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Comparative end-of-life communication and support in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada.

BMJ Open 2022 Jun 27;12(6):e062937. Epub 2022 Jun 27.

Department of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.

Objective: To compare end-of-life in-person family presence, patient-family communication and healthcare team-family communication encounters in hospitalised decedents before and during the COVID-19 pandemic.

Design: In a regional multicentre retrospective cohort study, electronic health record data were abstracted for a prepandemic group (pre-COVID) and two intrapandemic (March-August 2020, wave 1) groups, one COVID-19 free (COVID-ve) and one with COVID-19 infection (COVID+ve). Pre-COVID and COVID-ve groups were matched 2:1 (age, sex and care service) with the COVID+ve group. Read More

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Protocol for faecal microbiota transplantation in irritable bowel syndrome: the MISCEAT study - a randomised, double-blind cross-over study using mixed microbiota from healthy donors.

BMJ Open 2022 Jun 27;12(6):e056594. Epub 2022 Jun 27.

Department of Internal Medicine, Charles University Third Faculty of Medicine, Prague, Czech Republic.

Introduction: Several studies have demonstrated dysbiosis in irritable bowel syndrome (IBS). Therefore, faecal microbiota transplantation, whose effect and safety have been proven in infections, may hold promise in other conditions, including IBS. Our study will examine the effectiveness of stool transfer with artificially increased microbial diversity in IBS treatment. Read More

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Complications of cerebral air embolism associated with pleural lavage for empyema.

BMJ Case Rep 2022 Jun 27;15(6). Epub 2022 Jun 27.

Division of General Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

Standard initial treatment for acute empyema involves antibiotic administration and chest tube drainage; however, pleural lavage with saline is another treatment that mitigates the need for surgical drainage. Although this treatment is recognised as non-invasive and safe, the complications of cerebral air embolism are less recognised.In this case, a man in his late 40s was diagnosed with acute empyema and treated with chest tube (28 Fr) drainage and antibiotics. Read More

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First reported case of corneal infection caused by .

BMJ Case Rep 2022 Jun 27;15(6). Epub 2022 Jun 27.

Microbiology services, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneswar, India

A man in his 20s, with irritation, pain and photophobia in the left eye, was clinically diagnosed with herpes simplex virus nummular keratitis at our institute and advised topical antivirals and corticosteroids, causing resolution of active infiltrates. The infection recurred after 7 months and the patient did not respond to the previous regimen, so corneal scraping was sent for microbiological evaluation. Gram-positive bacilli grew on culture, which were identified as using VITEK 2 Compact system (bioMérieux, Marcy l'Etoile, France). Read More

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Neonatal facial hyperpigmentation.

BMJ Case Rep 2022 Jun 27;15(6). Epub 2022 Jun 27.

Department of Paediatrics, M S Ramaiah Academy of Health and Applied Sciences, Bangalore, Karnataka, India.

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Virtual respiratory therapy delivered through a smartphone app: a mixed-methods randomised usability study.

BMJ Open Respir Res 2022 Jun;9(1)

Physical Activity Research Group, Central Queensland University Appleton Institute, Rockhampton, Queensland, Australia.

Introduction: A new smartphone app (QUT Inspire) has been developed to detect inspiratory sound and deliver virtual incentive spirometry (ISy), a respiratory therapy technique used in postoperative recuperation, management of some chronic conditions and with potential applications in SARS-CoV-2 rehabilitation. The aim of this study was to compare the usability of this new app with a clinical ISy device as measured by effectiveness, efficiency and satisfaction.

Methods: In this mixed-methods randomised usability study, healthy volunteers (aged 39. Read More

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Indeterminate mycobacterium tuberculosis QuantiFERON post Moderna mRNA Covid-19 vaccination.

Samuel S Y Wang

Indian J Tuberc 2022 Jul 31;69(3):369-370. Epub 2022 Mar 31.

Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore, Singapore. Electronic address:

We report an interesting case of an indeterminate MTB QuantiFERON for a 26-year-old healthy soldier planned for a routine field exercise to Brunei. Further medical history revealed that the patient had a Moderna mRNA Covid-19 vaccine the day before his MTB QuantiFERON test. The patient was subsequently asked to repeat a T-spot test which was non-reactive, there were no longer any issues with the positive control for the T-spot test. Read More

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An unusual site of articular tuberculosis-A series of three conservatively managed cases.

Indian J Tuberc 2022 Jul 13;69(3):359-363. Epub 2021 Jul 13.

Department of Pulmonary Medicine, Government Medical College, Patiala, India. Electronic address:

Tuberculosis (TB) infection of the Sternoclavicular joint (SCJ) is a rare entity, with 1-2% of all osteo-articular cases reported. We report a series of three cases of TB of the SCJ, in the patients presented with swelling of SCJ. Cytology showed chronic granulomatous pathology in all three cases, with one patient having Cartridge base nucleic acid amplification test positive for TB and another one having acid fast bacilli positive on Ziehl Neelsen staining. Read More

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Ruxolitinib and tuberculosis: A case report with brief review.

Indian J Tuberc 2022 Jul 26;69(3):354-358. Epub 2021 Jun 26.

Department of Clinical Hematology, King George's Medical University, Lucknow, India.

JAK 2 inhibitors are widely used for the treatment of primary myelofibrosis. Ruxolitinib is the most commonly used JAK inhibitor in clinical practice. We report two cases of Primary Myelofibrosis who developed tuberculosis on active treatment with ruxolitinib. Read More

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Management of deep neck infections in adults and importance of clinical and laboratory findings.

J Investig Med 2022 Jun 27. Epub 2022 Jun 27.

Department of Otorhinolaryngology, Yildirim Beyazit University, Ankara, Turkey.

This study aimed to analyze laboratory and radiological imaging results in the prediction of treatment strategy in patients with deep neck infections. Eighty-three patients (55 (66.3%) men, mean age: 38. Read More

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Nipah virus, an emerging zoonotic disease causing fatal encephalitis.

Ali M Alam

Clin Med (Lond) 2022 Jun 27. Epub 2022 Jun 27.

Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, UK

Nipah virus is an acute febrile illness that can cause fatal encephalitis. It is an emerging zoonotic paramyxovirus endemic to south-east Asia and the western Pacific, and can be transmitted by its primary reservoir of fruit bats, through intermediate animal vectors and by human-to-human spread. Outbreaks of Nipah virus encephalitis have occurred in Malaysia, Singapore, Philippines, India and Bangladesh, with the most recent outbreak occurring in Kerala, India in late 2021. Read More

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COVID-19 pandemic response in one of the world's most complex and vulnerable settings.

BMJ Glob Health 2022 Jun;7(Suppl 3)

Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.

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A call for citizen science in pandemic preparedness and response: beyond data collection.

BMJ Glob Health 2022 Jun;7(6)

International Digital Health & AI Research Collaborative (I-DAIR), Geneva, Switzerland.

The COVID-19 pandemic has underlined the need to partner with the community in pandemic preparedness and response in order to enable trust-building among stakeholders, which is key in pandemic management. Citizen science, defined here as a practice of public participation and collaboration in all aspects of scientific research to increase knowledge and build trust with governments and researchers, is a crucial approach to promoting community engagement. By harnessing the potential of digitally enabled citizen science, one could translate data into accessible, comprehensible and actionable outputs at the population level. Read More

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Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections.

Young Hwan Lee

Clin Exp Pediatr 2022 Jun 22. Epub 2022 Jun 22.

Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea.

Despite studies on the etiology of Kawasaki disease (KD) ongoing for half a century since its discovery, its cause has not yet been clearly identified. Although the clinical, epidemiological, and pathophysiological characteristics of KD are presumed to be closely related to infectious diseases, studies of various pathogens to identify its etiology have been actively conducted. To date, bacteria, fungi, and viruses have been investigated to determine the relationship between KD and infection, among which viruses have attracted the most attention. Read More

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The effect of equipotent dose of propofol and sevoflurane on endoplasmic reticulum stress during breast cancer surgery.

Korean J Anesthesiol 2022 Jun 28. Epub 2022 Jun 28.

Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.

Background: Numerous studies suggest a benefit of the use of intravenous propofol over inhalational volatile anesthetic. The objective of this study was to compare the changes in endoplasmic reticulum (ER) stress of cancer cells and lymphocytes after propofol- or sevoflurane-based anesthesia during breast cancer surgery.

Methods: A total of 53 patients having breast cancer surgery were randomized and analyzed (28 for propofol, 25 for sevoflurane). Read More

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Hydrolocation Assisted Subclavian Venous Catheterization.

Korean J Anesthesiol 2022 Jun 28. Epub 2022 Jun 28.

Clinical Assistant Professor, Discipline of Anesthesia, Memorial University of Newfoundland.

Background: Of the three common central access sites, subclavian vein catheterization has the lowest risk of infection but the highest risk of pneumothorax. The main disadvantage of the short-axis ultrasound guided approach is difficult needle-tip visualization. We describe use of the hydrolocation technique to improve needle-tip localization. Read More

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Human IgE mAbs Identify Major Antigens of Parasitic Worm Infection.

J Allergy Clin Immunol 2022 Jun 24. Epub 2022 Jun 24.

Departments of Medicine , NIAID, National Institutes of Health; Bethesda, Maryland, United States of America; Pathology, Microbiology and Immunology, NIAID, National Institutes of Health; Bethesda, Maryland, United States of America. Electronic address:

Rationale: Much of our understanding of the targets of IgE comes from studies of allergy, though little is known about the natural immunogenic targets seen following parasitic worm infections. The use of human monoclonal antibodies (mAbs) allow for an unbiased, comprehensive characterization of the immunodominant antigens targeted by IgE in conditions (e.g. Read More

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RNA-seq analysis of nasopharyngeal swabs from asymptomatic and mildly symptomatic COVID-19 patients.

Int J Infect Dis 2022 Jun 24. Epub 2022 Jun 24.

School of Life Sciences and Technology, Bandung Institute of Technology, Bandung, West Java, Indonesia. Electronic address:

Objectives: The characterization of asymptomatic and mildly symptomatic COVID-19 patients by observing changes in gene expression profile and possible bacterial coinfection is relevant to be investigated. We aimed to identify transcriptomic and coinfection profiles in both groups of patients.

Methods: An RNA-seq analysis on nasopharyngeal swabs were performed using a shotgun sequencing pipeline. Read More

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When to test for COVID-19 using RT-PCR: a systematic review.

Int J Infect Dis 2022 Jun 24. Epub 2022 Jun 24.

Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Graduate Program in Medicine, Biomedical Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Graduate Program in Medicine, Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil. Electronic address:

Objectives: The aim of this study was to evaluate the time in days between symptom onset and first positive RT-PCR result for COVID-19.

Methods: This systematic review was conducted in the MEDLINE (PubMed), Embase, and Scopus databases using the following descriptors: "COVID-19", "SARS-CoV-2", "coronavirus", "RT-PCR", "real time PCR" and "diagnosis".

Results: The included studies were conducted in 31 different countries and reported on a total of 6831 patients. Read More

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Determinants of haemosporidian single- and co-infection risks in western palearctic birds.

Int J Parasitol 2022 Jun 24. Epub 2022 Jun 24.

Department of Ecology and Evolution, CH-1015 Lausanne, Switzerland; Musée cantonal de zoologie, CH-1014 Lausanne, Switzerland.

Understanding the drivers of infection risk helps us to detect the most at-risk species in a community and identify species whose intrinsic characteristics could act as potential reservoirs of pathogens. This knowledge is crucial if we are to predict the emergence and evolution of infectious diseases. To date, most studies have only focused on infections caused by a single parasite, leaving out co-infections. Read More

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Microbiology and antibiotics after second-stage revision of periprosthetic joint infections: A two-year follow-up cohort.

Infect Dis Now 2022 Jun 24. Epub 2022 Jun 24.

Centre de Référence en Infections Ostéoarticulaires complexes du Grand Ouest (CRIOGO), Academic hospital of Ponchaillou, 2 Rue Henri le Guilloux, Rennes, France.

Background: Optimal duration of antimicrobial regimen after reimplantation of two-stage procedures for periprosthetic joint infection (PJI) is poorly standardized. The aim of this study was to assess the characteristics of reimplantation microbiology with 6 weeks (2 stage positive culture) or 10 days (2 stage negative culture) of antibiotics in patients with complex chronic PJI and factors associated with microbiology at reimplantation.

Patients And Methods: We performed a retrospective single-center study including all consecutive complex PJI recipients managed by two-stage surgery in a referral centre, from 2015 to 2018. Read More

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Therapeutic Drug Monitoring of Vancomycin in Jordanian Patients. Development of Physiologically-Based Pharmacokinetic (PBPK) Model and Validation of Class II Drugs of Salivary Excretion Classification System (SECS).

Drug Res (Stuttg) 2022 Jun 27. Epub 2022 Jun 27.

College of Pharmacy, University of Petra, Amman, Jordan.

Vancomycin is a commonly used antibiotic for multi-drug resistant gram-positive infections treatment, especially methicillin-resistant Staphylococcus aureus (MRSA). Despite that, it has wide individual pharmacokinetic variability and nephrotoxic effect. Vancomycin trough concentrations for 57 Jordanian patients were measured in plasma and saliva through immunoassay and liquid chromatography-mass spectrometry (LC-MS/MS), respectively. Read More

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Scientific evidence of the duration of antibiotic treatment in intra-abdominal infections with surgical focus control.

Cir Esp (Engl Ed) 2022 Jun 24. Epub 2022 Jun 24.

Servicio de Cirugía General y Aparato Digestivo, Hospital del Mar de Barcelona, Spain.

A non-systematic review of the published scientific evidence has been carried out on the duration of empirical antibiotic treatment in surgical intra-abdominal infections (IIA) with effective focus control. Given the progressive increase in antibiotic resistance, it is urgent to have strategies to reduce the pressure on the microbiota. The American guidelines made by Mazuski et al. Read More

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In vitro activity of aztreonam/avibactam against isolates of Enterobacterales collected globally from ATLAS in 2019.

J Glob Antimicrob Resist 2022 Jun 25. Epub 2022 Jun 25.

Pfizer Inc, Kirkland, Canada.

Objectives: Infections caused by drug-resistant Enterobacterales including those producing metallo-β-lactamases (MBLs) are particularly challenging due to limited therapeutic options. The drug combination aztreonam/avibactam (ATM-AVI) is under clinical development for treating serious infections caused by these strains. This study assessed the in vitro activity of ATM-AVI against Enterobacterales isolates collected globally in the ATLAS surveillance programme in 2019. Read More

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Effects of the COVID-19 Pandemic on Spinal Fusion Procedures for Spinal Infections in a Nationwide Hospital Network in Germany.

J Neurol Surg A Cent Eur Neurosurg 2022 Jun 27. Epub 2022 Jun 27.

Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bad Saarow, Germany.

Background:  The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with spinal fusion procedures in the treatment of spinal infections (SI) during different phases of the pandemic.

Methods:  In this retrospective observational study, we examined the in-hospital prevalence and outcomes of spinal fusion procedures for SI (along with patient characteristics, rates of transfer to intensive care units, and mortality rates) during the first four waves of the pandemic compared with the corresponding prepandemic periods in 2019. Read More

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Characterizing Multiple Perpetrator Sexual Assaults in the Adolescent Female Population.

J Pediatr Adolesc Gynecol 2022 Jun 24. Epub 2022 Jun 24.

Division of General Pediatrics, Children's Hospital of Philadelphia, 3500 Civic Center Blvd., Philadelphia, Pennsylvania, 19104; The Perelman School of Medicine, The University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, Pennsylvania, 19104.

Study Objective: To determine whether differences exist between the acute presentations and post assault needs of youth presenting to an emergency department following multiple perpetrator sexual assault (MPSA) compared with those presenting after single perpetrator sexual assault.

Methods: A retrospective cohort study of all female adolescents evaluated in an urban pediatric emergency department (ED) between 2014 and 2021 for acute sexual assault was conducted. Demographic characteristics and assault outcomes were assessed using bivariate analyses. Read More

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Transcriptome analysis of IHHNV infection in Penaeus vannamei at different developmental stages.

Fish Shellfish Immunol 2022 Jun 24. Epub 2022 Jun 24.

School of Agriculture, Ludong University, Yantai, 264025, PR China. Electronic address:

Infectious hypodermal and haematopoietic necrosis virus (IHHNV) is the smallest known virus in shrimp, which causes runt-deformity syndrome (RDS) and leads to huge economic loss every year in penaeid shrimp farming. Previous studies have shown that the juvenile Penaeus vannamei is more susceptible to IHHNV infection than the adults, but the mechanism is still unclear. In order to investigate the mechanism of pathogenic differences in IHHNV infection of P. Read More

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Diagnostic accuracy of FDG PET for the identification of Vascular Graft Infection.

Ann Vasc Surg 2022 Jun 24. Epub 2022 Jun 24.

Houston Methodist Debakey Heart & Vascular Center, Houston, TX, USA. Electronic address:

Background: Fluorodeoxyglucose (FDG) positron emission tomography (FDG PET/CT) can be used to identify and localize infection in patients with vascular graft infections (VGI). We aimed to evaluate the diagnostic accuracy of 18F-FDG PET/CT by defining thresholds for standardized uptake value (SUV) and tissue-to-background ratio (TBR) that would accurately identify the presence of vascular graft infection.

Methods: Patients with suspected VGI were prospectively recruited and underwent 18F-FDG PET/CT scans. Read More

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Development of an antibiotics delivery system for topical treatment of the neglected tropical disease Buruli ulcer.

Int J Pharm 2022 Jun 24:121954. Epub 2022 Jun 24.

ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal. Electronic address:

Skin infection by Mycobacterium ulcerans causes Buruli ulcer (BU) disease, a serious condition that significantly impact patient' health and quality of life and can be very difficult to treat. Treatment of BU is based on daily systemic administration of antibiotics for at least 8 weeks and presents drawbacks associated with the mode and duration of drug administration and potential side effects. Thus, new therapeutic strategies are needed to improve the efficacy and modality of BU therapeutics, resulting in a more convenient and safer antibiotic regimen. Read More

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The future of long-acting cabotegravir plus rilpivirine therapy: Deeds and misconceptions.

Int J Antimicrob Agents 2022 Jun 24:106627. Epub 2022 Jun 24.

University of Siena, Department of Medical Biotechnologies, Siena, Italy.

HIV infection is currently managed as a chronic disease thanks to the improvement of antiretroviral therapy (ART). In this light, treatment is lifelong. Therefore, switch to new regimens is a natural event during long-term therapies to avoid problems related to toxicity, adherence, failure and potential selection of drug resistance. Read More

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