To the Editor: It has been reported that dengue is known as the most frequent human arboviral infection in the world, with 50 million cases per year and 2.5-to-3 million people at risk of contamination, estimated by OMS.1 Co-circulation of the four types of dengue viruses and expansion of the dengue epidemic gave rise to infection enhancement and a big expansion of clinical aspects of the d
To the Editor: Linezolid is an antibiotic approved for use in cases of infection by highly-resistant bacteria. It has weak activity as an inhibitor of monoamine oxidase.1 It was reported in 2001 to be associated with a case of serotonin syndrome.2 The association of linezolid with serotonin syndrome has been replicated, and it is now accepted pr
The effects of RU-486, a glucocorticoid antagonist, on HIV infection and replication in depressed and nondepressed women were studied using ex vivo models of HIV infection. RU-486 treatment of cells decreased HIV reverse transcriptase activity of monocyte-derived macrophages in a model of acute infectivity. RU-486 also decreased HIV viral replication in the chronically-infected T-cell line ACH-2, but not in the promonocyte cell line U1
Currently, human papillomavirus (HPV) research focuses on HPV infection in adults and sexual transmission. Data on HPV infection in children are slowly becoming available. It is a matter of debate whether mother-to-child transmission of HP
The goal of this study was to compare transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) for the diagnosis of cardiac devicerelated endocarditis (CDI).
The diagnosis of infective endocarditis (IE) was established by using the modified Duke criteria based mainly on echocardiography and blood culture results. No previous studies have compared ICE with TEE for the diagno
(MedPage Today) -- Short-term estrogen therapy induced cellular changes in urothelium consistent with improved ability to fight off urinary tract infection, results from clinical and preclinical studies suggested.
AbstractObjective To evaluate the effect of initial low energy permissive underfeeding (trophic feeding) versus full energy enteral feeding (full feeding) on physical function and secondary outcomes in patients with acute lung injury.Design Prospective longitudinal follow-up evaluation of the NHLBI ARDS Clinical Trials Networks EDEN trialSetting 41hospitals in the United States.Participants 525 patients with acute lung injury.Interventions Randomised assignment to trophic or full feeding fo
A cold mist humidifier in a nursery caused the first outbreak of nosocomial Legionellosis in term neonates. Legionella pneumophila serogroups 3 and 1 infected 28% of exposed neonates causing severe pneumonia or milder atypical symptoms, conferring a 33% overall mortality.
Pneumonia is most problematic for children in developing countries. In 2010, Brazil introduced a 10-valent pneumococcal conjugate vaccine (PCV10) to its National Immunization Program. To assess the vaccines effectiveness for preventing pneumonia, we analyzed rates of hospitalization among children 224 months of age who had pneumonia from all causes from January 2005 through August 2011. We used data from the National Hospitalization Information System to conduct an interrupted time-series analysis f
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The intravenous (IV) route is the standard way to administer abciximab to patients during percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI), but pharmacokinetic principles predict that the intracoronary (IC) route would be better. Because of the short half-life of abciximab and its avid binding to multiple integrin types during the first pass through the systemic circulation, less drug may reach exposed IIb/IIIa epitopes on activ
Background: Acute otitis media (AOM) occurs as a complication of viral upper respiratory tract infections in young children. AOM and respiratory viruses both display seasonal variation. Our objective was to examine the temporal association between circulating
Background: There is scarce information about changes in serotypes and clonal types of Streptococcus pneumoniae causing acute otitis media (AOM) in recent years, particularly in European countries. Methods: Pneumococcal serotypes and clones from S. pneumonia
During the 2009 influenza A (H1N1) pandemic, pregnant women were at risk for severe influenza illness. This concern was complicated by questions about vaccine safety in pregnant women that were raised by anecdotal reports of fetal deaths after vaccination.|We explored the safety of influenza vaccination of pregnant women by linking Norwegian national registries and medical consultation data to determine influenza diagnosis, vaccination status, birth outcomes, and background information for pregnant women before, during, and after the pandemic. We used Cox regression models to estimate hazard ratios for fetal death, with the gestational day as the time metric and vaccination and pandemic exposure as time-dependent exposure variables.|There were 117,347 eligible pregnancies in Norway from 2009 through 2010. Fetal mortality was 4.9 deaths per 1000 births. During the pandemic, 54% of pregnant women in their second or third trimester were vaccinated. Vaccination during pregnancy
Recent advances in antiretroviral therapy (ART) have drastically improved the quality of life for people with HIVinfection. However, owing to the persistence of latent HIV in the presence of therapy, patients must remain on therapy indefinitely. Currently, the solution to the HIVpandemic rests on the prevention of new infections and many decades of ART for the steadily expanding number of people infected worldwide. ART is costly, requires ongoing medical care, and can have side effects, thereby preventing its universal availability. Therefore, to escape the ironic burdens of therapy, efforts have begun to develop treatments for latent HIVinfection. Current approaches propose either complete eradication of infectionor induction of a state of stringent control over viral replication without ART. This review will discuss these strategies in detail and their potential for clinical development.
We determined the factors associated with hepatitis C (HCV) infection among rural Appalachian drug users.|This study included 394 injection drug users (IDUs) participating in a study of social networks and infectious disease risk in Appalachian Kentucky. Trained staff conducted HCV, HIV, and herpes simplex-2 virus (HSV-2) testing, and an interviewer-administered questionnaire measured self-reported risk behaviors and sociometric network characteristics.|The prevalence of HCV infection was 54.6% among rural IDUs. Lifetime factors independently associated with HCV infection included HSV-2, injecting for 5 or more years, posttraumatic stress disorder, injection of cocaine, and injection of prescription opioids. Recent (past-6-month) correlates of HCV infection included sharing of syringes (adjusted odds ratio = 2.24; 95% confidence interval = 1.32, 3.82) and greater levels of eigenvector centrality in the drug network.|One factor emerged that was potentially unique to rural IDUs: the
The US Army Medical Research Unit-Kenya (USAMRU-K) conducts surveillance for influenza-like illness (ILI) in Kenya. We describe the temporal and geographic progression of A(H1N1)pdm09 as it emerged in Kenya and characterize the outpatient population with A(H1N1)pdm09 infection.|We included patients with ILI aged 2 months to 18 years enrolled during June 2009-August 2010. Respiratory specimens were tested by real-time reverse-transcription polymerase chain reaction for influenza virus. Patients with A(H1N1)pdm09 infection were compared to those with seasonal influenza A virus infection and those with ILI who had no virus or a virus other than influenza virus identified (hereafter, "noninfluenza ILI").|Of 4251 patients with ILI, 193 had laboratory-confirmed A(H1N1)pdm09 infection. The first pandemicinfluenza case detected by USAMRU-K surveillance was in August 2009; peak activity nationwide occurred during October-November 2009. Patients with A(H1N1)pdm09 infection were more likely to
Influenza data gaps in sub-Saharan Africa include incidence, case fatality, seasonal patterns, and associations with prevalent disorders.|Nasopharyngeal samples from children aged <12 years who were admitted to Kilifi District Hospital during 2007-2010 with severe or very severe pneumonia and resided in the local demographic surveillance system were screened for influenza A, B, and C viruses by molecular methods. Outpatient children provided comparative data.|Of 2002 admissions, influenza A virus infection was diagnosed in 3.5% (71), influenza B virus infection, in 0.9% (19); and influenza C virus infection, in 0.8% (11 of 1404 tested). Four patients with influenza died. Among outpatients, 13 of 331 (3.9%) with acute respiratory infection and 1 of 196 without acute respiratory infection were influenza positive. The annual incidence of severe or very severe pneumonia, of influenza (any type), and of influenza A, was 1321, 60, and 43 cases per 100,000 <5 years of age, respectively. Peak
Fibrotic lung injury is often attributed to a myriad of factors, including environmental exposure, age, genetic predisposition, epigenetics, coexisting conditions, acute lung injury, and viral infection. No effective therapies, other than lung transplantation, have proven effective against lung fibrosis. Loss of cellular homeostasis mechanisms in alveolar epithelial type I cells and any inability of type II progenitor cells to resist and repair epithelial injury are indicators that impaired response t
The significance of acute exacerbations in chronic obstructive pulmonary disease (AECOPDs) is increasingly appreciated. AECOPDs result in significant morbidity and mortality and are a significant driver of health care costs. Frequent AECOPDs are associated with poor quality of life and more rapid decline in lung function. As such, reducing their frequency or severity is a key paradigm of COPD therapy. Bronchodilators alone and in combination with inhaled corticosteroids are the current standards of ca
Co-infection with a respiratory virus was not associated with worse outcomes among patients infected during the H1N1 influenza A virus pandemic of 2009. Still, a population-based prospective study shows that non-influenza viruses can help to shape a flu outbreak. More »
In children, bilateral otitis media appears to be only slightly more severe than unilateral, according to a study whose authors offer advice on how to judge severity. And a systematic review offers guidance on when to use antibiotics. More »
Adding a urine analysis to a simple clinical tool can significantly improve the likelihood of detecting serious bacterial infections in young febrile children. The best way also involves gut feelings, temperature, and other factors. More »