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).
Leukocytes participate in the immune control of herpes simplex virus (HSV). Data from HIV coinfections, germ line mutations, and case reports suggest involvement of CD4 T cells and plasmacytoid dendritic cells (pDC). We investigated the relationships between these cells and recurrent genital herpes disease severity in the general population. Circulating CD4 T-cell responses to HSV-2 were measured in specimens from 67 immunocompetent individuals with measured genital lesion and HSV shedding rates. Similarly, pDC number and functional responses to HSV-2 were analyzed in 40 persons. CD4 responses and pDC concentrations and responses ranged as much as 100-fold between persons while displaying moderate within-person consistency over time. No correlations were observed between these immune response parameters and genital HSV-2 severity. Cytomegalovirus (CMV) coinfection was not correlated with differences in HSV-2-specific CD4 T-cell responses. The CD4 T-cell response to HSV-2 was much more
Because mucosal inflammation contributes to colorectal carcinogenesis, we studied the impact of intestinal infections on risk of this malignancy among people with AIDS (PWA). Using the population-based HIV/AIDS Cancer Match, which includes approximately half of all PWA in the United States, the cancer registries ascertained colorectal cancers (ICD-O3 codes C180-C189, C199, C209, and C260). During 4-120 months after AIDS onset, risk of cancer occurring after AIDS-defining intestinal infections (considered as time-dependent exposures) was estimated with hazard ratios (HR) and 95% confidence intervals (CI) calculated by Cox regression. Analyses included cancers overall and by histology and anatomic site. After excluding 118 squamous cell rectal cancers (possible anal cancers), we analyzed 320 incident colorectal cancer cases that occurred among 471,909 PWA. Colorectal cancer risk was marginally elevated following cryptosporidiosis (HR=2.08, 95% CI=0.93-4.70, p=0.08) and mucocutaneous
At the time of the 2009-10 influenzapandemic there was considerable unease about vaccination. Early surveys suggested that the intention to be vaccinated amongst healthcare workers was low.|To determine what influenced vaccination uptake among general practice healthcare workers in Shropshire County Primary Care Trust in the UK.|A cross-sectional survey was distributed to all frontline healthcare workers in Shropshire County's general practices in June 2010. All 45 practices participated. Questionnaires were distributed by practice managers to frontline staff and returned by post. Practices with the lowest return rates were reminded by telephone after 3 months.|205 valid replies were received, giving a response rate of 48.0%. 10.0% reported being infected with the pandemic H1N1 strain by the time they received the questionnaire. 172 (83.9%) respondents reported that they had been vaccinated against H1N1. Influenzainfection prior to vaccination had a negative impact on uptake
Neurologic complications associated with influenzainfection represent rare, but often underappreciated, manifestations of both seasonal and global pandemicinfluenza. Seizures are the most common neurologic complication, occurring as febrile seizures, as exacerbations in patients with epilepsy, or as symptoms of other influenza-induced neurologic disorders. Encephalopathy is the second most common neurologic complication associated with influenza. A wide spectrum of conditions ranging from coma with severe long-term morbidity or mortality and more mild altered mental states that resolve with minimal-to-no sequelae have been reported. Other less common neurologic complications that have been described include stroke, focal neurologic deficits, Guillain-Barr syndrome, acute disseminated encephalomyelitis, and transverse myelitis.
To assess adherence to real-time changes in guidelines for influenza diagnosis and use of oseltamivir during the 2009 influenza A(H1N1) pandemic, we reviewed medical records of patients with confirmed or suspected influenza-like illness (ILI) and those with no viral testing in a large Los Angeles (California, USA) hospital. Of 882 tested patients, 178 had results positive for influenza; 136 of the remaining patients received oseltamivir despite negative or no results. Oseltamivir use was consistent with national recommendations in >90%. Of inpatients, children were less likely than adults to have ILI at testing and to receive oseltamivir if ILI was found. Of outpatients, children were more likely to have positive test results; 20% tested did not have ILI or other influenza signs and symptoms. Twenty-five of 96 test-positive patients and 13 of 19 with lower respiratory tract disease were, inappropriately, not treated. Variations between practice and national recommendations could
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 »