddian引流(3.4%)、双相引流(2.6%)、PERDOMO(6.95%)。总死亡率为零。总的发病率为27.69%,总的特异性道德为14.7%,主要表现为CR化脓和外胆管瘘。术后平均停留时间为6天;复发率1.7%,延迟30个月。双方差中术后并发症的预测因素为:囊肿大小(p=0.02),囊肿在肝圆顶的位置(p=0.002),手术治疗:根治性或保守性(p=0.02),性别因素(p=0.015)。多变量研究发现,仅性别与术后并发症之间存在显著关联。结论肝胆外科和麻醉的进展正在改变手术态度,支持根治性手术,并在发病率、住院时间和复发方面产生有利的后果。据信,外科医生的经验是手术治疗成功的最重要因素。这有助于预防并发症。
{"title":"Hydatid cysts of the liver opening in the biliary tracts: about 120 cases comparative study between radical and conservative treatment","authors":"G. Talbi, W. Ferjaoui, S. Omrani, M. Hajri, S. Baccouche, Nizar Cherni, L. Gharbi, Nefaa Arfaa, H. Mestiri, R. Bayar","doi":"10.37897/rjid.2022.1.5","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.5","url":null,"abstract":"Background. Hepatic hydatid disease is still common in Tunisia, is deemed benign disease but concerns its complications; the most frequent is the rupture in biliary ducts. The aim of the work was to study the results of surgical treatment of hydatid cysts of the open liver in the bile ducts and to deduce the predictive factors of postoperative complications. Methods. This was a retrospective study, done in the department of general surgery of Mongi Slim hospital, over a period of 11 years (from January 2000 to December 2013) and collecting 115 patients. Judging criteria were specific morbidity, length of postoperative stay and recurrence. Results. The median age was 43 years (62 women and 53 men). The clinic consisted of typical cholangitis episodes (6.95%), 6.95% of patients were asymptomatic. 50 radical interventions and 65 conservative interventions were performed, supplemented by treatment of the fistula as follows: Fistula blindness (43.47%), trans-fistulo-oddian drainage (3.4%), bipolar drainage (2.6%), PERDOMO (6.95%). The overall mortality was zero. The overall morbidity was 27.69% with an overall specific morality of 14.7% mainly represented by the suppuration of the CR and the external biliary fistulas. The median postoperative stay was 6 days; the recurrence rate was 1.7% with a delay of 30 months. The predictive factors of postoperative complications in bi variance were: The size of the cyst (p = 0.02), The location of a cyst in the hepatic dome (p = 0.002), Surgical treatment: radical or conservative (p = 0.02), The sex factor (p = 0.015). The multivariate study who found a significant association between sex only and postoperative complications. Conclusion. Advances in hepatobiliary surgery and anesthesia are changing the surgical attitude in favor of radical procedures with favorable consequences in terms of morbidity, length of stay and recurrence. It is believed that the surgeon’s experience is the most important factor in the success of surgical treatment. This helps to prevent complications.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46786407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concentration of alpha-defensins in the blood plasma of children with Helicobacter pylori – associated peptic ulcer of the duodenum 幽门螺杆菌相关性十二指肠消化性溃疡患儿血浆中α-防御素的浓度
Q4 Immunology and Microbiology Pub Date : 2022-03-31 DOI: 10.37897/rjid.2022.1.4
T. Sorokman, P. Moldovan, I. Sokolnyk, D.I. Koliesnik, N. Popelyuk
Introduction. Various gastrointestinal and extragastric diseases are associated with H. pylori in children and adolescents, but the strongest testing and treatment guidelines are only for children and adolescents with peptic ulcer. The most promising developments now are the study of the antibacterial effect of endogenous antimicrobial peptides (AP), among which the most important are defenses 1-3 (human neutrophil peptides, HNPs1-3). Objective. To investigate the concentration of HNPs 1-3 in children with H. pylori-associated peptic ulcer of the duodenum (DU). Methods. A study of 65 children with DU (47 children with H. pylori-associated DU, 18 children with H. pylori-negative DU) and 25 healthy children aged 7-18 years with the determination of HNPs 1-3 levels in plasma. Results. More common was H. pylori in the group of children with III grade of inflammation than in the group of children with II grade (χ2:p<0.0001). A significant association was found between mucosal inflammation activity and the presence of H. pylori (r=0.66, p<0.0001). The mean level of HNP1-3 in healthy children was 13.67±0.96 ng/ml, in children with DU it was probably higher and was 104.88±11.5 ng/ml (p=0.005). There is a direct correlation between the level of HNP1-3 and the severity of DU in children (r=0.67, p>0.05), as well as between HNP1-3 and the activity of the inflammatory process (r=0.73, p>0.01). In children with H. pylori-associated DU, HNP1-3 values were significantly higher (107.34±16.18 [98.45-119.22]) ng/ml than those in children with DU not associated with H. pylori infection (66.70±11.31 [59.54-73.29]) ng/ml and in healthy children (13.67±0.96 [7.27-18.91] ng/ml). Conclusion. Elevated plasma HNP1-3 levels in children with DU in the presence of H. pylori are likely to be a protective response to limit infection that can be used as a potential biomarker of adverse events.
介绍儿童和青少年的各种胃肠道和胃外疾病都与幽门螺杆菌有关,但最有力的检测和治疗指南仅适用于患有消化性溃疡的儿童和青少年。目前最有希望的进展是内源性抗菌肽(AP)的抗菌作用研究,其中最重要的是防御1-3(人中性粒细胞肽,HNPs1-3)。客观的研究幽门螺杆菌相关性十二指肠消化性溃疡(DU)患儿血清HNP 1-3的浓度。方法。一项针对65名DU儿童(47名幽门螺杆菌相关DU儿童,18名幽门螺杆杆菌阴性DU儿童)和25名7-18岁健康儿童的血浆HNP 1-3水平测定研究。后果幽门螺杆菌在III级炎症组中比II级炎症组更常见(χ2:p0.05),在HNP1-3与炎症过程活性之间也更常见(r=0.73,p>0.05),HNP1-3值(107.34±16.18[9845-119.22])ng/ml显著高于与幽门螺杆菌感染无关的DU儿童(66.70±11.31[59.54-73.29])ng/ml和健康儿童(13.67±0.96[7.27-18.91]ng/ml)。结论幽门螺杆菌存在下DU儿童血浆HNP1-3水平升高可能是限制感染的保护性反应,可作为不良事件的潜在生物标志物。
{"title":"Concentration of alpha-defensins in the blood plasma of children with Helicobacter pylori – associated peptic ulcer of the duodenum","authors":"T. Sorokman, P. Moldovan, I. Sokolnyk, D.I. Koliesnik, N. Popelyuk","doi":"10.37897/rjid.2022.1.4","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.4","url":null,"abstract":"Introduction. Various gastrointestinal and extragastric diseases are associated with H. pylori in children and adolescents, but the strongest testing and treatment guidelines are only for children and adolescents with peptic ulcer. The most promising developments now are the study of the antibacterial effect of endogenous antimicrobial peptides (AP), among which the most important are defenses 1-3 (human neutrophil peptides, HNPs1-3). Objective. To investigate the concentration of HNPs 1-3 in children with H. pylori-associated peptic ulcer of the duodenum (DU). Methods. A study of 65 children with DU (47 children with H. pylori-associated DU, 18 children with H. pylori-negative DU) and 25 healthy children aged 7-18 years with the determination of HNPs 1-3 levels in plasma. Results. More common was H. pylori in the group of children with III grade of inflammation than in the group of children with II grade (χ2:p<0.0001). A significant association was found between mucosal inflammation activity and the presence of H. pylori (r=0.66, p<0.0001). The mean level of HNP1-3 in healthy children was 13.67±0.96 ng/ml, in children with DU it was probably higher and was 104.88±11.5 ng/ml (p=0.005). There is a direct correlation between the level of HNP1-3 and the severity of DU in children (r=0.67, p>0.05), as well as between HNP1-3 and the activity of the inflammatory process (r=0.73, p>0.01). In children with H. pylori-associated DU, HNP1-3 values were significantly higher (107.34±16.18 [98.45-119.22]) ng/ml than those in children with DU not associated with H. pylori infection (66.70±11.31 [59.54-73.29]) ng/ml and in healthy children (13.67±0.96 [7.27-18.91] ng/ml). Conclusion. Elevated plasma HNP1-3 levels in children with DU in the presence of H. pylori are likely to be a protective response to limit infection that can be used as a potential biomarker of adverse events.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43840038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HIV medication to prevent fetal infection during pregnancy 预防怀孕期间胎儿感染的HIV药物
Q4 Immunology and Microbiology Pub Date : 2022-03-31 DOI: 10.37897/rjid.2022.1.2
T. Cioroba, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
When it has been declared a global epidemic, HIV infection became a challenge for medical world. Even if there is only one healed case cited in literature, treatment for HIV-infection have evolved during time leading to very good results in disease control and limitation of virus transmission. When it comes for viral transmission, an essential research topic became the prevention of mother to fetal transmission. In the long run, many discovered antiretroviral drugs proved to be efficient in controlling HIV infection during pregnancy and thereby in reducing the risk of viral transmission to the fetus. But along with use of the HIV-treatment in pregnancy, many questions have appeared. Are the drugs safe for the fetus, or are there any adverse pregnancy outcomes? Should the treatment be adjusted for the desired results in pregnancy, or should the initial treatment be changed when the pregnancy is diagnosed? Many retrospective or prospective observational studies and comparative studies have been conducted in order to answer those questions and to analyze the efficacy and the safety of mostly used antiretroviral drugs in pregnancy. This article reviews the existing studies, guidelines and recommendations regarding the combined antiretroviral HIV treatment during pregnancy for fetal infection prevention.
当它被宣布为全球流行病时,艾滋病毒感染成为医学界的一个挑战。即使文献中只引用了一个治愈的病例,HIV感染的治疗方法也随着时间的推移而发展,在疾病控制和限制病毒传播方面取得了非常好的效果。当谈到病毒传播时,一个重要的研究课题是预防母婴传播。从长远来看,许多发现的抗逆转录病毒药物被证明可以有效控制怀孕期间的艾滋病毒感染,从而降低病毒传播给胎儿的风险。但随着在怀孕期间使用艾滋病毒治疗,出现了许多问题。这些药物对胎儿安全吗?或者有任何不良妊娠结局吗?应该根据妊娠期的预期结果调整治疗方法,还是在诊断为妊娠时改变最初的治疗方法?已经进行了许多回顾性或前瞻性观察性研究和比较研究,以回答这些问题,并分析大多数使用的抗逆转录病毒药物在妊娠期的疗效和安全性。本文综述了关于妊娠期联合抗逆转录病毒-艾滋病治疗预防胎儿感染的现有研究、指南和建议。
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引用次数: 0
Menstrual cycle abnormalities in women vaccinated against COVID-19 接种新冠肺炎疫苗的妇女月经周期异常
Q4 Immunology and Microbiology Pub Date : 2022-03-31 DOI: 10.37897/rjid.2022.1.3
Ioana Zechiu
As more reports of menstrual cycle abnormalities after COVID-19 vaccine inoculation are emerging in media and in clinical practice as well, it was deemed necessary to investigate these claims. This review aims to gather current scientific evidence on COVID vaccination’s effect on menstrual cycle. Further and extensive research is undeniably needed to fully understand these phenomena, but current studies have demonstrated an undeniable link between some menstrual cycle abnormalities (especially heavy menstrual flow and variations in cycle length) and breakthrough bleeding in non-menstruating population and vaccination against SARS-CoV-2. Up to this point, these disturbances seem to be temporary, not lasting for more than a few cycles. The reported menstrual changes have appeared after inoculations of all brands of vaccines, and no particular technology (mRNA or adenovirus-vectored) was particularly associated with them. The greatest concerns raised were those regarding fertility. However, until now, there is no evidence of any of the COVID vaccines affecting fertility when comparing vaccinated and unvaccinated populations.
随着媒体和临床实践中越来越多的关于接种COVID-19疫苗后月经周期异常的报道,有必要对这些说法进行调查。本综述旨在收集COVID疫苗接种对月经周期影响的现有科学证据。不可否认,要充分了解这些现象需要进一步和广泛的研究,但目前的研究已经证明,在非经期人群中,一些月经周期异常(尤其是月经量大和周期长度变化)与突破性出血与接种SARS-CoV-2疫苗之间存在不可否认的联系。到目前为止,这些干扰似乎是暂时的,不会持续超过几个周期。报告的月经变化是在接种了所有品牌的疫苗后出现的,没有特定的技术(mRNA或腺病毒载体)与它们特别相关。提出的最大关切是关于生育问题。然而,到目前为止,在比较接种疫苗和未接种疫苗的人群时,没有证据表明任何COVID疫苗会影响生育能力。
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引用次数: 0
Uptake of the COVID-19 vaccine in pregnancy 妊娠期接种新冠肺炎疫苗
Q4 Immunology and Microbiology Pub Date : 2022-03-31 DOI: 10.37897/rjid.2022.1.1
Miliana Cretu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with a devastating morbidity and mortality. Pregnant women seem to be at increased susceptibility to have a severe disease and suffer adverse pregnancy outcomes. The only solution to mitigate this pandemic is prophylaxis by mass vaccination. We report a review based on current literature about the evidence available on efficacy and safety of anti-COVID-19 vaccines in pregnancy to aid women decide whether to vaccinate or not, while being pregnant or lactating. Studies so far did not find concerning maternal or fetal outcomes and show a similar efficiency of mRNA vaccines as in non-pregnant population. Moreover, anti-SARS-CoV-2 antibodies resulted from the vaccination seem to be transferred to the newborn through the placenta or the breastmilk building up the neonatal immunity. However, the exclusion from clinical trials created a great deficiency of evidence regarding the vaccination in this high-risk population resulting in their reluctance.
2019冠状病毒病(新冠肺炎)已迅速成为一种全球大流行,其发病率和死亡率都是毁灭性的。孕妇似乎更容易患上严重疾病,并遭受不良妊娠结局。缓解这一流行病的唯一解决方案是通过大规模疫苗接种进行预防。我们报告了一篇基于当前文献的综述,该综述涉及抗COVID-19疫苗在妊娠期的有效性和安全性证据,以帮助女性在怀孕或哺乳期决定是否接种疫苗。到目前为止,研究还没有发现与母体或胎儿结局有关的结果,并且显示mRNA疫苗在非妊娠人群中的效率相似。此外,疫苗接种产生的抗严重急性呼吸系统综合征冠状病毒2型抗体似乎通过胎盘或母乳转移到新生儿身上,从而增强新生儿免疫力。然而,临床试验被排除在外,导致这一高危人群的疫苗接种证据严重不足,导致他们不愿接种。
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引用次数: 0
期刊
Revista Romana de Boli Infectioase
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