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1.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 48-53, set.-dez. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1381107

RESUMO

A ciência endodôntica possui um vasto conhecimento e com esse conhecimento os seus inúmeros questionamentos. Algumas teorias e conceitos mudam constantemente e trazem à tona contradições e divergências clínicas no âmbito biológico e prático. A patência foraminal é uma prática que permite que um instrumento de pequeno calibre ultrapasse o forame apical, com o intuito de limpar passivamente e prevenir o acúmulo de detritos e inibir a proliferação de microorganismos que podem causar infecções pós tratamento endodôntico. Essa prática gera discussão interna entre especialistas da área, mas as vantagens da técnica são inúmeras, principalmente no que diz respeito aos casos de polpa necrosada. Casos como esse não são solucionados com sucesso sem a utilização da patência apical. Por outro lado, existem contradições em relação aos casos em que a polpa está viva. Esse trabalho tem como objetivo analisar as vantagens e desvantagens da patência apical, bem como, se os benefícios excedem os possíveis danos que ela pode trazer(AU)


Endodontic science has vast knowledge and with this knowledge its countless questions. Some theories and concepts are constantly changing and bring to light clinical contradictions and divergences in the biological and practical scope. Foraminal patency is a practice that allows a small-caliber instrument to go beyond the apical foramen, in order to passively clean and prevent the accumulation of debris in the region and inhibit the proliferation of microorganisms that can cause infections after endodontic treatment. This practice generates internal discussion among specialists in the field, but the advantages of the technique are numerous, especially with regard to cases of necrotic pulp. Cases like this are not successfully resolved without the use of apical patency. On the other hand, there are contradictions regarding the cases where the pulp is alive. This work aims to analyze the advantages and disadvantages of apical patency, as well as whether the benefits exceed the harm it can bring(AU)


Assuntos
Humanos , Masculino , Adulto , Tratamento do Canal Radicular , Ápice Dentário , Preparo de Canal Radicular , Infecções
2.
Shock ; 58(3): 224-230, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36125356

RESUMO

ABSTRACT: Background: Risk stratification of emergency department patients with suspected acute infections and/or suspected sepsis remains challenging. We prospectively validated a 29-messenger RNA host response classifier for predicting severity in these patients. Methods: We enrolled adults presenting with suspected acute infections and at least one vital sign abnormality to six emergency departments in Greece. Twenty-nine target host RNAs were quantified on NanoString nCounter and analyzed with the Inflammatix Severity 2 (IMX-SEV-2) classifier to determine risk scores as low, moderate, and high severity. Performance of IMX-SEV-2 for prediction of 28-day mortality was compared with that of lactate, procalcitonin, and quick sequential organ failure assessment (qSOFA). Results: A total of 397 individuals were enrolled; 38 individuals (9.6%) died within 28 days. Inflammatix Severity 2 classifier predicted 28-day mortality with an area under the receiver operator characteristics curve of 0.82 (95% confidence interval [CI], 0.74-0.90) compared with lactate, 0.66 (95% CI, 0.54-0.77); procalcitonin, 0.67 (95% CI, 0.57-0.78); and qSOFA, 0.81 (95% CI, 0.72-0.89). Combining qSOFA with IMX-SEV-2 improved prognostic accuracy from 0.81 to 0.89 (95% CI, 0.82-0.96). The high-severity (rule-in) interpretation band of IMX-SEV-2 demonstrated 96.9% specificity for predicting 28-day mortality, whereas the low-severity (rule-out) band had a sensitivity of 78.9%. Similarly, IMX-SEV-2 alone accurately predicted the need for day-7 intensive care unit care and further boosted overall accuracy when combined with qSOFA. Conclusions: Inflammatix Severity 2 classifier predicted 28-day mortality and 7-day intensive care unit care with high accuracy and boosted the accuracy of clinical scores when used in combination.


Assuntos
Infecções , Sepse , Adulto , Serviço Hospitalar de Emergência , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Ácido Láctico , Escores de Disfunção Orgânica , Pró-Calcitonina , RNA Mensageiro , Sepse/diagnóstico , Sepse/genética
3.
San Salvador; MINSAL; sept. 16, 2022. 23 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1393464

RESUMO

Resumen de eventos de notificación hasta SE 34/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events until SE 34/2022. International alerts. Epidemiological situation of dengue. Epidemiological situation of zika and chikungunya. Acute respiratory infection. Pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
4.
San Salvador; MINSAL; sept. 16, 2022. 23 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1393466

RESUMO

Resumen de eventos de notificación hasta SE 35/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events until SE 35/2022. International alerts. Epidemiological situation of dengue. Epidemiological situation of zika and chikungunya. Acute respiratory infection. Pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
5.
San Salvador; MINSAL; sept. 1, 2022. 22 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1392870

RESUMO

Resumen de eventos de notificación hasta SE 32/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events until SE 32/2022. International alerts. Epidemiological situation of dengue. Epidemiological situation of zika and chikungunya. Acute respiratory infection. Pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
6.
San Salvador; MINSAL; sept.1, 2022. 22 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1392871

RESUMO

Resumen de eventos de notificación hasta SE 33/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events until SE 33/2022. International alerts. Epidemiological situation of dengue. Epidemiological situation of zika and chikungunya. Acute respiratory infection. Pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
7.
BMC Pediatr ; 22(1): 556, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36127630

RESUMO

BACKGROUND: Although self-limiting viral infections are predominant, children with acute infections are often prescribed antibiotics by family physicians. The aim of the study is to evaluate the impact of two interventions, namely C-reactive protein point-of-care testing and educational training, on antibiotic prescribing by family physicians. METHODS: This randomised controlled intervention study included acutely ill children consulted by 80 family physicians from urban and rural practices in Latvia. The family physicians were divided into two groups of 40. The family physicians in the intervention group received both interventions, i.e. C-reactive protein point-of-care testing and educational training, whereas the family physicians in the control group continued to dispense their standard care. The primary outcome measure was the antibiotic prescribing at the index consultation (delayed or immediate prescription) in both study groups. The secondary outcome was CRP testing per study group. Patient- and family physician- related predictors of antibiotic prescribing were analysed as associated independent variables. Practice location effect on the outcomes was specially addressed, similar to other scientific literature. RESULTS: In total, 2039 children with acute infections were enrolled in the study. The most common infections observed were upper and lower respiratory tract infections. Overall, 29.8% (n = 607) of the study population received antibiotic prescription. Our binary logistic regression analysis did not find a statistically significant association between antibiotic prescriptions and the implemented interventions. In the control group of family physicians, a rural location was associated with more frequent antibiotic prescribing and minimal use of CRP testing of venous blood samples. However, in the intervention group of family physicians, a rural location was associated with a higher level of C-reactive protein point-of-care testing. Furthermore, in rural areas, a significant reduction in antibiotic prescribing was observed in the intervention group compared with the control group (29.0% (n = 118) and 37.8% (n = 128), respectively, p = 0.01). CONCLUSION: Our results show that the availabilty of C-reactive protein point-of-care testing and educational training for family physicians did not reduce antibiotic prescribing. Nevertheless, our data indicate that regional variations in antibiotic-prescribing habits exist and the implemented interventions had an effect on family physicians practices in rural areas.


Assuntos
Infecções , Médicos de Família , Antibacterianos/uso terapêutico , Proteína C-Reativa/análise , Criança , Humanos , Letônia , Testes Imediatos , Padrões de Prática Médica
8.
Medicina UPB ; 41(2): 100-106, julio-diciembre 2022. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1392112

RESUMO

Objetivo: el virus SARS-COV-2 llegó a Medellín el 9 de marzo del 2020, afectando hasta el 8 de octubre 2021 a 397.395 personas en esta ciudad. Este estudio busca describir el comportamiento clínico de los pacientes hospitalizados en la Clínica SOMA en el periodo entre julio 1 de 2020 y enero 31 de 2021, así como identificar variables clínicas y paraclínicas asociadas a su ingreso a UCI y la mortalidad. Metodología: cohorte retrospectiva con datos de historias clínicas de adultos admitidos en la Clínica SOMA por Covid-19 entre julio 1 de 2020 y enero 31 de 2021. Resultados: se identificaron 849 individuos adultos con Covid-19, de los cuales 326 fueron hospitalizados (38.4%), la mortalidad fue del 13%. Los factores más asociados a severidad fueron la disnea, hipertensión arterial, enfermedad cardiovascular, dímero D elevado, deshidrogenasa láctica, linfopenia y una mayor edad. Conclusiones: nuestro estudio evidenció un comportamiento similar al descrito en otros estudios en el mundo frente a variables al ingreso por Covid-19, que se asocian con peores desenlaces clínicos.


Objective: SARS COV-2 virus arrived in Medellin on March 9, 2020, affecting 397 395 people in Medellin by Oct 8, 2021. This study aims to describe the clinical behavior of patients hospitalized in SOMA Clinic between July 1st, 2020, and January 31st, 2021, and to identify clinical and paraclinical variables associated with ICU entry and mortality. Methodology: retrospective cohort with data from medical records of all patients over 18 years of age admitted to the SOMA Clinic for Covid-19 between July 1st, 2020, and January 31st, 2021. Results: 849 patients with Covid-19 consulted the emergency room of the SOMA Clinic, out of which 326 were hospitalized (38.4%) with a mortality of 13%. Dyspnea, hypertension, cardiovascular disease, elevated D-dimer values, lactic dehydrogenase, and lymphopenia and older age were associated with severity. Conclusions: like other studies worldwide, we evidenced clinical and paraclinical parameters at entry that are associated with worst clinical outcomes in a SARS-COV-2 infection.


Objetivo: o vírus SARS-COV-2 chegou a Medellín em 9 de março de 2020, afetando 397.395 pessoas nesta cidade até 8 de outubro de 2021. Este estudo busca descrever o comportamento clínico dos pacientes internados na Clínica SOMA no período entre 1º de julho de 2020 e 31 de janeiro de 2021, bem como identificar variáveis clínicas e paraclínicas associadas à sua admissão na UTI e mortalidade. Metodologia: coorte retrospectiva com dados de prontuários de adultos internados na Clínica SOMA por Covid-19 entre 1º de julho de 2020 e 31 de janeiro de 2021.Resultados: foram identificados 849 indivíduos adultos com Covid-19, dos quais 326 foram hospitalizados (38,4%), a mortalidade foi de 13%. Os fatores mais associados à gravidade foram dispneia, hipertensão arterial, doença cardiovascular, D-dímero elevado, desidrogenase lática, linfopenia e idade avançada. Conclusões: nosso estudo mostrou um comportamento semelhante ao descrito em outros estudos no mundo frente às variáveis na admissão por Covid-19, que estão associadas a piores desfechos clínicos.


Assuntos
Humanos , COVID-19 , Vírus , Mortalidade , Serviço Hospitalar de Emergência , Infecções , Unidades de Terapia Intensiva , Linfopenia
9.
Rev. esp. quimioter ; 35(4): 344-356, ag. - sept. 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-205380

RESUMO

La atención de pacientes con sospecha de un proceso infeccioso en los servicios de urgencias hospitalarios(SUH) se haincrementado en la última década hasta suponer alrededor del15-20% de todas las atenciones diarias. En la valoración inicialde estos enfermos se toman muestras para los distintos estudios microbiológicos en un 45% de los casos, donde predomina la obtención de hemocultivos (HC), en el 14,6% de todosellos. La rentabilidad diagnóstica de estos HC es muy variable(2-20%). Los focos o procesos infecciosos más frecuentes sospechados o confirmados de las bacteriemias verdaderas(BV) enlos SUH son la infección del tracto urinario (45%) y la infecciónrespiratoria (25%). Por todo ello, la sospecha y confirmaciónde la BV tiene un relevante significado diagnóstico, pronósticoy obliga a cambiar algunas de las decisiones más importantesa tomar en el SUH. Entre otras, indicar el alta o ingreso, extraer HC y administrar el antimicrobiano adecuado y precoz.La intención de esta revisión es poner de manifiesto las evidencias científicas publicadas en los últimos cinco años, aclararlas controversias existentes actuales y comparar la capacidadpara predecir bacteriemia de los últimos modelos predictivospublicados desde el año 2017 con los ya existentes en esa fecha, año en el que se publicó una revisión que dejaba abierta lapropuesta de seguir buscando un modelo con un rendimientoadecuado para los SUH. Y así, a partir de ella, generar distintasrecomendaciones que ayuden a definir el papel que pueden tener estos modelos o escalas en la mejora de la indicación deobtención de los HC, así como en la toma inmediata de otrasdecisiones diagnóstico-terapéuticas (administración precozy adecuada del tratamiento antibiótico, solicitud de estudios complementarios y otras muestras microbiológicas, intensidaddel soporte hemodinámico, necesidad de ingreso, etc.) (AU)


The care of patients with a suspected infectious processin hospital emergency department (ED) has increased in thelast decade to account for around 15-20% of all daily care.In the initial evaluation of these patients, samples are takenfor the different microbiological studies in 45% of the cases,where obtaining blood cultures (BC) predominates, in 14.6%of all of them. The diagnostic yield of these BC is highly variable (2-20%). The most frequent suspected or confirmed focior infectious processes of true bacteremia (TB) in the ED areurinary tract infection (45%) and respiratory infection (25%).For all these reasons, the suspicion and confirmation of TB hasa relevant diagnostic and prognostic significance and requireschanging some of the most important decisions to be made inthe ED. Among others, indicate discharge or admission, extractBC and administer the appropriate and early antimicrobial. Theintention of this review is to highlight the scientific evidencepublished in the last five years, clarify the current controversies and compare the ability to predict bacteremia of the latest predictive models published since 2017 with those alreadyexisting on that date, year in which a review was publishedthat left open the proposal to continue searching for a modelwith adequate performance for ED. And so, based on it, generate different recommendations that help define the role thatthese models or scales can have in improving the indicationfor obtaining BC, as well as in the immediate making of otherdiagnostic-therapeutic decisions (administration early andappropriate antibiotic treatment, request for complementary studies and other microbiological samples, intensity of hemodynamic support, need for admission, etc.) (AU)


Assuntos
Humanos , Bacteriemia , Serviço Hospitalar de Emergência , Infecções , Infecções/diagnóstico , Infecções/tratamento farmacológico , Biomarcadores , Hemocultura
10.
Medicine (Baltimore) ; 101(34): e30158, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36042587

RESUMO

This study aimed to investigate the effect on the severity and prognostic value of serum procalcitonin for elderly patients with oral and maxillofacial infections. We divided 163 elderly patients with severe oral and maxillofacial infection into survival and death groups according to the prognosis between June 2015 and May 2021, measured serum procalcitonin by enzyme-linked immunosorbent assay on the 1st, 2nd, 3rd, 5th, and 7th day after admission for the dynamic changes of serum procalcitonin level, collected the general physiological and biochemical indexes for the scores of acute physiology and general chronic condition, compared the correlation between serum procalcitonin, mean platelet count and APACHE score, analyzed the prognostic value of serum procalcitonin levels at different time after admission by ROC curve. The serum procalcitonin level increased significantly in both groups after admission, sharply increased at first and then rapidly decreased in the survival group, and continued to rise or declined slowly with fluctuation of high level in the death group. There was a negative correlation between serum procalcitonin level and mean platelet count (r = -0.698, P < .05) and a positive correlation between serum procalcitonin and APACHE II (R = 0.803, P < .05). The ROC curve showed that the serum procalcitonin level had little value on the first day and great value on the third day in predicting the prognosis of elderly patients with severe oral and maxillofacial infection (PCT1d = 0.539, PCT3d = 0.875, P < .05). The serum procalcitonin level is correlated with the severity of the disease in elderly patients with severe oral and maxillofacial space infection. Dynamic observation of it is helpful for the prognosis judgment of patients. After admission, serum procalcitonin level on the third day has a great value for the prognosis judgment of elderly patients with severe oral and maxillofacial space infection.


Assuntos
Infecções , Doenças da Boca , Pró-Calcitonina , Sepse , APACHE , Idoso , Humanos , Infecções/diagnóstico , Infecções/mortalidade , Doenças da Boca/diagnóstico , Doenças da Boca/mortalidade , Pró-Calcitonina/sangue , Prognóstico , Curva ROC , Estudos Retrospectivos
11.
San Salvador; MINSAL; ago. 05, 2022. 22 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1382083

RESUMO

Resumen de eventos de notificación hasta SE 29/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events until SE 29/2022. International alerts. Epidemiological situation of dengue. Epidemiological situation of zika and chikungunya. Acute respiratory infection. Pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
12.
San Salvador; MINSAL; ago. 10, 2022. 22 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1382088

RESUMO

Resumen de eventos de notificación hasta SE 31/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events until SE 31/2022. International alerts. Epidemiological situation of dengue. Epidemiological situation of zika and chikungunya. Acute respiratory infection. Pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
14.
Cell Biol Int ; 46(10): 1557-1570, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35811438

RESUMO

A crucial component of the immune system are chemokiness. Chemokine's dysregulation has been linked to a number of pathological diseases. Recently, CXCL17, a chemokine belonging to the CXC subfamily, was identified. With regard to a number of physiological conditions and disorders, CXCL17 either has homeostatic or pathogenic effects. Some research suggests that CXCL17 is an orphan ligand, despite the fact that G protein-coupled receptor (GPR) 35 has been suggested as a possible receptor for CXCL17. Since CXCL17 is primarily secreted by mucosal epithelia, such as those in the digestive and respiratory tracts, under physiological circumstances, this chemokine is referred to as a mucosal chemokine. Macrophages and monocytes are the cells that express GPR35 and hence react to CXCL17. In homeostatic conditions, this chemokine has anti-inflammatory, antibacterial, and chemotactic properties. CXCL17 promotes angiogenesis, metastasis, and cell proliferation in pathologic circumstances like malignancies. However, other studies suggest that CXCL17 may have anti-tumor properties. Additionally, studies have shown that CXCL17 may have a role in conditions such as idiopathic pulmonary fibrosis, multiple sclerosis, asthma, and systemic sclerosis. Additionally, deregulation of CXCL17 in some diseases may serve as a biomarker for diagnosis and prognosis. Clarifying the underlying mechanism of CXCL17's activity in homeostatic and pathological situations may thus increase our understanding of its role and hold promise for the development of novel treatment strategies.


Assuntos
Quimiocinas CXC , Infecções , Inflamação , Neoplasias , Quimiocinas , Quimiocinas CXC/fisiologia , Humanos , Infecções/imunologia , Inflamação/imunologia , Neoplasias/imunologia , Receptores Acoplados a Proteínas G
15.
Bull Math Biol ; 84(9): 92, 2022 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-35864431

RESUMO

Zika virus (ZIKV) recently reemerged in the Americas and rapidly expanded in global range. It is posing significant concerns of public health due to its link to birth defects and its complicated transmission routes. Southeast Asia is badly hit by ZIKV, but limited information was found on the transmission potential of ZIKV in the region. In this paper, we develop a new dynamic process-based mathematical model, which incorporates the interactions among humans (sexual transmissibility), and between human and mosquitoes (biting transmissibility), as well as the essential impacts of temperature. The model is first validated by fitting the 2016 ZIKV outbreak in Singapore via Markov chain Monte Carlo method. Based on that, we demonstrate the effects of temperature on mosquito ecology and ZIKV transmission, and further clarify the potential risk of ZIKV outbreak in Southeast Asian countries. The results show that (i) the estimated infection reproduction number [Formula: see text] in Singapore fell from 6.93 (in which the contribution of sexual transmission was 0.89) to 0.24 after the deployment of control strategies; (ii) the optimal temperature for the reproduction of ZIKV infections and adult mosquitoes are estimated to be [Formula: see text]C and [Formula: see text]C, respectively; and (iii) the [Formula: see text] in Southeast Asia could be between 3 and 7, with an inverted-U shape around the year. The large values of [Formula: see text] and the simulative patterns of ZIKV transmission in each country highlights the high risk of ZIKV attack in Southeast Asia.


Assuntos
Aedes , Culicidae , Infecções , Infecção por Zika virus , Zika virus , Animais , Ásia Sudeste/epidemiologia , Humanos , Conceitos Matemáticos , Modelos Biológicos , Mosquitos Vetores , Temperatura
16.
Sci Rep ; 12(1): 11186, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35778513

RESUMO

The dose-response model has been widely used for quantifying the risk of infection of airborne diseases like COVID-19. The model has been used in the room-average analysis of infection risk and analysis using passive scalars as a proxy for aerosol transport. However, it has not been employed for risk estimation in numerical simulations of droplet dispersion. In this work, we develop a framework for the evaluation of the probability of infection in droplet dispersion simulations using the dose-response model. We introduce a version of the model that can incorporate the higher transmissibility of variant strains of SARS-CoV2 and the effect of vaccination in evaluating the probability of infection. Numerical simulations of droplet dispersion during speech are carried out to investigate the infection risk over space and time using the model. The advantage of droplet dispersion simulations for risk evaluation is demonstrated through the analysis of the effect of ambient wind, humidity on infection risk, and through a comparison with risk evaluation based on passive scalars as a proxy for aerosol transport.


Assuntos
COVID-19 , Infecções , Administração por Inalação , Aerossóis/efeitos adversos , Humanos , RNA Viral , SARS-CoV-2
17.
Front Immunol ; 13: 880196, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35774787

RESUMO

Human disseminated protothecosis is a rare infection caused by members of the genus Prototheca, an achlorophyllic algae always associated with debilitated hosts. The presence of non-budding cells and large, spherical cells (sporangia) with endosporulation (morula) in histology is proof of Prototheca infection. Regrettably, due to the lack of specificity of clinical features and low awareness among clinicians, protothecosis is always underestimated and misdiagnosed. The available data on a species-specific analysis of this infection are limited. In this review, we summarize the etiological, epidemiological, and clinical aspects of disseminated protothecosis. The potential pathogenicity and clinical differences between P. zopfii and P. wickerhamii were observed. Additionally, the skin not only became the main invasion site but also the most involved organ by the pathogen. With the increasing numbers of immunocompromised individuals throughout the world, the incidence of disseminated infection caused by Prototheca is bound to increase, and disseminated protothecosis that accompanies skin symptoms should be taken into account by clinicians.


Assuntos
Infecções , Prototheca , Dermatopatias Infecciosas , Humanos , Infecções/etiologia , Pele/patologia , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/patologia
18.
Cells ; 11(14)2022 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-35883569

RESUMO

Glucocorticoids (GC) are highly potent negative regulators of immune and inflammatory responses. Effects of GC are primarily mediated by the glucocorticoid receptor (GR) which is expressed by all cell types of the immune system. It is, therefore, difficult to elucidate how endogenous GC mediate their effects on immune responses that involve multiple cellular interactions between various immune cell subsets. This review focuses on endogenous GC targeting specific cells of the immune system in various animal models of infection and inflammation. Without the timed release of these hormones, animals infected with various microbes or challenged in inflammatory disease models succumb as a consequence of overshooting immune and inflammatory responses. A clearer picture is emerging that endogenous GC thereby act in a cell-specific and disease model-dependent manner, justifying the need to develop techniques that target GC to individual immune cell types for improved clinical application.


Assuntos
Glucocorticoides , Receptores de Glucocorticoides , Animais , Modelos Animais de Doenças , Glucocorticoides/metabolismo , Glucocorticoides/farmacologia , Infecções/metabolismo , Inflamação/metabolismo , Camundongos , Receptores de Glucocorticoides/metabolismo
19.
Curr Opin Infect Dis ; 35(4): 363-369, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35849527

RESUMO

PURPOSE OF REVIEW: To review recent medical literature addressing antimicrobial stewardship in solid organ transplant (SOT) recipients. RECENT FINDINGS: Few studies with a strict focus on SOT patients have been published to date. Team-based antimicrobial stewardship interventions in SOT populations do have beneficial impacts on antimicrobial stewardship-relevant outcomes. Several studies have compared SOT-specific antibiograms to widely accepted hospital antibiograms; these studies all have found important differences in resistance rates among bacterial pathogens. Novel biomarkers like virome monitoring for assessing the net state of immunosuppression hold promise for individualized antimicrobial stewardship interventions. SUMMARY: SOT patients are an understudied population with respect to antimicrobial stewardship interventions. Current antimicrobial stewardship interventions for SOT patients are largely extrapolated from studies in general patient populations and may not accurately reflect SOT-specific infection risks or outcomes. Antimicrobial stewardship interventions do impact SOT-relevant care goals but require significantly more research to achieve the depth and reach of antimicrobial stewardship interventions developed for general populations.


Assuntos
Gestão de Antimicrobianos , Infecções , Transplante de Órgãos , Gestão de Antimicrobianos/métodos , Humanos , Testes de Sensibilidade Microbiana , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/métodos , Transplantados
20.
Alerta (San Salvador) ; 5(2): 118-125, jul. 22, 2022. graf, tab
Artigo em Espanhol | LILACS, BISSAL | ID: biblio-1379964

RESUMO

Reportes actuales sugieren que el antecedente de infección por SARS - CoV-2 y completar un esquema de vacunación otorga mayor protección contra la presentación sintomática de COVID -19. Se comparó el riesgo de enfermar de COVID -19 entre el personal de salud con esquema completo de vacuna contra SARS - CoV-2 BNT162b2 y el antecedente de infección por SARS - CoV-2. Estudio de cohorte histórica en 1874 trabajadores de la salud del Nuevo Hospital Civil de Guadalajara inmunizados con la vacuna BNT162b2 entre enero y marzo de 2021. Después de seis meses de seguimiento, el grupo de no expuestos (sin antecedente de infección) fue de 1397 y el grupo expuesto (con antecedente de infección), de 477 sujetos. La incidencia de infección por SARS - CoV-2 fue de 39 casos. El riesgo de infección en la cohorte posterior a la inmunización fue de 0,021. El grupo de inmunización híbrida presentó un riesgo menor de infección comparado con el grupo de inmunización artificial (0,015 y 0,243). La inmunización híbrida contribuyó a una reducción del riesgo atribuible a la población de 0,003 (R0 0,024; Rp 0,020). La hospitalización se presentó en el 7,69 % de los casos confirmados con SARS - CoV-2. El riesgo de hospitalización en inmunización híbrida es de 0,210 y de 0,143 en el grupo de inmunización artificial (RR 1,46 IC95 % 0,13 -16,11). Se llegó a la conclusión que la inmunización híbrida podría contribuir a reducir el riesgo de infección por SARS - CoV-2, potenciando la inmunidad generada por la vacuna contra COVID -19


Current reports suggest that a history of SARS - CoV-2 infection and completing a vaccination schedule provides greater protection against the symptomatic presentation of COVID -19. The risk of becoming ill with COVID -19 was compared between health personnel with a complete SARS - CoV-2 BNT162b2 vaccine schedule and a history of SARS - CoV-2 infection. Historical cohort study in 1874 health workers of the New Civil Hospital of Guadalajara immunized with the BNT162b2 vaccine between January and March 2021. After six months of follow-up, the non-exposed group (without a history of infection) was 1397 and the exposed group (with a history of infection), of 477 subjects. The incidence of SARS - CoV-2 infection was 39 cases. The risk of infection in the post-immunization cohort was 0.021. The hybrid immunization group had a lower risk of infection compared to the artificial immunization group (0.015 and 0.243). Hybrid immunization contributed to a population-attributable risk reduction of 0.003 (R0 0.024, Rp 0.020). Hospitalization occurred in 7.69% of confirmed cases with SARS - CoV-2. The risk of hospitalization in hybrid immunization is 0.210 and 0.143 in the artificial immunization group (RR 1.46 CI95% 0.13 -16.11). It was concluded that hybrid immunization could help reduce the risk of SARS - CoV-2 infection, enhancing the immunity generated by the vaccine against COVID -19


Assuntos
Imunização , Pessoal de Saúde , Síndrome Respiratória Aguda Grave , El Salvador , Vacina BNT162 , Infecções
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