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1.
Bioanalysis ; 16(4): 203-217, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38226838

RESUMO

Background: Clinical dosage of toxic and essential elements in blood is well established and the collection method is still by venipuncture. This method has drawbacks and is not suited for everyone. Volumetric absorptive microsampling (VAMS) has been shown to have advantages over venipuncture. Materials & methods: Using inductively coupled plasma tandem mass spectrometry, a method for quantifying elements in whole blood sampled on VAMS was developed/validated. Method's performance was assessed by comparison with whole blood results. Results: Validation and performance assessment tests tend to show that most of the targeted elements provides accurate and reproducible results comparing to a method of reference. Conclusion: Overall, VAMS presents good preliminary results to eventually become an alternative to venipuncture for blood sampling for some trace elements analysis purposes.


Assuntos
Espectrometria de Massas em Tandem , Oligoelementos , Espectrometria de Massas em Tandem/métodos , Coleta de Amostras Sanguíneas/métodos , Manejo de Espécimes/métodos , Teste em Amostras de Sangue Seco/métodos
2.
Proc Natl Acad Sci U S A ; 120(33): e2301926120, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37552753

RESUMO

Swine are a primary source for the emergence of pandemic influenza A viruses. The intensification of swine production, along with global trade, has amplified the transmission and zoonotic risk of swine influenza A virus (swIAV). Effective surveillance is essential to uncover emerging virus strains; however gaps remain in our understanding of the swIAV genomic landscape in Southeast Asia. More than 4,000 nasal swabs were collected from pigs in Cambodia, yielding 72 IAV-positive samples by RT-qPCR and 45 genomic sequences. We unmasked the cocirculation of multiple lineages of genetically diverse swIAV of pandemic concern. Genomic analyses revealed a novel European avian-like H1N2 swIAV reassortant variant with North American triple reassortant internal genes, that emerged approximately seven years before its first detection in pigs in 2021. Using phylogeographic reconstruction, we identified south central China as the dominant source of swine viruses disseminated to other regions in China and Southeast Asia. We also identified nine distinct swIAV lineages in Cambodia, which diverged from their closest ancestors between two and 15 B.P., indicating significant undetected diversity in the region, including reverse zoonoses of human H1N1/2009 pandemic and H3N2 viruses. A similar period of cryptic circulation of swIAVs occurred in the decades before the H1N1/2009 pandemic. The hidden diversity of swIAV observed here further emphasizes the complex underlying evolutionary processes present in this region, reinforcing the importance of genomic surveillance at the human-swine interface for early warning of disease emergence to avoid future pandemics.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A , Influenza Humana , Infecções por Orthomyxoviridae , Doenças dos Suínos , Suínos , Animais , Humanos , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H1N1/genética , Vírus Reordenados/genética , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/veterinária , Influenza Humana/epidemiologia , Vírus da Influenza A/genética , Genômica , Filogenia , Camboja/epidemiologia , Doenças dos Suínos/epidemiologia
3.
Front Public Health ; 11: 1124016, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37151588

RESUMO

Background: Data on the epidemiology of Streptococcus pneumoniae among influenza-like illness (ILI) cases, particularly in low- and middle-income countries are scarce. This study assessed the prevalence, risk factors and serotype distribution of S. pneumoniae carriage among ILI cases in metropolitan Vientiane, Lao People's Democratic Republic. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced among infants in October 2013. Methods: Active ILI surveillance was conducted through weekly phone calls in an open community-based cohort study (April 2015-February 2019), involving 5,690 participants from 1,142 randomly selected households. Participants reporting ILI symptoms provided a nasopharyngeal swab and answered a questionnaire. S. pneumoniae and serotype pneumococcal-positive samples were screened by Multiplex PCR assays. Chi-squared tests and generalized linear mixed models were used to test for variables associated with pneumococcal positivity. Results: Among 1,621 ILI episodes, 269 (16.6%) tested positive for nasopharyngeal pneumococcal carriage, with the highest prevalence (55.4%) in children under 5 years. Pneumococcal carriage was significantly associated with concurrent detection of Hemophilus influenzae (adjusted odds ratio [aOR]: 6.93; 95% CI: 2.10-22.9) and exposure to household cigarette smoke (aOR: 1.65; 95% CI: 1.07-2.54). PCV13 serotypes accounted for 37.8% of all pneumococcal isolates. Detection of PCV13 serotypes among ILI cases aged under 5 years declined significantly between 2015/16 and 2018/19. Conclusions: Community-based surveillance of S. pneumoniae among ILI cases complement surveillance at healthcare facilities to provide a more complete picture of pneumococcal carriage. Our findings contribute also to the growing body of evidence on the effects of PCV13 introduction on circulating serotypes and their potential replacement.


Assuntos
Influenza Humana , Infecções Pneumocócicas , Lactente , Criança , Humanos , Pré-Escolar , Idoso , Streptococcus pneumoniae , Sorogrupo , Estudos de Coortes , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Laos/epidemiologia , Portador Sadio/epidemiologia , Vacinas Conjugadas/farmacologia
4.
J R Soc Interface ; 20(202): 20220890, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37194271

RESUMO

Contact structure among livestock populations influences the transmission of infectious agents among them. Models simulating realistic contact networks therefore have important applications for generating insights relevant to livestock diseases. This systematic review identifies and compares such models, their applications, data sources and how their validity was assessed. From 52 publications, 37 models were identified comprising seven model frameworks. These included mathematical models (n = 8; including generalized random graphs, scale-free, Watts-Strogatz and spatial models), agent-based models (n = 8), radiation models (n = 1) (collectively, considered 'mechanistic'), gravity models (n = 4), exponential random graph models (n = 9), other forms of statistical model (n = 6) (statistical) and random forests (n = 1) (machine learning). Overall, nearly half of the models were used as inputs for network-based epidemiological models. In all models, edges represented livestock movements, sometimes alongside other forms of contact. Statistical models were often applied to infer factors associated with network formation (n = 12). Mechanistic models were commonly applied to assess the interaction between network structure and disease dissemination (n = 6). Mechanistic, statistical and machine learning models were all applied to generate networks given limited data (n = 13). There was considerable variation in the approaches used for model validation. Finally, we discuss the relative strengths and weaknesses of model frameworks in different use cases.


Assuntos
Gado , Modelos Teóricos , Animais , Modelos Estatísticos , Movimento
5.
PLoS Negl Trop Dis ; 17(5): e0010739, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37216407

RESUMO

Schistosomiasis is a major neglected tropical disease (NTD) affecting both humans and animals. The morbidity and mortality inflicted upon livestock in the Afrotropical region has been largely overlooked, in part due to a lack of validated sensitive and specific tests, which do not require specialist training or equipment to deliver and interpret. As stressed within the recent WHO NTD 2021-2030 Roadmap and Revised Guideline for schistosomiasis, inexpensive, non-invasive, and sensitive diagnostic tests for livestock-use would also facilitate both prevalence mapping and appropriate intervention programmes. The aim of this study was to assess the sensitivity and specificity of the currently available point-of-care circulating cathodic antigen test (POC-CCA), designed for Schistosoma mansoni detection in humans, for the detection of intestinal livestock schistosomiasis caused by Schistosoma bovis and Schistosoma curassoni. POC-CCA, together with the circulating anodic antigen (CAA) test, miracidial hatching technique (MHT), Kato-Katz (KK) and organ and mesentery inspection (for animals from abattoirs only), were applied to samples collected from 195 animals (56 cattle and 139 small ruminants (goats and sheep) from abattoirs and living populations) from Senegal. POC-CCA sensitivity was greater in the S. curassoni-dominated Barkedji livestock, both for cattle (median 81%; 95% credible interval (CrI): 55%-98%) and small ruminants (49%; CrI: 29%-87%), than in the S. bovis-dominated Richard Toll ruminants (cattle: 62%; CrI: 41%-84%; small ruminants: 12%, CrI: 1%-37%). Overall, sensitivity was greater in cattle than in small ruminants. Small ruminants POC-CCA specificity was similar in both locations (91%; CrI: 77%-99%), whilst cattle POC-CCA specificity could not be assessed owing to the low number of uninfected cattle surveyed. Our results indicate that, whilst the current POC-CCA does represent a potential diagnostic tool for cattle and possibly for predominantly S. curassoni-infected livestock, future work is needed to develop parasite- and/or livestock-specific affordable and field-applicable diagnostic tests to enable determination of the true extent of livestock schistosomiasis.


Assuntos
Gado , Esquistossomose mansoni , Humanos , Animais , Bovinos , Ovinos , Sistemas Automatizados de Assistência Junto ao Leito , Teorema de Bayes , Análise de Classes Latentes , Antígenos de Helmintos , Esquistossomose mansoni/epidemiologia , Schistosoma mansoni , Sensibilidade e Especificidade , Prevalência , Fezes/química
6.
Sci Rep ; 13(1): 5542, 2023 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-37015945

RESUMO

Social mixing patterns are key determinants of infectious disease transmission. Mathematical models parameterised with empirical data from contact pattern surveys have played an important role in understanding epidemic dynamics and informing control strategies, including for SARS-CoV-2. However, there is a paucity of data on social mixing patterns in many settings. We conducted a community-based survey in Cambodia in 2012 to characterise mixing patterns and generate setting-specific contact matrices according to age and urban/rural populations. Data were collected using a diary-based approach from 2016 participants, selected by stratified random sampling. Contact patterns were highly age-assortative, with clear intergenerational mixing between household members. Both home and school were high-intensity contact settings, with 27.7% of contacts occurring at home with non-household members. Social mixing patterns differed between rural and urban residents; rural participants tended to have more intergenerational mixing, and a higher number of contacts outside of home, work or school. Participants had low spatial mobility, with 88% of contacts occurring within 1 km of the participants' homes. These data broaden the evidence-base on social mixing patterns in low and middle-income countries and Southeast Asia, and highlight within-country heterogeneities which may be important to consider when modelling the dynamics of pathogens transmitted via close contact.


Assuntos
COVID-19 , Doenças Transmissíveis , Humanos , Doenças Transmissíveis/epidemiologia , Camboja/epidemiologia , COVID-19/epidemiologia , SARS-CoV-2 , Comportamento Social
7.
Bioanalysis ; 15(2): 71-81, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36891957

RESUMO

Background: Lead is harmful for humans by having adverse effects on different biological systems. Venepuncture is the gold standard for blood lead level analysis, but this method has many flaws. The goal of this research was to develop and validate a more practical approach for blood sampling. Materials & methods: Mitra® devices based on VAMS® and inductively coupled plasma-MS/MS technologies were employed. Performance evaluation of the newly developed method was also performed by comparing it versus a commonly used method at the Centre de Toxicologie du Québec for blood lead level analysis. Results: Comparison showed no signs of significant difference between the two methods. Conclusion: VAMS may be a useful alternative sampling approach for further research on blood lead analysis and possibly for many other trace elements.


Assuntos
Chumbo , Espectrometria de Massas em Tandem , Humanos , Espectrometria de Massas em Tandem/métodos , Manejo de Espécimes/métodos , Coleta de Amostras Sanguíneas/métodos , Teste em Amostras de Sangue Seco/métodos
8.
Public Health Pract (Oxf) ; 4: 100325, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36246412

RESUMO

Objectives: Non-pharmaceutical interventions have been crucial to reduce transmission of the SARS-CoV-2 virus in many countries including the United Kingdom. A key research priority has been to better understand psychological and social determinants of health behaviours. We aimed to quantify the impact of luck perception on contact and preventive behaviours among adults in the UK, adjusting for key confounders. Study design: A cross-sectional study. Methods: Data were collected between July 28 and August 31, 2020. Luck perception, which refers to a belief whether individual's SARS-CoV-2 infection status is determined by fate or chance, was measured using Chance score, drawing on Health Locus of Control Theory. Self-reporting online questionnaires were administered to obtain participants' contact patterns and frequencies of avoiding crowds, hand washing and wearing a mask. Associations between luck perception and protective behaviours and contact patterns were quantified using regression models. Results: Data from 233 survey respondents were analysed. Chance score was negatively associated with all protective behaviours; avoiding crowds (adjusted odds ratio (aOR) 0.46, 95% confidence interval (CI) 0.25-0.86, p = 0.02), washing hands (aOR 0.35, 95%CI 0.17-0.70, p = 0.003), and wearing masks (aOR 0.58, 95%CI 0.34-0.99, p = 0.046). For non-physical contacts (with or without distancing), a significant interaction was identified between Chance score and ethnicity. Chance score increased the number of non-physical contacts among white British, an opposite trend was observed for non-white participants. Conclusions: Luck perception during the pandemic may affect individuals' health protection behaviours and contact patterns. Further mechanistic understandings of human behaviours against infectious diseases are indispensable for effective response to future pandemics.

9.
Molecules ; 27(17)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36080419

RESUMO

L-Tryptophan (TRP) metabolites and related biomarkers play crucial roles in physiological functions, and their imbalances are implicated in central nervous system pathologies and neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), Alzheimer's disease, Parkinson's disease, schizophrenia and depression. The measurement of TRP metabolites and related biomarkers possesses great potential to elucidate the disease mechanisms, aid preclinical drug development, highlight potential therapeutic targets and evaluate the outcomes of therapeutic interventions. An effective, straightforward, sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed for the simultaneous determination of 24 TRP-related compounds in miniaturised murine whole blood samples. Sampling and sample pretreatment miniaturisation were achieved thanks to the development of a volumetric dried blood microsampling approach. Volumetric absorptive microsampling (VAMS) allows the accurate sampling of microvolumes of blood with advantages including, but not limited to, minimal sampling invasiveness, logistical improvements, method sustainability in terms of solvents and energy consumption, and improvement of animal studies in the framework of the 3Rs (Replacement, Reduction and Refinement) principles on animal welfare. The VAMS-LC-MS/MS method exhibited good selectivity, and correlation coefficient values for the calibration curves of each analyte were >0.9987. The limits of quantitation ranged from 0.1 to 25 ng/mL. The intra- and inter-day precisions in terms of RSD were <9.6%. All analytes were stable in whole blood VAMS samples stored at room temperature for at least 30 days with analyte losses < 14%. The developed method was successfully applied to the analysis of biological samples from mice, leading to the unambiguous determination of all the considered target analytes. This method can therefore be applied to analyse TRP metabolites and related biomarkers levels to monitor disease states, perform mechanistic studies and investigate the outcomes of therapeutic interventions.


Assuntos
Espectrometria de Massas em Tandem , Triptofano , Animais , Biomarcadores , Coleta de Amostras Sanguíneas/métodos , Cromatografia Líquida/métodos , Teste em Amostras de Sangue Seco/métodos , Camundongos , Espectrometria de Massas em Tandem/métodos
10.
Front Vet Sci ; 9: 915487, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35968008

RESUMO

Background: Improving livestock health is considered critical to address poverty, malnutrition and food insecurity in low- and middle-income countries (LMICs). Modifications of livestock management practices is also increasingly recognized as an important strategy to mitigate global threats such as climate change and novel disease emergence. Smallholders are, however, under various constraints which prohibit them from altering health practices for livestock and little is known about how the adoption of these practices may be promoted. The proposed scoping review aims to systematically map evidence around "what practices are (not) adopted by smallholders under what circumstances, how and why?." Method and analysis: We conducted initial scoping searches to broadly define types of animal health practices relevant for smallholders in LMICs and formulated search terms. A scoping review protocol was designed and registered. A systematic literature search will be conducted using electronic databases including CAB Abstract, Scopus, MEDLINE, EMBASE, and Web of Science Core Collection. Gray literature will be searched from AGRIS and Standards for Supporting Agricultural Livelihoods in Emergencies. Articles in English, pertaining to the animal health practices considered highly relevant will be considered eligible for inclusion. Articles will be screened at two stages by two independent reviewers; screening of titles, abstracts, and keywords, followed by full-article screening. The first reviewer will review 100% of the articles at both stages. The second reviewer will review a random sample of 20% of the articles at both stages. Any disagreements will be resolved using inputs from the third reviewer. A thematic analysis will be conducted to catalog contexts and mechanisms for adoption and discussed under a realist framework. Discussion: Understanding of the mechanisms underlying the adoption of animal health practices by livestock smallholders in LMICs is crucial for successful implementation of interventions including those which are based on a One Health approach. This review will identify the extent of this knowledge across disciplines and inform future research priorities for the design of effective and feasible interventions which can contribute toward Sustainable Development Goal 2. Registration: This protocol is registered within the Open Science Framework (https://doi.org/10.17605/OSF.IO/FUQAX).

11.
Pharmacol Res Perspect ; 10(5): e01004, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36036654

RESUMO

Altered physiology caused by critical illness may change midazolam pharmacokinetics and thereby result in adverse reactions and outcomes in this vulnerable patient population. This study set out to determine which critical illness-related factors impact midazolam pharmacokinetics in children using population modeling. This was an observational, prospective, controlled study of children receiving IV midazolam as part of routine care. Children recruited into the study were either critically-ill receiving continuous infusions of midazolam or otherwise well, admitted for elective day-case surgery (control) who received a single IV bolus dose of midazolam. The primary outcome was to determine the population pharmacokinetics and identify covariates that influence midazolam disposition during critical illness. Thirty-five patients were recruited into the critically ill arm of the study, and 54 children into the control arm. Blood samples for assessing midazolam and 1-OH-midazolam concentrations were collected opportunistically (critically ill arm) and in pre-set time windows (control arm). Pharmacokinetic modeling demonstrated a significant change in midazolam clearance with acute inflammation (measured using C-Reactive Protein), cardio-vascular status, and weight. Simulations predict that elevated C-Reactive Protein and compromised cardiovascular function in critically ill children result in midazolam concentrations up to 10-fold higher than in healthy children. The extremely high concentrations of midazolam observed in some critically-ill children indicate that the current therapeutic dosing regimen for midazolam can lead to over-dosing. Clinicians should be aware of this risk and intensify monitoring for oversedation in such patients.


Assuntos
Estado Terminal , Midazolam , Proteína C-Reativa , Criança , Humanos , Inflamação/tratamento farmacológico , Estudos Prospectivos
13.
Proc Natl Acad Sci U S A ; 118(41)2021 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-34615712

RESUMO

Zoonotic spillover and hybridization of parasites are major emerging public and veterinary health concerns at the interface of infectious disease biology, evolution, and control. Schistosomiasis is a neglected tropical disease of global importance caused by parasites of the Schistosoma genus, and the Schistosoma spp. system within Africa represents a key example of a system where spillover of animal parasites into human populations has enabled formation of hybrids. Combining model-based approaches and analyses of parasitological, molecular, and epidemiological data from northern Senegal, a region with a high prevalence of schistosome hybrids, we aimed to unravel the transmission dynamics of this complex multihost, multiparasite system. Using Bayesian methods and by estimating the basic reproduction number (R0 ), we evaluate the frequency of zoonotic spillover of Schistosoma bovis from livestock and the potential for onward transmission of hybrid S. bovis × S. haematobium offspring within human populations. We estimate R0 of hybrid schistosomes to be greater than the critical threshold of one (1.76; 95% CI 1.59 to 1.99), demonstrating the potential for hybridization to facilitate spread and establishment of schistosomiasis beyond its original geographical boundaries. We estimate R0 for S. bovis to be greater than one in cattle (1.43; 95% CI 1.24 to 1.85) but not in other ruminants, confirming cattle as the primary zoonotic reservoir. Through longitudinal simulations, we also show that where S. bovis and S. haematobium are coendemic (in livestock and humans respectively), the relative importance of zoonotic transmission is predicted to increase as the disease in humans nears elimination.


Assuntos
Número Básico de Reprodução/estatística & dados numéricos , Gado/parasitologia , Schistosoma haematobium/patogenicidade , Esquistossomose Urinária/transmissão , Esquistossomose Urinária/veterinária , Animais , Bovinos/parasitologia , Cabras/parasitologia , Humanos , Doenças Negligenciadas/parasitologia , Senegal/epidemiologia , Ovinos/parasitologia , Zoonoses/parasitologia , Zoonoses/transmissão
14.
One Health ; 13: 100310, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34458546

RESUMO

Literature on potential anthropogenic drivers of zoonotic disease risk in the Indian subcontinent is sparse. We conducted a scoping review to identify primary sources, published 2000-2020, to clarify what research exists and on which areas future research should focus. We summarised findings thematically by disease. Of 80 sources included, 78 (98%) were original research articles and two were conference abstracts. Study designs and methods were not always clearly described, but 74 (93%) were quantitative (including one randomised trial), five (6%) were mixed-methods, and one was qualitative. Most sources reported research from India (39%) or Bangladesh (31%), followed by Pakistan (9%), Nepal (9%), Bhutan and Sri Lanka (6% each). Topically, most focused on rabies (18; 23%), Nipah virus (16; 20%) or leptospirosis (11; 14%), while 12 (15%) did not focus on a disease but instead on knowledge in communities. People generally did not seek post-exposure prophylaxis for rabies even when vaccination programmes were available and they understood that rabies was fatal, instead often relying on traditional medicines. Similarly, people did not take precautions to protect themselves from leptospirosis infection, even when they were aware of the link with rice cultivation. Nipah was correlated with presence of bats near human habitation. Official information on diseases, modes of transmission and prevention was lacking, or shared informally between friends, relatives, and neighbours. Behaviour did not correspond to disease knowledge. This review identifies various human behaviours which may drive zoonotic disease risk in the Indian subcontinent. Increasing community knowledge and awareness alone is unlikely to be sufficient to successfully change these behaviours. Further research, using interdisciplinary and participatory methods, would improve understanding of risks and risk perceptions and thus help in co-designing context-specific, relevant interventions.

15.
Bioanalysis ; 13(24): 1851-1863, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34463128

RESUMO

COVID-19 led to changes in the way blood samples are collected. As societies were isolated to control viral spread, access to facilities became limited. Remote sample collection with a volumetric microsampling approach, using Mitra® devices based on VAMS® technology, proved to be highly effective. It allowed people to collect high-quality samples at home and post them to a laboratory. This enabled scientists to conduct large serosurveillance studies, with results showing that seroprevalence of COVID-19 was higher than initially expected. Furthermore, remote microsampling studies by several institutions were conducted to measure the relationship between antigen levels and antibody response and duration. VAMS technology was also used in COVID-19 clinical trials. In summary, the independent research reviewed in this paper proved that VAMS is an effective sample collection alternative.


Assuntos
COVID-19/diagnóstico , Coleta de Amostras Sanguíneas/métodos , COVID-19/epidemiologia , COVID-19/virologia , Teste em Amostras de Sangue Seco/métodos , Humanos , Vigilância da População , SARS-CoV-2/isolamento & purificação , Manejo de Espécimes/métodos
16.
Pharmaceuticals (Basel) ; 14(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209566

RESUMO

Therapeutic drug monitoring (TDM) of antiseizure medications (ASMs) represents a valuable tool to establish an appropriate patient therapy, to collect important information about drugs' interactions and to evaluate patient's metabolic capabilities. In recent years, a new volumetric absorptive microsampling technique using VAMS® technology and Mitra® devices, consisting of a sampling technique for the collection of fixed-volume capillary blood, was developed. These new devices provide a new home-sampling technique for whole blood that has been spread out to simplify sample collection from finger-pricks. This review is aimed to compare published articles concerning the application of VAMS® in epilepsy and to identify the strengths and improvement points for the TDM of antiseizure medications. VAMS® allowed a minimally invasive blood sampling even in the absence of trained personnel. Good stability data have indicated that storage and delivery can be facilitated only for specific ASMs. Trueness and precision parameters have been evaluated, and the hematocrit (HCT) effect was minimized.

17.
BMJ Open ; 11(5): e049437, 2021 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-34035110

RESUMO

OBJECTIVES: Concern about trainee work-related well-being has been raised in recent years and is the subject of several reviews, reports and research studies. This study aimed to understand the experiences of trainees working in a large intensive care unit during the first surge of the COVID-19 pandemic from an educational and operational perspective in order to highlight what worked and what could be improved. DESIGN: A qualitative study using peer-to-peer semistructured interviews, developed using appreciative inquiry methodology, was conducted during July 2020. Responses were analysed using a thematic analysis technique. SETTING: A large, tertiary intensive care unit in the UK. PARTICIPANTS: All trainees in anaesthesia and intensive care working on the intensive care unit during the first surge were invited to participate. RESULTS: Forty interviews were conducted and four over-arching themes were identified. These were: feeling safe and supported; physical demands; the emotional burden of caring; and a sense of fulfilment, value and personal development. Positive aspects of the organisational response to the pandemic included communication, personal protective equipment supply, team working and well-being support. Suggestions for improvement focused on rest facilities, rota patterns and hierarchies, creating opportunities for reflection and ensuring continued educational and training opportunities despite operational demands. CONCLUSIONS: Trainees described opportunities for learning and fulfilment, as well as challenges, in working through a pandemic. Trainees described their needs and how well these were met during the pandemic. Ideas for improvement most frequently related to basic needs including safety and fatigue, but suggestions also related to supporting learning and development. The appreciative inquiry methodology of the project facilitated effective reflection on positive aspects of trainee experiences.


Assuntos
COVID-19 , Pandemias , Cuidados Críticos , Humanos , Equipamento de Proteção Individual , Pesquisa Qualitativa , SARS-CoV-2
18.
Sci Rep ; 11(1): 3215, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33547388

RESUMO

In Thailand, leptospirosis is primarily associated with those who work in agricultural occupations. Leptospirosis control is hampered by a poor understanding of the complex interactions between humans, animal reservoirs, Leptospira, and the variable spatial environment in which these factors coexist. We aimed to address key knowledge gaps concerning leptospirosis disease dynamics and the human-animal-water-source interface in two high-risk areas in Thailand. We conducted a cross-sectional survey among 746 study participants in two high-risk areas for leptospirosis in Thailand: Sisaket (SSK) and Nakhon Si Thammarat (NST). Interactions among humans, animals and water sources were quantified and analyzed. The presence of different animal species and thus contact patterns were different in NST and SSK. The consumption of water from the shared sources between the two areas was different. Those whose occupations were related to animals or environmental water and those who consumed water from more than two sources were more likely to have been infected with leptospirosis, with adjusted odds ratios 4.31 (95% CI 1.17-15.83) and 10.74 (95% CI 2.28-50.53), respectively. Understanding specific water-source sharing networks and human-animal contact patterns is useful when designing national and area-specific control programmes to prevent and control leptospirosis outbreaks.


Assuntos
Leptospira/isolamento & purificação , Leptospirose/epidemiologia , Adulto , Animais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Tailândia/epidemiologia , Microbiologia da Água
19.
Bioanalysis ; 12(17): 1243-1261, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32915068

RESUMO

Aim: Multiplexed, high-throughput analysis facilitates therapeutic drug monitoring. 14 drugs with various physico-chemical properties were quantitated in dried blood microsamples. Methods: Analytes were extracted employing eight solvent compositions and seven extraction methods. The applicability of liquid serum, dried serum and dried whole blood calibrators was investigated. Results: High recoveries were attained. Calibration using dried serum yielded lowest total error. Reducing sample hematocrit caused outstanding elevations in recovery of analytes with high polarity or affinity to erythrocytes. 9-day analyte stability was demonstrated. Conclusion: Based on the analysis of spiked samples, multiplexed testing of drugs in dried blood microsamples seems feasible, but with analyte-dependent method performance. Dried serum calibration allows the adaptation of serum-based workflows. Further evaluation using real-life specimens is needed.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Cromatografia Líquida/métodos , Teste em Amostras de Sangue Seco/métodos , Espectrometria de Massas em Tandem/métodos , Humanos , Fluxo de Trabalho
20.
Lancet Planet Health ; 4(8): e330-e342, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32800151

RESUMO

BACKGROUND: Schistosomiasis is a neglected tropical disease of global medical and veterinary importance. As efforts to eliminate schistosomiasis as a public health problem and interrupt transmission gather momentum, the potential zoonotic risk posed by livestock Schistosoma species via viable hybridisation in sub-Saharan Africa have been largely overlooked. We aimed to investigate the prevalence, distribution, and multi-host, multiparasite transmission cycle of Haematobium group schistosomiasis in Senegal, West Africa. METHODS: In this epidemiological study, we carried out systematic surveys in definitive hosts (humans, cattle, sheep, and goats) and snail intermediate hosts, in 2016-18, in two areas of Northern Senegal: Richard Toll and Lac de Guiers, where transmission is perennial; and Barkedji and Linguère, where transmission is seasonal. The occurrence and distribution of Schistosoma species and hybrids were assessed by molecular analyses of parasitological specimens obtained from the different hosts. Children in the study villages aged 5-17 years and enrolled in school were selected from school registers. Adults (aged 18-78 years) were self-selecting volunteers. Livestock from the study villages in both areas were also randomly sampled, as were post-mortem samples from local abattoirs. Additionally, five malacological surveys of snail intermediate hosts were carried out at each site in open water sources used by the communities and their animals. FINDINGS: In May to August, 2016, we surveyed 375 children and 20 adults from Richard Toll and Lac de Guiers, and 201 children and 107 adults from Barkedji and Linguère; in October, 2017, to January, 2018, we surveyed 386 children and 88 adults from Richard Toll and Lac de Guiers, and 323 children and 85 adults from Barkedji and Linguère. In Richard Toll and Lac de Guiers the prevalence of urogenital schistosomiasis in children was estimated to be 87% (95% CI 80-95) in 2016 and 88% (82-95) in 2017-18. An estimated 63% (in 2016) and 72% (in 2017-18) of infected children were shedding Schistosoma haematobium-Schistosoma bovis hybrids. In adults in Richard Toll and Lac de Guiers, the prevalence of urogenital schistosomiasis was estimated to be 79% (52-97) in 2016 and 41% (30-54) in 2017-18, with 88% of infected samples containing S haematobium-S bovis hybrids. In Barkedji and Linguère the prevalence of urogenital schistosomiasis in children was estimated to be 30% (23-38) in 2016 and 42% (35-49) in 2017-18, with the proportion of infected children found to be shedding S haematobium-S bovis hybrid miracidia much lower than in Richard Toll and Lac de Guiers (11% in 2016 and 9% in 2017-18). In adults in Barkedji and Linguère, the prevalence of urogenital schistosomiasis was estimated to be 26% (17-36) in 2016 and 47% (34-60) in 2017-18, with 10% of infected samples containing S haematobium-S bovis hybrids. The prevalence of S bovis in the sympatric cattle population of Richard Toll and the Lac de Guiers was 92% (80-99), with S bovis also found in sheep (estimated prevalence 14% [5-31]) and goats (15% [5-33]). In Barkedji and Linguère the main schistosome species in livestock was Schistosoma curassoni, with an estimated prevalence of 73% (48-93) in sheep, 84% (61-98) in goats and 8% (2-24) in cattle. S haematobium-S bovis hybrids were not found in livestock. In Richard Toll and Lac de Guiers 35% of infected Bulinus spp snail intermediate hosts were found to be shedding S haematobium-S bovis hybrids (68% shedding S haematobium; 17% shedding S bovis); however, no snails were found to be shedding S haematobium hybrids in Barkedji and Linguère (29% shedding S haematobium; 71% shedding S curassoni). INTERPRETATION: Our findings suggest that hybrids originate in humans via zoonotic spillover from livestock populations, where schistosomiasis is co-endemic. Introgressive hybridisation, evolving host ranges, and wider ecosystem contexts could affect the transmission dynamics of schistosomiasis and other pathogens, demonstrating the need to consider control measures within a One Health framework. FUNDING: Zoonoses and Emerging Livestock Systems programme (UK Biotechnology and Biological Sciences Research Council, UK Department for International Development, UK Economic and Social Research Council, UK Medical Research Council, UK Natural Environment Research Council, and UK Defence Science and Technology Laboratory).


Assuntos
Doenças dos Bovinos/epidemiologia , Doenças das Cabras/epidemiologia , Schistosoma/fisiologia , Esquistossomose/epidemiologia , Esquistossomose/veterinária , Doenças dos Ovinos/epidemiologia , Caramujos/parasitologia , Adolescente , Adulto , Idoso , Distribuição Animal , Animais , Bovinos , Doenças dos Bovinos/parasitologia , Doenças dos Bovinos/transmissão , Criança , Feminino , Doenças das Cabras/parasitologia , Doenças das Cabras/transmissão , Cabras , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Única , Prevalência , Schistosoma haematobium/fisiologia , Esquistossomose/parasitologia , Esquistossomose/transmissão , Senegal/epidemiologia , Ovinos , Doenças dos Ovinos/parasitologia , Doenças dos Ovinos/transmissão , Carneiro Doméstico , Adulto Jovem
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