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
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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Background 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. Methods 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
BACKGROUND Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. METHODS AND FINDINGS We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010).
The nature of influenza viral shedding during naturally acquired infection is not well understood.|A cohort study was conducted in Hutterite colonies in Alberta, Canada. Flocked nasal swabs were collected during 3 influenza seasons (2007-2008 to 2009-2010) from both symptomatic and asymptomatic individuals infected with influenza. Samples were tested by real-time reverse-transcription polymerase chain reaction for influenza A and influenza B, and the viral load (VL) was determined for influenza A positive samples.|Eight hundred thirty-nine participants were included in the cohort; 25% (208) tested positive for influenza viruses. They experienced 238 episodes of viral shedding, of which 23 (10%) were not accompanied by symptoms. For seasonal and pandemic H1N1, VL peaked at or before onset of acute respiratory infection. For H3N2, VL peaked 2 days after the onset of acute respiratory infection, which corresponded to peaks in systemic and respiratory symptom scores. Although the duration
We assessed prevalences of seven sexually transmitted infections (STIs) in Peru, stratified by risk behaviours, to help to define care and prevention priorities.|In a 2002 household-based survey of the general population, we enrolled randomly selected 18-29-year-old residents of 24 cities with populations greater than 50 000 people. We then surveyed female sex workers (FSWs) in these cities. We gathered data for sexual behaviour; vaginal specimens or urine for nucleic acid amplification tests for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; and blood for serological tests for syphilis, HIV, and (in subsamples) herpes simplex virus 2 (HSV2) and human T-lymphotropic virus. This study is a registered component of the PREVEN trial, number ISRCTN43722548.|15 261 individuals from the general population and 4485 FSWs agreed to participate in our survey. Overall prevalence of infection with HSV2, weighted for city size, was 135% in men, 136% in women, and 606%
Chlamydia trachomatis (CT) and Herpes simplex virus type 2 (HSV-2) genital infections are among the more frequent sexually transmissible infections with different prevalence by age, populations and geographical areas. Both are widespread, have an asymptomatic latent stage detectable only by laboratory and can have serious consequences such as tubal infertility and neonatal herpes. The direct isolation of CT in cervical or urethral discharge through Nucleic Acid Amplification Test (NAATs) allows to detect and to treat the infection with effective antibiotic medication. The screening of all women younger than 25 year old showed to be effective in reducing tubal complications but not in decreasing the incidence of the infection in the general population. Only a proactive screening of younger women, repeated yearly and associated with an effective partner notification could achieve a decrease of the incidence rate in the general population. The detection of type specific herpetic
Pregnant women were at increased risk for serious outcomes of 2009 pandemicinfluenza A virus subtype H1N1 (influenza A[H1N1]pdm09) infection, but little is known about the overall impact of the pandemic on neonatal and maternal outcomes.|We identified live births that occurred from 1 July 2008 through 31 May 2010 in 5 Kaiser Permanente regions. Pregnant women were considered to have influenza if they had a positive result of a laboratory test for influenza virus or if they received a diagnosis of influenza during a period in which seasonal influenza virus or A(H1N1)pdm09 was the predominant circulating virus.|There were 111 158 births from 109 015 pregnancies involving 107 889 mothers; 368 pregnant women (0.3%) received a diagnosis of influenza due to seasonal virus, and 959 (0.9%) received a diagnosis of influenza due to A(H1N1)pdm09; 107 688 did not receive an influenza diagnosis. Pregnant women with influenza due to A(H1N1)pdm09 were more likely than women with seasonal influenza
The objective of this review is to provide updated information on the clinical spectrum and natural history of human influenza, including risk factors for severe disease, and to identify the knowledge gap in this area.|We searched the MEDLINE database of the recent literature for the period January 2009 to August 17, 2011 with regard to the abovementioned aspects of human influenza, focusing on A(H1N1)pdm09 and seasonal influenza.|The clinical spectrum and outcomes of cases of A(H1N1)pdm09 influenza have been mild and rather indistinguishable from those of seasonal influenza. Sporadic cases covering a wide range of neurological complications have been reported. Underlying predisposing conditions considered to be high-risk for A(H1N1)pdm09 infections are generally similar to those of seasonal influenza, but with two additional risk groups: pregnant women and the morbidly obese. Co-infections with bacteria and D222/N variants or 225G substitution of the viral genome have also been
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 »