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Artemisinin (ART) combination therapy is the main treatment for malaria. Pfk13 mutations (or K13 mutations, Kelch 13) are associated with ART resistance. This study aims to conduct a systematic review and meta-analysis of the prevalence of K13 mutations with ART resistance in malaria-endemic countries. An electronic search of studies in 2018 and a manual search in 2020 were performed to identify relevant studies. The risk of bias was assessed using the National Institutes of Health (NIH) quality assessment tool for observational cohort and cross-sectional studies. Data analysis was performed using R 4.1.0. Heterogeneity was estimated using the statistic I2 and Cochran Q test. A total of 170 studies were included in our review. Of these, 55 studies investigated the prevalence of K13 mutations in Southeast Asia. The meta-analysis showed that Southeast Asia had the highest prevalence of K13 mutations, whereas Africa, South America, Oceania, and other Asian countries outside Southeast Asia had a low prevalence of K13 mutations. The C580Y mutation was the most common in Southeast Asia with 35.5% (95%CI: 25.4-46.4%), whereas the dominant mutation in Africa was K189T (22.8%, 95%CI: 7.6-43.2%). This study revealed the emergence of ART resistance associated with K13 mutations in Southeast Asia. The diversity of each type of K13 mutation in other regions was also reported.
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Antimaláricos , Artemisininas , Polimorfismo Genético , Artemisininas/uso terapéutico , Humanos , Antimaláricos/uso terapéutico , Prevalencia , Resistencia a Medicamentos/genética , Plasmodium falciparum/genética , Plasmodium falciparum/efectos de los fármacos , Malaria/tratamiento farmacológico , Malaria/epidemiología , Malaria Falciparum/tratamiento farmacológico , Malaria Falciparum/epidemiología , Malaria Falciparum/parasitología , Mutación , Proteínas Protozoarias/genética , Asia Sudoriental/epidemiologíaRESUMEN
Background: The Japanese government advised mild or asymptomatic coronavirus disease-2019 (COVID-19) cases to self-isolate at home, while more severe individuals were treated at health posts. Poor compliance with self-isolation could be a potential reason for the new outbreak. Our study aimed to find out the correlation between the rising new cases of COVID-19 and home-based patients in Japan. Methods: A secondary data analysis study was conducted with the data from COVID-19- involved databases collected from Johns Hopkins University, Japanese Ministry of Health, Labour and Welfare, and Community Mobility Reports of Google. New community cases, stringency index, number of tests, and active cases were analyzed. Using a linear regression model, an independent variable was utilized for a given date to predict the future number of community cases. Results: Research results show that outpatient cases, the stringency, and Google Mobility Trend were all significantly associated with the number of COVID-19 community cases from the sixth day to the ninth day. The model predicting community cases on the eighth day (R2=0.8906) was the most appropriate showing outpatients, residential index, grocery and pharmacy index, retail and recreation index, and workplaces index were positively related (ß1=24.2, 95% CI: 20.3- 26.3, P<0.0001; ß2=277.7, 95% CI: 171.8-408.2, P<0.0001; ß3=112.4, 95% CI: 79.8-158.3, P<0.0001; ß4=73.1, 95% CI: 53- 04.4, P<0.0001; ß5=57.2, 95% CI: 25.2-96.8, P=0.001, respectively). In contrast, inpatients, park index, and adjusted stringency index were negatively related to the number of community cases (ß6=-2.8, 95% CI: -3.9 - -1.6, P<0.0001; ß7=-33, 95% CI: -43.6 - -27, P<0.0001; ß8=-14.4, 95% CI: -20.1- -12, P<0.0001, respectively). Conclusion: Outpatient cases and indexes of Community Mobility Reports were associated with COVID-19 community cases.
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[This corrects the article DOI: 10.1371/journal.pntd.0009808.].
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ABSTRACT: Facial synkinesis can happen as a negative event following the recovery of facial nerve paralysis. In this case report, five months after right facial nerve decompression surgery following right sided head trauma, a 21-year-old female patient developed oral-ocular synkinesis. During her attempt to voluntarily smile, she experienced uncontrolled winking of her right eye. Exercise therapy was used as a treatment modality which largely improved her facial nerve function and decreased her synkinesis. As a treatment modality, exercise therapy was used which saw a great improvement in both her facial nerve function and decreased her synkinesis.
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Traumatismos Craneocerebrales , Parálisis Facial , Sincinesia , Adulto , Descompresión , Músculos Faciales , Nervio Facial , Femenino , Humanos , Sincinesia/etiología , Adulto JovenRESUMEN
BACKGROUND: Predictive markers represent a solution for the proactive management of severe dengue. Despite the low mortality rate resulting from severe cases, dengue requires constant examination and round-the-clock nursing care due to the unpredictable progression of complications, posing a burden on clinical triage and material resources. Accordingly, identifying markers that allow for predicting disease prognosis from the initial diagnosis is needed. Given the improved pathogenesis understanding, myriad candidates have been proposed to be associated with severe dengue progression. Thus, we aim to review the relationship between the available biomarkers and severe dengue. METHODOLOGY: We performed a systematic review and meta-analysis to compare the differences in host data collected within 72 hours of fever onset amongst the different disease severity levels. We searched nine bibliographic databases without restrictive criteria of language and publication date. We assessed risk of bias and graded robustness of evidence using NHLBI quality assessments and GRADE, respectively. This study protocol is registered in PROSPERO (CRD42018104495). PRINCIPAL FINDINGS: Of 4000 records found, 40 studies for qualitative synthesis, 19 for meta-analysis. We identified 108 host and viral markers collected within 72 hours of fever onset from 6160 laboratory-confirmed dengue cases, including hematopoietic parameters, biochemical substances, clinical symptoms, immune mediators, viral particles, and host genes. Overall, inconsistent case classifications explained substantial heterogeneity, and meta-analyses lacked statistical power. Still, moderate-certainty evidence indicated significantly lower platelet counts (SMD -0.65, 95% CI -0.97 to -0.32) and higher AST levels (SMD 0.87, 95% CI 0.36 to 1.38) in severe cases when compared to non-severe dengue during this time window. CONCLUSION: The findings suggest that alterations of platelet count and AST level-in the first 72 hours of fever onset-are independent markers predicting the development of severe dengue.
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Biomarcadores/sangre , Dengue Grave/sangre , Dengue Grave/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Aspartato Aminotransferasas/sangre , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Pronóstico , Dengue Grave/diagnóstico , Adulto JovenRESUMEN
SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.