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Central artery pulse pressure, not central arterial stiffness impact on all-cause mortality in patients with viral pneumonia infection. 影响病毒性肺炎感染者全因死亡率的是中心动脉脉压,而非中心动脉僵化。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-21 DOI: 10.1186/s12879-024-10091-y
Lin Jin, Jianxiong Chen, Lingheng Wu, Mengjiao Zhang, Xiaobo Tang, Cuiqin Shen, Jiali Sun, Lianfang Du, Xifu Wang, Zhaojun Li

Objectives: COVID-19 viral pneumonia can result in increased arterial stiffness, along with cardiac and systemic inflammatory responses. This study aimed to investigate the association between arterial stiffness, inflammation severity, and all-cause mortality in patients with COVID-19.

Methods: In this study, anthropometric data, pneumonia infection severity, and blood tests were analyzed. Arterial stiffness was assessed using the non-invasive assessment indices, including arterial velocity pulse index (AVI) and central arterial pulse pressure (CAPP). Infection volumes and percentages for the whole lungs, most lobes, and most segments were extracted from CT images using artificial intelligence-based quantitative analysis software. The relationship between arterial stiffness, central hemodynamics, and all-cause mortality was investigated.

Results: In multivariable Cox regression analysis, high CAPP was significantly associated with all-cause mortality (hazard ratio: 0.263, 95% CI, 0.073-0.945, p = 0.041). Whole lung infection percentages were independently associated with high CAPP, with an area under the curve (AUC) of 0.662 and a specificity of 89.09%.

Conclusions: High CAPP, but not high AVI, demonstrated independent prognostic value for all-cause mortality in patients due to COVID-19 pneumonia infection. Evaluating this parameter could help in risk assessment and improve diagnostic and therapeutic strategies in viral pneumonia infections.

目的:COVID-19 病毒性肺炎可导致动脉僵硬度增加,并伴有心脏和全身炎症反应。本研究旨在探讨 COVID-19 患者动脉僵化、炎症严重程度和全因死亡率之间的关联:本研究分析了人体测量数据、肺炎感染严重程度和血液检测结果。动脉僵化采用无创评估指数进行评估,包括动脉速度脉搏指数(AVI)和中心动脉脉搏压(CAPP)。使用基于人工智能的定量分析软件从 CT 图像中提取了全肺、大部分肺叶和大部分肺段的感染体积和百分比。研究了动脉僵化、中心血流动力学和全因死亡率之间的关系:在多变量 Cox 回归分析中,高 CAPP 与全因死亡率显著相关(危险比:0.263,95% CI,0.073-0.945,p = 0.041)。全肺感染百分比与高CAPP独立相关,曲线下面积(AUC)为0.662,特异性为89.09%:高 CAPP(而非高 AVI)对 COVID-19 肺炎感染患者的全因死亡率具有独立的预后价值。评估该参数有助于风险评估,并改善病毒性肺炎感染的诊断和治疗策略。
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引用次数: 0
Prediction of lumpy skin disease virus using customized CBAM-DenseNet-attention model. 使用定制的 CBAM-DenseNet-attention 模型预测块状皮肤病病毒。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-19 DOI: 10.1186/s12879-024-10032-9
Muhammad Mujahid, Tahir Khurshaid, Mejdl Safran, Sultan Alfarhood, Imran Ashraf

Lumpy skin disease virus (LSDV) is an extremely infectious, viral, and chronic skin disease that is caused by the Capripox virus. This viral disease is predominantly found in cows. Mosquitoes and ticks are the primary transmitters for the spread of this virus. Recently, LSDV has been rapidly spreading all over the world, especially in several areas of Pakistan, India, and Iran. Thousands of cows have died due to this infectious virus in Pakistan and early detection of LSDV is needed to avoid further loss. The prediction and classification of LSDV are hindered by the lack of publicly available datasets. Despite a few studies using LSDV datasets, such datasets are often small, which may lead to model overfitting. In this regard, we collect the dataset from several online sources, as well as, collecting images from veterinary farms in different areas of Pakistan. Deep learning has been widely used in the medical field for disease detection and classification. Therefore, this study leverages DenseNet deep learning models for LSDV detection and classification. Experiments are performed using VGG-16, ResNet-50, MobileNet-V2, custom-designed convolutional neural network, and Inception-V3. The DenseNet architecture presents a Convolutional Block Attention Module (CBAM) and Spatial Attention (SA) for the prediction and classification of LSD. Results demonstrate that a 99.11% accuracy can be obtained on the augmented dataset while a 94.23% accuracy can be achieved with the original dataset for chicken pox, monkey pox, and LSDV. Comparison with state-of-the-art studies corroborates the superior performance of the proposed model.

结节性皮肤病病毒(LSDV)是一种传染性极强的病毒性慢性皮肤病,由 Capripox 病毒引起。这种病毒性疾病主要发生在奶牛身上。蚊子和蜱虫是这种病毒的主要传播者。最近,LSDV 在全球迅速蔓延,尤其是在巴基斯坦、印度和伊朗的一些地区。在巴基斯坦,数以千计的奶牛死于这种传染性病毒,因此需要及早检测 LSDV 以避免更大的损失。由于缺乏公开可用的数据集,LSDV 的预测和分类工作受到了阻碍。尽管有一些研究使用了 LSDV 数据集,但这些数据集通常较小,可能会导致模型过度拟合。为此,我们从多个在线来源收集数据集,并从巴基斯坦不同地区的兽医养殖场收集图像。深度学习已广泛应用于医疗领域的疾病检测和分类。因此,本研究利用 DenseNet 深度学习模型进行 LSDV 检测和分类。实验使用 VGG-16、ResNet-50、MobileNet-V2、定制设计的卷积神经网络和 Inception-V3 进行。DenseNet 架构采用了卷积块注意模块(CBAM)和空间注意模块(SA),用于 LSD 的预测和分类。结果表明,增强数据集的准确率为 99.11%,而原始数据集对水痘、猴痘和 LSDV 的准确率为 94.23%。与最先进研究的比较证实了所提出模型的卓越性能。
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引用次数: 0
Unraveling Cordia myxa's anti-malarial potential: integrative insights from network pharmacology, molecular modeling, and machine learning. 揭示 Cordia myxa 的抗疟潜力:从网络药理学、分子建模和机器学习中获得的综合见解。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-19 DOI: 10.1186/s12879-024-10078-9
Yufei Miao, Wenkang Liu, Sarah Mohammed Saeed Alsallameh, Norah A Albekairi, Ziyad Tariq Muhseen, Christopher J Butch

Malaria is a potentially fatal infective illness caused due to parasites that belong to the Plasmodium genus, which are transferred to humans with the help of the stings of affected female Anopheles mosquitoes, and it persists as a serious public wellness problem worldwide. Cordia myxa is a medicinal plant that possesses various medicinal characteristics like antimicrobial, anti-inflammation, antioxidant, and antidiabetic activities, which makes it an important natural resource for the therapy of different maladies in traditional medicine. In this investigation, a certain network pharmacology method has been utilized to identify the potent active components, possible targets as well as signaling pathways present in C. myxa in relation to malaria therapy. The active compounds were submitted to molecular docking approaches to validate their successful activity against the potential targets. The study concluded that three constituents named cosmosiin, stigmastanol, robinetin, and quercetin were highly active and could regulate the expression of Interleukin 6 (IL6) and Cysteine-aspartic acid protease 3 (CASP3), which may act as a potential therapeutic target for malaria treatment. These analyses are validated by molecular dynamics simulation which reflects on the overall structural stability of the intermolecular conformation and interactions. These results can also be witnessed in simulation-based trajectories binding free energies, which concluded the significant role of electrostatic and van der Waals energies in total intermolecular interactions. Finally, we utilized machine learning to predict the anti-malarial activity of C. myxa compounds, comparing them with approved drugs. Using the Chemprop model and MAIP predictions, we assessed ten compounds, revealing their potential as lead anti-malarial agents. This study establishes a groundwork for comprehending the function of the anti-malaria action of C. myxa.

疟疾是由疟原虫属寄生虫引起的一种可能致命的传染性疾病,这种寄生虫借助受感染的雌性按蚊的螫针传播给人类,一直是全球严重的公共健康问题。Cordia myxa 是一种药用植物,具有抗菌、消炎、抗氧化和抗糖尿病等多种药用特性,是传统医学治疗各种疾病的重要天然资源。在这项研究中,我们采用了某种网络药理学方法来确定 C. myxa 中与疟疾治疗有关的强效活性成分、可能的靶点以及信号通路。活性化合物被提交到分子对接方法中,以验证它们对潜在靶点的成功活性。研究得出的结论是,名为 cosmosiin、stigmastanol、robinetin 和 quercetin 的三种成分具有很高的活性,可以调节白细胞介素 6(IL6)和半胱氨酸-天冬氨酸蛋白酶 3(CASP3)的表达,而后者可能是疟疾治疗的潜在靶点。分子动力学模拟验证了这些分析,反映了分子间构象和相互作用的整体结构稳定性。这些结果也可以在基于模拟的轨迹结合自由能中得到证实,从而得出结论:静电能和范德华能在整个分子间相互作用中发挥了重要作用。最后,我们利用机器学习预测了 C. myxa 化合物的抗疟疾活性,并将其与已批准的药物进行了比较。利用 Chemprop 模型和 MAIP 预测,我们评估了十种化合物,揭示了它们作为抗疟疾先导药物的潜力。这项研究为理解 myxa 抗疟疾作用的功能奠定了基础。
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引用次数: 0
Clinical characteristics of HIV-associated tracheobronchial Talaromyces marneffei infection in seven patients in Guangxi, China. 中国广西七名患者感染 HIV 相关气管支气管塔拉罗米菌的临床特征。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-19 DOI: 10.1186/s12879-024-10046-3
Mianluan Pan, Hongjie Wu, Hairong Lin, Zhimin Peng, Jie Huang, Jianquan Zhang

Objectives: Tracheobronchial Talaromyces marneffei (T. marneffei) infections among HIV-infected patients are rare. To improve understanding, we analyzed the clinical features, immune mechanisms, treatment, and prognosis of these patients.

Methods: We collected clinical information from HIV-positive patients with talaromycosis admitted to the Fourth People's Hospital of Nanning from January 2015 to June 2022. Patients who presented with culture and/or histopathological proof of tracheobronchial T. marneffei infection were included.

Results: A total of 108 patients with respiratory infections who underwent bronchoscopy were enrolled. Seven patients with tracheobronchial T. marneffei infection, all of whom were men with a median age of 48 years (range 39-50 years), were analyzed. Cough, sputum, fever, and weight loss were the most common symptoms. The total white blood cell count was normal or decreased, and all lymphocyte counts were decreased. All patients had reduced CD4+ T-cell counts, with values less than 50 cells/µL. The chest CT imaging signs included patchy signals or large areas of exudation, bronchial stenosis and occlusion. This was different from the lack of bronchial involvement. Endoscopically, the trachea and bronchial mucosa showed congestion, edema, surface attachment, nodules, lumen stenosis, obstruction, etc. T. marneffei spores were found via bronchial mucosal pathology in all 7 patients. Five patients were initially treated with intravenous infusion of amphotericin B for 2 weeks, followed by oral itraconazole capsules (200 mg) twice daily, and two patients were initially treated with itraconazole. Six patients were remission, and 1 died.

Conclusions: The clinical features of trachea invasion and nontracheal invasion are not unique, but chest CT reveals manifestations such as masses, solid shadows, and bronchial stenosis/obstruction. Bronchoscopy should be performed if possible, and the presence or absence of trachea T. marneffei infection should be confirmed. Antiviral therapy combined with antifungal therapy can improve patient prognosis.

目的:艾滋病毒感染者中气管支气管马内菲氏菌(Talaromyces marneffei,T. marneffei)感染非常罕见。为了加深了解,我们对这些患者的临床特征、免疫机制、治疗和预后进行了分析:我们收集了2015年1月至2022年6月南宁市第四人民医院收治的HIV阳性滑石霉菌病患者的临床资料。方法:收集南宁市第四人民医院从2015年1月至2022年6月收治的HIV阳性滑液菌病患者的临床资料,纳入经培养和/或组织病理学证明感染气管支气管滑液菌的患者:结果:共纳入108名接受支气管镜检查的呼吸道感染患者。结果:共有 108 名呼吸道感染患者接受了支气管镜检查,其中 7 名患者患有气管支气管 T. marneffei 感染,均为男性,中位年龄为 48 岁(39-50 岁)。咳嗽、咳痰、发烧和体重减轻是最常见的症状。白细胞总数正常或减少,所有淋巴细胞计数均下降。所有患者的 CD4+ T 细胞计数均下降,数值低于 50 cells/µL。胸部 CT 成像征象包括斑片状信号或大面积渗出、支气管狭窄和闭塞。这与支气管未受累不同。内窥镜检查显示,气管和支气管粘膜充血、水肿、表面附着物、结节、管腔狭窄、阻塞等。所有 7 名患者的支气管粘膜病理检查均发现了 T. marneffei 孢子。5 名患者最初接受两性霉素 B 静脉输注治疗 2 周,随后口服伊曲康唑胶囊(200 毫克),每日 2 次;2 名患者最初接受伊曲康唑治疗。6名患者病情缓解,1名患者死亡:气管侵犯和非气管侵犯的临床特征并不独特,但胸部 CT 可显示肿块、实性阴影和支气管狭窄/阻塞等表现。如有可能,应进行支气管镜检查,并确认是否存在气管 T. marneffei 感染。抗病毒治疗结合抗真菌治疗可改善患者的预后。
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引用次数: 0
Epidemiology of pneumococcal meningitis in sentinel hospital surveillance of Viet Nam, 2015-2018. 2015-2018 年越南哨点医院监测的肺炎球菌脑膜炎流行病学。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1186/s12879-024-10065-0
Dac Trung Nguyen, Thi Loan Nguyen, Allison Olmsted, Thi Hong Duong, Hong Mai Hoang, Lien Huong Nguyen, Mahamoudou Ouattara, Jennifer Milucky, Fernanda C Lessa, Thi Trang Dai Vo, Van Thanh Phan, Thi Hien Anh Nguyen, Nguyen My Nguyet Pham, Huu Khanh Truong, Thi Quynh Tram Phan, Thi Hong Hoa Bui, Van Khang Pham, Makiko Iijima, Binh Le, Lindsay Kim, Jennifer Loo Farrar

Background: Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), and Neisseria meningitidis (N. meningitidis) are leading causes of childhood bacterial meningitis and preventable by vaccines. The aim of this hospital-based sentinel surveillance is to describe the epidemiological characteristics of pneumococcal meningitis, including disease burden, and to provide baseline data on pneumococcal serotype distribution to support decision making for pneumococcal conjugate vaccine (PCV) introduction in Vietnam.

Methods: Surveillance for probable bacterial meningitis in children 1-59 months of age is conducted in three tertiary level pediatric hospitals: one in Hanoi and two in Ho Chi Minh City. Cerebrospinal fluid (CSF) specimens were collected via lumbar puncture from children with suspected meningitis. Specimens were transferred immediately to the laboratory department of the respective hospital for cytology, biochemistry, and microbiology testing, including culture. PCR testing was conducted on CSF specimens for bacterial detection (S. pneumoniae, H. influenzae, and N. meningitidis) and pneumococcal serotyping.

Results: During 2015-2018, a total of 1,803 children with probable bacterial meningitis were detected; 1,780 had CSF specimens available for testing. Of 245 laboratory-confirmed positive cases, the majority were caused by S. pneumoniae (229,93.5%). Of those with S. pneumoniae detected, over 70% were caused by serotypes included in currently available PCV products; serotypes 6 A/6B (27.1%), 14 (19.7%), and 23 F (16.2%) were the most common serotypes. Children with laboratory-confirmed pneumococcal meningitis were more likely to live in Hanoi (p < 0.0001) and children 12-23 months of age were at greater odds (OR = 1.65, 95% CI: 1.11, 2.43; p = 0.006) of having confirmed pneumococcal meningitis compared to children < 12 months of age when compared to those without laboratory-confirmed bacterial meningitis. Additionally, children with confirmed pneumococcal meningitis were more likely to exhibit signs and symptoms consistent with clinical meningitis compared to negative laboratory-confirmed meningitis cases (p < 0.0001) and had a greater odds of death (OR = 6.18, 95% CI: 2.98, 12.86; p < 0.0001).

Conclusions: Pneumococcal meningitis contributes to a large burden of bacterial meningitis in Vietnamese children. A large proportion are caused by serotypes covered by PCVs currently available. Introduction of PCV into the routine immunization program could reduce the burden of pneumococcal meningitis in Viet Nam.

背景:肺炎链球菌(S. pneumoniae)、流感嗜血杆菌(H. influenzae)和脑膜炎奈瑟菌(N. meningitidis)是儿童细菌性脑膜炎的主要病因,可通过疫苗预防。这项基于医院的哨点监测旨在描述肺炎球菌脑膜炎的流行病学特征,包括疾病负担,并提供肺炎球菌血清型分布的基线数据,为越南引入肺炎球菌结合疫苗 (PCV) 提供决策支持:方法:在三家三级儿科医院对 1-59 个月大的儿童可能患细菌性脑膜炎的情况进行监测:一家在河内,两家在胡志明市。通过腰椎穿刺采集疑似脑膜炎患儿的脑脊液(CSF)标本。标本被立即转移到相应医院的实验室部门进行细胞学、生物化学和微生物学检测,包括培养。对 CSF 标本进行 PCR 检测,以检测细菌(肺炎双球菌、流感嗜血杆菌和脑膜炎双球菌)和肺炎球菌血清型:2015-2018年期间,共发现1803名可能患有细菌性脑膜炎的儿童;1780名儿童的脑脊液标本可供检测。在 245 例实验室确诊的阳性病例中,大多数由肺炎链球菌引起(229 例,占 93.5%)。在检测出肺炎双球菌的病例中,超过 70% 是由目前可用的 PCV 产品中的血清型引起的;最常见的血清型为 6 A/6B 型(27.1%)、14 型(19.7%)和 23 F 型(16.2%)。经实验室确诊患有肺炎球菌脑膜炎的儿童更有可能生活在河内(p 结论:河内是肺炎球菌脑膜炎的高发区:肺炎球菌脑膜炎是越南儿童细菌性脑膜炎的主要病因。其中很大一部分是由现有 PCV 所涵盖的血清型引起的。将 PCV 纳入常规免疫计划可减轻越南肺炎球菌脑膜炎的负担。
{"title":"Epidemiology of pneumococcal meningitis in sentinel hospital surveillance of Viet Nam, 2015-2018.","authors":"Dac Trung Nguyen, Thi Loan Nguyen, Allison Olmsted, Thi Hong Duong, Hong Mai Hoang, Lien Huong Nguyen, Mahamoudou Ouattara, Jennifer Milucky, Fernanda C Lessa, Thi Trang Dai Vo, Van Thanh Phan, Thi Hien Anh Nguyen, Nguyen My Nguyet Pham, Huu Khanh Truong, Thi Quynh Tram Phan, Thi Hong Hoa Bui, Van Khang Pham, Makiko Iijima, Binh Le, Lindsay Kim, Jennifer Loo Farrar","doi":"10.1186/s12879-024-10065-0","DOIUrl":"https://doi.org/10.1186/s12879-024-10065-0","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), and Neisseria meningitidis (N. meningitidis) are leading causes of childhood bacterial meningitis and preventable by vaccines. The aim of this hospital-based sentinel surveillance is to describe the epidemiological characteristics of pneumococcal meningitis, including disease burden, and to provide baseline data on pneumococcal serotype distribution to support decision making for pneumococcal conjugate vaccine (PCV) introduction in Vietnam.</p><p><strong>Methods: </strong>Surveillance for probable bacterial meningitis in children 1-59 months of age is conducted in three tertiary level pediatric hospitals: one in Hanoi and two in Ho Chi Minh City. Cerebrospinal fluid (CSF) specimens were collected via lumbar puncture from children with suspected meningitis. Specimens were transferred immediately to the laboratory department of the respective hospital for cytology, biochemistry, and microbiology testing, including culture. PCR testing was conducted on CSF specimens for bacterial detection (S. pneumoniae, H. influenzae, and N. meningitidis) and pneumococcal serotyping.</p><p><strong>Results: </strong>During 2015-2018, a total of 1,803 children with probable bacterial meningitis were detected; 1,780 had CSF specimens available for testing. Of 245 laboratory-confirmed positive cases, the majority were caused by S. pneumoniae (229,93.5%). Of those with S. pneumoniae detected, over 70% were caused by serotypes included in currently available PCV products; serotypes 6 A/6B (27.1%), 14 (19.7%), and 23 F (16.2%) were the most common serotypes. Children with laboratory-confirmed pneumococcal meningitis were more likely to live in Hanoi (p < 0.0001) and children 12-23 months of age were at greater odds (OR = 1.65, 95% CI: 1.11, 2.43; p = 0.006) of having confirmed pneumococcal meningitis compared to children < 12 months of age when compared to those without laboratory-confirmed bacterial meningitis. Additionally, children with confirmed pneumococcal meningitis were more likely to exhibit signs and symptoms consistent with clinical meningitis compared to negative laboratory-confirmed meningitis cases (p < 0.0001) and had a greater odds of death (OR = 6.18, 95% CI: 2.98, 12.86; p < 0.0001).</p><p><strong>Conclusions: </strong>Pneumococcal meningitis contributes to a large burden of bacterial meningitis in Vietnamese children. A large proportion are caused by serotypes covered by PCVs currently available. Introduction of PCV into the routine immunization program could reduce the burden of pneumococcal meningitis in Viet Nam.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Rate and predictors of loss to follow-up in HIV care in a low-resource setting: analyzing critical risk periods. 在资源匮乏的环境中,艾滋病护理随访损失的比率和预测因素:分析关键风险期。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1186/s12879-024-10089-6
Tamrat Endebu, Girma Taye, Wakgari Deressa

Background: Patient loss-to-follow-up (LTFU) in HIV care is a major challenge, especially in low-resource settings. Although the literature has focused on the total rate at which patients disengage from care, it has not sufficiently examined the specific risk periods during which patients are most likely to disengage from care. By addressing this gap, researchers and healthcare providers can develop more targeted interventions to improve patient engagement in HIV care.

Methods: We conducted a retrospective cohort study on newly enrolled adult HIV patients at seven randomly selected high-volume health facilities in Ethiopia from May 2022 to April 2024. Data analysis was performed using SPSS version 26, with a focus on the incidence rate of LTFU during the critical risk periods. Cumulative hazard analysis was used to compare event distributions, whereas a Poisson regression model was used to identify factors predicting LTFU, with statistical significance set at p < 0.05.

Results: The analysis included 737 individuals newly enrolled in HIV care; 165 participants (22.4%, 95% CI: 19.5-25.2) were LTFU by the end of two years, of which 50.1% occurred within the first 6 months, 29.7% within 7-12 months, and 19.4% from 13 to 24 months on ART. The overall incidence rate of LTFU was 18.3 per 1,000 PMO (95% CI: 15.9-20.6), with rates of 167.7 in the first 6 months, 55.4 in 7-12 months, and 18.1 in 13-24 months. Incomplete addresses lacking a phone number or location information (IRR: 1.61; 95% CI: 1.14, 2.27) and poor adherence (IRR: 1.78; 95% CI: 1.28, 2.48) were factors predicting the incidence rate of LTFU.

Conclusion: LTFU peaked in the first 6 months, accounting for approximately half of total losses, remained elevated from months 7-12, and stabilized after the first year of HIV care and treatment. Address information and adherence were predictors of LTFU. To effectively minimize LTFU, efforts should focus on intensive support during the first six months of care, followed by sustained efforts and monitoring in the next six months. Our findings highlight a critical period for targeted interventions to reduce LTFU in HIV care.

背景:在艾滋病护理过程中,患者失去随访(LTFU)是一项重大挑战,尤其是在资源匮乏的环境中。尽管文献关注的是患者脱离治疗的总比率,但并未充分研究患者最有可能脱离治疗的特定风险期。通过弥补这一不足,研究人员和医疗服务提供者可以制定更有针对性的干预措施,以提高患者参与艾滋病护理的积极性:我们对 2022 年 5 月至 2024 年 4 月期间在埃塞俄比亚随机选取的七家大容量医疗机构中新入院的成年 HIV 患者进行了一项回顾性队列研究。数据分析采用 SPSS 26 版本,重点关注关键风险期的 LTFU 发生率。累积危险分析用于比较事件分布,而泊松回归模型则用于确定预测LTFU的因素,统计显著性以p为标准:分析对象包括 737 名新加入艾滋病治疗的患者;165 名参与者(22.4%,95% CI:19.5-25.2)在两年后出现了 LTFU,其中 50.1% 发生在接受抗逆转录病毒疗法的前 6 个月,29.7% 发生在 7-12 个月,19.4% 发生在接受抗逆转录病毒疗法的 13-24 个月。LTFU的总发生率为18.3%.PMO(95% CI:15.9-20.6),其中前6个月为167.7%.,7-12个月为55.4%.,13-24个月为18.1%.。缺少电话号码或位置信息的不完整地址(IRR:1.61;95% CI:1.14, 2.27)和依从性差(IRR:1.78;95% CI:1.28, 2.48)是预测 LTFU 发生率的因素:结论:LTFU 在前 6 个月达到峰值,约占总损失的一半,在第 7-12 个月仍居高不下,在接受 HIV 护理和治疗的第一年后趋于稳定。地址信息和依从性是预测 LTFU 的因素。要想有效地将 LTFU 降到最低,就应将工作重点放在护理前六个月的强化支持上,然后在接下来的六个月中持续努力并进行监测。我们的研究结果突显了有针对性的干预措施的关键时期,以减少艾滋病护理中的 "LTFU"。
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引用次数: 0
Correction: Long COVID is not the same for everyone: a hierarchical cluster analysis of long COVID symptoms 9 and 12 months after SARS-CoV-2 test. 更正:长 COVID 并非对每个人都一样:SARS-CoV-2 检测后 9 个月和 12 个月长 COVID 症状的分层聚类分析。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1186/s12879-024-10086-9
Marta Moniz, Carolina Ruivinho, Ana Rita Goes, Patrícia Soares, Andreia Leite
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引用次数: 0
Distribution and antifungal susceptibility profiles of Candida species isolated from candidemia patients admitted to Egyptian tertiary hospitals: a cross-sectional study. 从埃及三级医院收治的念珠菌血症患者中分离出的念珠菌种类的分布和抗真菌药敏谱:一项横断面研究。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1186/s12879-024-10007-w
Heba Sherif Abdel Aziz, Dalia Kadry Ismail, Nessma Sayed Ahmed Mohammed, Marwa O Elgendy, Dina M Bassiouny

Background: Candidemia is a widespread threat that can lead to significant complications in healthcare settings.

Objectives: Our study aimed to identify isolates of Candida isolated from blood culture bottles of patients with candidemia and assess their antifungal susceptibility profiles.

Methods: We conducted a cross-sectional study at Cairo University tertiary care hospitals over 16 months including 90 patients. Candida isolates were collected from blood culture bottles, and identified using MALDI-TOF MS technology of VITEK MS PRIME (bioMérieux) with the corresponding database VITEK IVD Database 3.2. followed by antifungal susceptibility testing using VITEK 2 Compact system.

Results: Candida albicans was the most common species isolated from both pediatric and adult patients with percentages of 47.3% and 36.4% respectively, followed by Candida parapsilosis with percentages of 32.6% and 25.0% respectively. Voriconazole showed the highest antifungal activity at 90.9% of isolates in adults and 95.7% in pediatrics, followed by caspofungin and micafungin. The mean hospital stays for adults ranged from 8 to 30 days and from 10 to 42 days in the pediatric group.

Conclusions: C. albicans remains the predominant species isolated from both pediatric and adult candidemia patients, despite a notable increase in other species. C. tropicalis and C. parapsilosis are considered the most common non-albicans Candida (NAC) species. The rise in Candida species other than albicans highlights the urgent need for effective antifungal stewardship programs. Voriconazole exhibited the higher antifungal activity followed by caspofungin and micafungin.

背景:念珠菌血症是一种广泛存在的威胁,可导致医疗机构出现严重并发症:我们的研究旨在鉴定从念珠菌血症患者血培养瓶中分离出的念珠菌,并评估其抗真菌药敏谱:我们在开罗大学三级医院开展了一项横断面研究,历时 16 个月,其中包括 90 名患者。从血培养瓶中收集念珠菌分离物,使用 VITEK MS PRIME(生物梅里埃公司)的 MALDI-TOF MS 技术和相应的数据库 VITEK IVD Database 3.2 进行鉴定,然后使用 VITEK 2 Compact 系统进行抗真菌药敏试验:结果:白色念珠菌是儿童和成人患者中最常见的分离菌种,分别占 47.3% 和 36.4%,其次是副丝状念珠菌,分别占 32.6% 和 25.0%。伏立康唑的抗真菌活性最高,占成人分离株的 90.9%,占儿科分离株的 95.7%,其次是卡泊芬净和米卡芬净。成人患者的平均住院时间为 8 至 30 天,儿童患者的平均住院时间为 10 至 42 天:结论:白念珠菌仍是从儿童和成人念珠菌血症患者中分离出的主要菌种,尽管其他菌种明显增加。热带念珠菌和副丝状念珠菌被认为是最常见的非白色念珠菌(NAC)。白念珠菌以外的念珠菌种类的增加凸显了对有效抗真菌管理计划的迫切需求。伏立康唑的抗真菌活性较高,其次是卡泊芬净和米卡芬净。
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引用次数: 0
Clinical characteristics of pregnant women with COVID-19 and infection outcomes in one of the largest cities in the Brazilian Amazon. 巴西亚马逊地区最大城市之一感染 COVID-19 孕妇的临床特征和感染结果。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1186/s12879-024-09982-x
Ana Paula Figueiredo de Montalvão França, Jenephy Thalita Rosa Paixão, Ricardo Roberto de Souza Fonseca, Rogério Valois Laurentino, Luana Gabriella Figueiredo de Montalvão Leite, Amanda Souza França Veras, Francisco Jordano da Silva Feitosa Ribeiro, Pablo Fabiano Moura das Neves, Luís Fábio Magno Falcão, Ana Carla Figueiredo de Montalvão Serrão, Aldemir Branco Oliveira-Filho, Luiz Fernando Almeida Machado

Background: Pregnancy can be a risk factor for the development of more severe COVID-19 with a possible increase in the risk of complications during pregnancy/birth and adverse neonatal outcomes. This study aimed to describe and analyze the clinical and epidemiological aspects of SARS-CoV-2 infection in women in the perinatal period attended in the city of Belém, northern region of Brazil.

Methods: This is a clinical, observational, analytical, and cross-sectional study with a quantitative approach, conducted at the Santa Casa de Misericórdia do Pará Foundation (FSCMPA). It included 230 pregnant women hospitalized at FSCMPA with a positive SARS-CoV-2 RT-PCR molecular test between April 2020 and June 2022. Clinical and epidemiological information (origin, gestational age, prenatal care, comorbidities, birth complications, and chest tomography) were obtained from medical records, and correlation was made between the types of cases (mild, moderate, and severe) and maternal outcome. The chi-square test and G test were used to assess the possibility of association between variables.

Results: Evidence of association was observed between the severity of COVID-19 and the following parameters: gestational age, specific pregnancy comorbidities, baby and maternal death, birth complications, and prematurity. Dyspnea, headache, anosmia, odynophagia, diarrhea, and chest pain were the symptoms most related to disease aggravation. The maternal mortality rate in the study was 8.7%.

Conclusion: Specific pregnancy-related and pre-existing comorbidities associated with SARS-CoV-2 infection directly contribute to the worsening clinical condition, leading to complications such as prematurity, fetal, and maternal death.

背景:妊娠可能是感染更严重的 COVID-19 的危险因素,可能会增加妊娠/分娩并发症和新生儿不良结局的风险。本研究旨在描述和分析巴西北部贝伦市围产期妇女感染 SARS-CoV-2 的临床和流行病学情况:这是一项临床、观察、分析和横断面研究,采用定量方法,在巴拉圣母之家基金会(Santa Casa de Misericórdia do Pará,FSCMPA)进行。研究对象包括 2020 年 4 月至 2022 年 6 月期间在巴拉圣母之家基金会(FSCMPA)住院且 SARS-CoV-2 RT-PCR 分子检测呈阳性的 230 名孕妇。研究人员从病历中获取了临床和流行病学信息(籍贯、孕龄、产前护理、合并症、分娩并发症和胸部断层扫描),并将病例类型(轻度、中度和重度)与产妇结局进行了相关性分析。采用卡方检验(chi-square test)和G检验(G test)来评估变量之间存在关联的可能性:结果:COVID-19 的严重程度与下列参数之间存在关联:胎龄、特定的妊娠合并症、婴儿和产妇死亡、出生并发症和早产。呼吸困难、头痛、嗅觉障碍、吞咽困难、腹泻和胸痛是与病情加重最相关的症状。该研究的孕产妇死亡率为 8.7%:结论:与 SARS-CoV-2 感染相关的特定妊娠合并症和原有合并症直接导致临床状况恶化,导致早产、胎儿和产妇死亡等并发症。
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引用次数: 0
A qualitative study of Chicago gay men and the Mpox outbreak of 2022 in the context of HIV/AIDS, PrEP, and COVID-19. 以艾滋病毒/艾滋病、PrEP 和 COVID-19 为背景,对芝加哥男同性恋和 2022 年 Mpox 疫情爆发进行定性研究。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-10-18 DOI: 10.1186/s12879-024-09491-x
Daniel Hughes, Jeffrey Ai, Parsia Vazirnia, Tyson McLeish, Chandler Krajco, Richard Moraga, Katherine Quinn

During the 2022 mpox outbreak, our study conducted 30 interviews with a recruited sample of Chicago gay men (age 18+) during June-September to investigate their experiences of mpox, HIV/AIDS, and COVID-19. Participants were interviewed with a semi-structured guide about gay sexual identity and social experiences; HIV/AIDS, ART, and PrEP; and COVID-19 behaviors and vaccination. All 30 interview respondents had been fully vaccinated for COVID-19 and expressed minimal COVID-19 vaccine hesitancy. All the men living with HIV in our study were on ART with HIV well controlled. A majority of HIV- participants (70%) were on PrEP, with participants universally aware of PrEP benefits. Additionally, most participants had already received at least one shot of the Jynneos mpox vaccine, with many interviewees enduring long lines, sometimes at multiple locations, before vaccination in primarily gay social spaces. These Chicago gay men demonstrated widespread enthusiasm for mpox vaccination as a disease prevention strategy and most of them had already been vaccinated despite significant barriers. The enthusiasm of the participants in our study emerged within a medical landscape shaped by both COVID-19 vaccination and HIV/AIDS-related health interventions including ART and PrEP, which may have helped instill increased medical trust among this population. Our study suggests that out urban gay men may comprise a distinctive minority population with increased medical trust due to specific social, sexual, and historical experiences.

在 2022 年麻疹疫情爆发期间,我们的研究在 6 月至 9 月间对招募的芝加哥男同性恋样本(18 岁以上)进行了 30 次访谈,调查他们对麻疹、艾滋病和 COVID-19 的经历。我们采用半结构化指南对受访者进行了访谈,内容包括男同性恋的性身份和社会经历;艾滋病病毒/艾滋病、抗逆转录病毒疗法和 PrEP;以及 COVID-19 行为和疫苗接种。所有 30 位受访者都已接种了 COVID-19 疫苗,对 COVID-19 疫苗的犹豫程度极低。在我们的研究中,所有感染艾滋病毒的男性都在接受抗逆转录病毒疗法,艾滋病毒得到了很好的控制。大多数感染艾滋病毒的参与者(70%)都在接受 PrEP 治疗,参与者普遍了解 PrEP 的益处。此外,大多数参与者已经至少接种过一针 Jynneos mpox 疫苗,许多受访者在接种疫苗前都排起了长队,有时是在多个地点,接种地点主要是男同性恋社交场所。这些芝加哥男同性恋者表现出了对接种麻腮风疫苗这一疾病预防策略的广泛热情,尽管存在很大的障碍,但他们中的大多数人已经接种了疫苗。在我们的研究中,COVID-19 疫苗接种以及包括抗逆转录病毒疗法和 PrEP 在内的艾滋病毒/艾滋病相关健康干预措施所形成的医疗环境中,参与者的热情高涨,这可能有助于在这一人群中灌输更多的医疗信任。我们的研究表明,由于特殊的社会、性和历史经历,城市外流男同性恋可能是一个独特的少数群体,他们对医疗的信任度更高。
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引用次数: 0
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BMC Infectious Diseases
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